Probiotic use during and beyond pregnancy: maternal impacts

Humans of all sizes are home to trillions of microbes. Mothers are an especially important mobile multiverse because of their role in passing on actual live microbes but also helping to train their babies for their future synbiotic life. The maternal microbiome plays an important role in overall health during pregnancy, particularly with hormonal, metabolic and immune changes impacting the maternal microbiome. Harnessing the human-microbial synergy in the form of probiotics has been shown to impact maternal health and the health of the developing fetus.

Mom’s Bugs Impact Baby: Why it All Matters

The composition of the maternal microbiota changes during pregnancy, becoming less diverse with altered levels of specific microbial communities; this seems to have wide-ranging affects on the maternal pair. Meconium levels of Bacteroides, Parabacteroide, Lachnospiraceae genera increased in infants of mothers with gestational diabetes. Reduced faecal levels of bifidobacteria and increased Staphylococcus aureus species were associated with a greater risk of childhood obesity.

Studies showed higher placenta levels of Prevotella, Mobiluncus, Gardnerella, Bacteroides, andPeptostreptococcus genera were linked with an increased incidence of preterm birth.

Dysbiosis (altered composition and/or functioning) of maternal microbiota during pregnancy also increases the risk of developing vaginal infections, preeclampsia, hypertension, cardiovascular disease, excessive weight gain and renal dysfunction.

Its Not Just Baby Who Benefits – Moms rejoice!

Several studies have shown probiotic modulation can positively impact maternal health. Pregnancy is a predisposing factor for developing vaginal infections including vulvovaginal candidiasis and bacterial vaginitis. Unfortunately, if left untreated, vulvovaginal candidiasis can possibly result in chorioamnionitis with premature births, infection of the neonate or spontaneous abortion, highlighting the inter-connectedness of the urogenital tract in successful pregnancy and delivery outcomes.

Changes in hormones during pregnancy relax intestinal smooth muscle, reducing peristalsis, thus increasing the risk of constipation. A study of pregnant women who consumed 300g of yogurt containing specific probiotic strains of Lactobacillus acidophilus and Bifidobacterium lactis three times per day showed reduction in constipation, reduced gastrointestinal transit time and increased frequency of defecation. Impacts of probiotics on gastrointestinal function and quality of life were assessed with a 16-day study of multiple strains of probiotics (including L. plantarum, L. bulgaricus, L. paracasei, L. plantarum, and L. casei) administered in two cycles, including two days without probiotics. Results showed a significant reduction in the severity of nausea, vomiting, and constipation, corresponding to improved maternal quality of life.

Obesity increases the risks of developing gestational diabetes, preeclampsia, hypertension, macrosomia, and fetal death. Elevated fecal levels of Staphylococcus and Bacteroides were found in overweight and obese pregnant women compared to normal weight pregnant women.

A randomized controlled study providing a multispecies probiotic with Lacticaseibacillus rhamnosus and Bifidobacterium lactis strains to pregnant women from the first trimester until exclusive breast feeding ended showed a reduction in gestational diabetes from 36% to 13%.

Women diagnosed with gestational diabetes mellitus who were provided with a daily probiotic containing L. casei, B. bifidum and L. acidophilus strains (2×10⁹CFU/g) for 6 weeks observed in a significant reduction in fasting blood sugar, serum insulin and reduced insulin resistance compared to the control. Similar findings were reported from a 12-week study with mothers in their second trimester, who received probiotics with strains of L. acidophilus, B. bifidum and L. casei; Mothers had lower levels of blood sugar, CRP, and triglycerides. Other studies showed varying effects of probiotics on blood sugar, and further studies have been recommended to elucidate impacts of specific strains.

The effect of probiotic supplementation on prevention of preeclampsia was assessed in pregnant women receiving strains of L. rhamnosus, L. acidophilus and B. lactis in dairy products; a significant reduction in rates of preeclampsia were reported. These maternal metabolic improvements after taking probiotics are important to reduce multiple potentially detrimental fetal outcomes.

One such negative outcome is preterm birth and probiotics have been explored in this area for their potential to reduce the likelihood of its occurrence. 106 women between 24-34 weeks of gestation who experienced premature rupture of membranes were administered either a vaginal probiotic capsule or a control in combination with antibiotics over 10 days. The probiotic capsules contained equal amounts of Lactobacillus gasseri and L. rhamnosus (10⁸ CFUs) strains each. Participants receiving the probiotics versus antibiotics alone had a higher mean birth gestational age and a higher latency period – both about 2-3 weeks longer than the control. Other studies evaluating probiotic consumption in pregnant women also identified a lower risk of preterm birth when the probiotics were consumed during early pregnancy; however, there was no apparent benefit of probiotic consumption if intake was initiated during late pregnancy.

Studies have also been conducted to assess the impact of probiotic consumption on postpartum depression – a stigmatized and under-reported condition, which negatively impacts mothers and their ability to care for their infants and themselves. Studies indicate that mothers receiving a probiotic multispecies formulation containing strains of B. longum and L. helveticus experienced significantly less anxiety and depression. A similar study with strains of L. rhamnosus suggested similar benefits, although this was based on retrospective self reported data on mental health.

There are multiple ways that pregnant women can benefit from consumption of specific probiotic strains consumed in adequate amounts for appropriate durations for the health benefits for the growing fetus and long-term health outcomes and quality of life for mothers. Utilizing the synergistic potential of probiotic microbes is a low risk, and under-utilized method to positively impact maternal-infant health.

About IPA

The International Probiotics Association (IPA) is a global non-profit organization bringing together through its membership, the probiotic sector’s stakeholders including but not limited to academia, scientists, health care professionals, consumers, industry and regulators. The IPA’s mission is to promote the safe and efficacious use of probiotics throughout the world. Holding NGO status before Codex Alimentarius, the IPA is also recognized as the unified “Global Voice of Probiotics” around the world.