Cooper Natalie A M, Moores Rachel
aWomen's Health Research Unit, The Blizard Institute, Queen Mary University bBarts and the London School of Medicine, London, UK.
Curr Opin Obstet Gynecol. 2014 Dec;26(6):487-92. doi: 10.1097/GCO.0000000000000126.
The aim of this review was to evaluate recently published review articles which examine the use of nutritional supplements to prevent preterm birth (PTB) by modifying vaginal bacteria.
Probiotics, vitamin D and vitamin C were all identified as nutritional supplements that have the potential to alter bacterial flora and consequently reduce PTB and treat or prevent genital infections. Evidence shows that probiotics may reduce the incidence of PTB as well as being effective at treating bacterial vaginosis, a known cause for PTB. Low vitamin D levels may be associated with bacterial vaginosis, although no evidence was identified which demonstrated that vitamin D supplementation reduced the risk of having bacterial vaginosis or PTB.There is little evidence regarding vitamin C supplementation, although it does suggest a possible benefit with regard to preterm rupture of membranes; however, this did not appear to reduce rates of PTB.
Although there is evidence that taking probiotics in pregnancy may reduce the incidence of PTB, it is mainly derived from small, poor quality studies. Vitamin D and vitamin C may have potential benefits, but these remain to be proven. Large randomized controlled trials are needed to more accurately evaluate the potential benefits of these low-cost interventions for reducing PTB and its consequences.
本综述旨在评估近期发表的综述文章,这些文章探讨了通过改变阴道细菌来使用营养补充剂预防早产(PTB)的情况。
益生菌、维生素D和维生素C均被确定为有可能改变细菌菌群,从而降低早产率并治疗或预防生殖器感染的营养补充剂。有证据表明,益生菌可能会降低早产的发生率,并且在治疗细菌性阴道病(已知的早产原因之一)方面也很有效。维生素D水平低可能与细菌性阴道病有关,尽管未发现有证据表明补充维生素D可降低患细菌性阴道病或早产的风险。关于补充维生素C的证据很少,尽管它确实提示对胎膜早破可能有益;然而,这似乎并未降低早产率。
尽管有证据表明孕期服用益生菌可能会降低早产的发生率,但这主要来自规模小、质量差的研究。维生素D和维生素C可能有潜在益处,但仍有待证实。需要进行大规模随机对照试验,以更准确地评估这些低成本干预措施在降低早产及其后果方面的潜在益处。