Probiotics in obstetric practice: efficacy and safety

Cover Page

Abstract


The intestinal microbiota modulates immune programming and can prevent the realization of an allergic phenotype. For the formation of a normal microbiocenosis of the intestine, skin and oral cavity, a sufficient quantitative and qualitative bacterial colonization of the newborn is necessary during the transition from a «sterile» intrauterine environment to microbial colonization, resulting in the appearance of more than 1014 microorganisms. Low levels of bifidobacteria and early colonization of potentially pathogenic bacteria are associated with the development of severe allergic reactions. Prescribing probiotics containing Lactobacillus rhamnosus GG (LGG) at a concentration of 108–1010 CFU from 36 weeks of gestation and during the first 3–4 months of lactation is associated with a 21% reduction in the risk of allergic reactions in the child.


Full Text

Restricted Access

About the authors

Juliia E. Dobrokhotova

Pirogov Russian National Research Medical University

Email: katyanikitina@mail.ru
ORCID iD: 0000-0001-5388-3669

Russian Federation, Moscow

D. Sci. (Med.), Prof.

Ekaterina I. Borovkova

Pirogov Russian National Research Medical University

Author for correspondence.
Email: katyanikitina@mail.ru

Russian Federation, Moscow

D. Sci. (Med.), Prof.

References

  1. Wold AE. The hygiene hypothesis revised: is the rising frequency of allergy due to changes in the intestinal flora? Allergy 1998;
  2. : 20.
  3. West CE, Renz H, Jenmalm MC et al. The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. J Allergy Clin Immunol 2015; 135: 3.
  4. Hill DA, Siracusa MC, Abt MC et al. Commensal bacteria-derived signals regulate basophil hematopoiesis and allergic inflammation. Nat Med 2012; 18: 538.
  5. Prescott SL, Björkstén B. Probiotics for the prevention or treatment of allergic diseases. J Allergy Clin Immunol 2007; 120: 255.
  6. Björkstén B, Sepp E, Julge K et al. Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol 2001; 108: 516.
  7. Kalliomäki M, Kirjavainen P, Eerola E et al. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol 2001; 107: 129.
  8. Adlerberth I, Strachan DP, Matricardi PM et al. Gut microbiota and development of atopic eczema in 3 European birth cohorts. J Allergy Clin Immunol 2007; 120: 343.
  9. Penders J, Thijs C, van den Brandt PA et al. Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study. Gut 2007; 56: 661.
  10. Zbinden A, Zbinden R, Berger C, Arlettaz R. Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy. Neonatology 2015; 107: 56.
  11. Jacobs SE, Tobin JM, Opie GF et al. Probiotic effects on late-onset sepsis in very preterm infants: a randomized controlled trial. Pediatrics 2013; 132: 1055.
  12. Rao SC, Athalye-Jape GK, Deshpande GC et al. Probiotic Supplementation and Late-Onset Sepsis in Preterm Infants: A Meta-analysis. Pediatrics 2016; 137: e20153684.
  13. Thomas JP, Raine T, Reddy S, Belteki G. Probiotics for the prevention of necrotising enterocolitis in very low-birth-weight infants: a meta-analysis and systematic review. Acta Paediatr 2017; 106: 1729.
  14. Esaiassen E, Cavanagh P, Hjerde E et al. Bifidobacterium longum Subspecies infantis Bacteremia in 3 Extremely Preterm Infants Receiving Probiotics. Emerg Infect Dis 2016; 22: 1664.
  15. Elias J, Bozzo P, Einarson A. Are probiotics safe for use during pregnancy and lactation? Can Fam Physician 2011; 57: 299.
  16. Dallanora S, Medeiros de Souza Y, Deon RG et al. Do probiotics effectively ameliorate glycemic control during gestational diabetes? A systematic review. Arch Gynecol Obstet 2018; 298: 477.
  17. Gibson GR, Hutkins R, Sanders ME et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol 2017; 14: 491.
