Students' Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR, Iran.
Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR, Iran.
Eur J Nutr. 2020 Feb;59(1):205-215. doi: 10.1007/s00394-019-01900-1. Epub 2019 May 8.
There is only some evidence about effectiveness of probiotics for preventing gestational hyperglycaemia. This trial examined the effects of probiotic yoghurts containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on maternal plasma glucose (primary outcome) and on some maternal and infant complications (secondary outcomes) in overweight and obese women with no diabetes in pregnancy.
Using stratified block randomization, women with pre- or early-pregnancy BMI ≥ 25 and fasting plasma glucose < 92 mg/dl at 22 weeks of gestation were assigned into probiotic or conventional yoghurt group, consuming 100 g/day from 24 weeks of gestation until delivery. The women and their infants were followed up until 1 month after birth.
In each group, one out of 65 women had intra-uterine foetal death and were not analysed for other outcomes. The mean BMI was 29.2 (SD 3.3) in probiotic and 30.3 (SD 4.1) in conventional yoghurt group. Four weeks after initiation of the treatment, plasma glucose levels were significantly lower in the probiotic than in conventional yoghurt group at fasting (mean difference adjusted for the BMI category) and baseline FPG (- 4.0 mg/dl; 95% confidence interval - 6.9, - 1.1) and 2-h OGTT (- 13.9; - 22.8, - 5.0). At the 1-h OGTT, however, the difference was not statistically significant (- 9.8; - 20.6, 0.9). Further, there was a significantly lower infant bilirubin level in the probiotic group on days 3-5 after birth (- 2.2 mg/dl; - 3.3, - 1.2). There were not statistically significant differences between the groups regarding the risk of gestational diabetes (6 vs 11; odds ratio 0.5; 0.2, 1.5), preterm delivery (3 vs 8; 0.3; 0.1, 1.2), and other maternal and infant outcomes.
The probiotics supplementation has some beneficial effects on glucose metabolism of overweight and obese pregnant women. Nevertheless, further studies are required to judge the clinical significance of such effects.
目前仅有一些关于益生菌预防妊娠期高血糖的有效性证据。本试验研究了含有嗜酸乳杆菌 La5 和双歧杆菌 Bb12 的益生菌酸奶对超重和肥胖且孕期无糖尿病的女性的母体血浆葡萄糖（主要结局）以及一些母体和婴儿并发症（次要结局）的影响。
采用分层区组随机化方法，将妊娠前或孕早期 BMI≥25 且 22 周时空腹血糖<92mg/dl 的女性分配至益生菌或常规酸奶组，从 24 周开始每天摄入 100g，直至分娩。随访女性及其婴儿直至产后 1 个月。
每组中各有 1 例孕妇发生宫内胎儿死亡，未对其他结局进行分析。益生菌组和常规酸奶组的平均 BMI 分别为 29.2（SD 3.3）和 30.3（SD 4.1）。治疗开始后 4 周，与常规酸奶组相比，益生菌组空腹时（按 BMI 类别调整的平均差值）和基线 FPG（-4.0mg/dl；95%置信区间-6.9，-1.1）和 2-h OGTT（-13.9；-22.8，-5.0）的血糖水平显著降低。然而，1-h OGTT 时的差异无统计学意义（-9.8；-20.6，0.9）。此外，益生菌组婴儿出生后 3-5 天的胆红素水平显著降低（-2.2mg/dl；-3.3，-1.2）。两组间妊娠期糖尿病的风险（6 例与 11 例；比值比 0.5；0.2，1.5）、早产（3 例与 8 例；0.3；0.1，1.2）和其他母婴结局无统计学差异。
益生菌补充对超重和肥胖孕妇的糖代谢有一定的有益影响。然而，需要进一步的研究来判断这种影响的临床意义。
