Kirihara Nami, Kamitomo Masato, Tabira Tatsunori, Hashimoto Takashi, Taniguchi Hiroko, Maeda Takatsugu
Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan.
J Obstet Gynaecol Res. 2018 Feb;44(2):241-247. doi: 10.1111/jog.13497. Epub 2017 Oct 10.
Recent reports have shown lower levels of Clostridium and higher levels of Lactobacillales in the intestinal microbiota in preterm birth patients compared to term birth patients. However, the influence of probiotics on perinatal status has not been elucidated. The aim of our study was to evaluate the effects of probiotics on perinatal outcomes.
We retrospectively evaluated the effects of oral probiotics on perinatal outcome in patients at high risk of preterm birth. Probiotics containing Streptococcus faecalis, Clostridium butyricum and Bacillus mesentericus were administered for prophylaxis of bacterial vaginosis or treatment of constipation starting at 12.5 ± 4.1 weeks until delivery. Patients not administered probiotics were defined as the non-probiotics group. Between these two groups, perinatal outcomes including gestational age at birth, birth weight, chorioamnionitis or funisitis and preterm birth before 32 weeks were compared. In addition, multivariate regression analyses were performed to evaluate factors influencing preterm birth before 32 weeks, chorioamnionitis/funisitis and normal vaginal flora.
The probiotics group showed longer gestation, higher birth weight, lower rates of chorioamnionitis and higher rates of normal vaginal flora compared to the non-probiotics group. Multivariate regression analysis showed that probiotics significantly suppressed preterm birth before 32 weeks and tended to suppress chorioamnionitis/funisitis. The adjusted odds ratios (95% confidence interval) for preterm birth before 32 weeks and chorioamnionitis/funisitis were 0.05 (0.01-0.71) and 0.07 (0.01-1.03), respectively.
Oral probiotics containing Clostridium had a significant effect on the prevention of preterm birth before 32 weeks of gestation.
最近的报告显示，与足月产患者相比，早产患者肠道微生物群中梭菌水平较低，乳杆菌目水平较高。然而，益生菌对围产期状况的影响尚未阐明。我们研究的目的是评估益生菌对围产期结局的影响。
我们回顾性评估了口服益生菌对早产高危患者围产期结局的影响。含有粪链球菌、丁酸梭菌和肠系膜芽孢杆菌的益生菌从12.5±4.1周开始给药，用于预防细菌性阴道病或治疗便秘，直至分娩。未服用益生菌的患者被定义为非益生菌组。比较这两组之间的围产期结局，包括出生时的孕周、出生体重、绒毛膜羊膜炎或脐带炎以及32周前的早产情况。此外，进行多因素回归分析以评估影响32周前早产、绒毛膜羊膜炎/脐带炎和正常阴道菌群的因素。
与非益生菌组相比，益生菌组的妊娠期更长、出生体重更高、绒毛膜羊膜炎发生率更低且正常阴道菌群发生率更高。多因素回归分析表明，益生菌显著抑制32周前的早产，并倾向于抑制绒毛膜羊膜炎/脐带炎。32周前早产和绒毛膜羊膜炎/脐带炎的校正比值比（95%置信区间）分别为0.05（0.01 - 0.71）和0.07（0.01 - 1.03）。
含梭菌的口服益生菌对预防妊娠32周前的早产有显著效果。