  18. Food and Agriculture Organization of the United Nations. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. http://www.who.int/foodsafety/publications/fs_management/en/probiotics.pdf
  19. Food and Agriculture Organization of the United Nations. Guidelines for the evaluation of probiotics in food ftp://ftp.fao.org/es/esn/food/wgreport2.pdf
  20. Boehm G, Lidestri M, Casetta P et al. Supplementation of a bovine milk formula with an oligosaccharide mixture increases counts of faecal bifidobacteria in preterm infants. Arch Dis Child Fetal Neonatal Ed 2002; 86: F178.
  21. Maslowski KM, Vieira AT, Ng A et al. Regulation of inflammatory responses by gut microbiota and chemoattractant receptor GPR43. Nature 2009; 461: 1282.
  22. Kelly D, Campbell JI, King TP et al. Commensal anaerobic gut bacteria attenuate inflammation by regulating nuclear-cytoplasmic shuttling of PPAR-gamma and RelA. Nat Immunol 2004; 5: 104.
  23. Dugoua JJ, Machado M, Zhu X et al. Probiotic safety in pregnancy: a systematic review and meta-analysis of randomized controlled trials of Lactobacillus, Bifidobacterium, and Saccharomyces spp. J Obstet Gynaecol Can 2009; 31: 542.
  24. Fiocchi A, Pawankar R, Cuello-Garcia C et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics. World Allergy Organ J 2015; 8: 4.
  25. Ho M, Chang YY, Chang WC et al. Oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 to reduce Group B Streptococcus colonization in pregnant women: A randomized controlled trial. Taiwan J Obstet Gynecol 2016; 55 (4): 515–18. DOI: 10.1016/j. tjog.2016.06.003
  26. Новикова С.В., Логутова Л.С., Игнатьева М.А. Клиническая оценка эффективности и безопасности применения препарата вагилак для лечения бактериального вагиноза у беременных. Мед. совет. 2018; 13: 90–4.
  27. [Novikova S.V., Logutova L.S., Ignatieva M.A. Clinical evaluation of the efficacy and safety of the use of the drug vagilac for the treatment of bacterial vaginosis in pregnant women. Med. sovet. 2018; 13: 90–4 (in Russian).]
  28. Радзинский В.Е., Ордиянц И.М., Апресян С.В. Эффективность коррекции дисбиоза влагалища в I триместре беременности. Рос. вестн. акушера-гинеколога. 2010; 10 (3): 38–41.
  29. [Radzinsky V.E., Ordiyants I.M., Apresyan S.V. The effectiveness of the correction of vaginal dysbiosis in the first trimester of pregnancy. Ros. vestn. akushera-ginekologa. 2010; 10 (3): 38–41 (in Russian).]
  30. Tang ML, Lahtinen SJ, Boyle RJ. Probiotics and prebiotics: clinical effects in allergic disease. Curr Opin Pediatr 2010; 22: 626.
  31. Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. J Allergy Clin Immunol 2008; 121: 116.
  32. Azad MB, Coneys JG, Kozyrskyj AL et al. Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and meta-analysis. BMJ 2013; 347: f6471.
  33. Kim JY, Kwon JH, Ahn SH et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr Allergy Immunol 2010; 21: e386.
  34. Boyle RJ, Ismail IH, Kivivuori S et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy 2011; 66: 509.
  35. Niers L, Martín R, Rijkers G et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy 2009; 64: 1349.
  36. Dotterud CK, Storrø O, Johnsen R, Oien T. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial.
  37. Br J Dermatol 2010; 163: 616.
  38. Rautava S, Kainonen E, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol 2012; 130: 1355.
  39. Petschow BW, Figueroa R, Harris CL et al. Effects of feeding an infant formula containing Lactobacillus GG on the colonization of the intestine: a dose-response study in healthy infants. J Clin Gastroenterol 2005; 39: 786.

Statistics

Views

Abstract - 42

PDF (Russian) - 0

Cited-By


PlumX

Dimensions

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies