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孕期和哺乳期母体营养补充对婴儿肠道或母乳微生物群的影响:系统评价。

Impact of Maternal Nutritional Supplementation during Pregnancy and Lactation on the Infant Gut or Breastmilk Microbiota: A Systematic Review.

机构信息

Medical School, St George's University of London, London SW17 0RE, UK.

Department of Women and Children's Health, King's College London, London SE1 7EH, UK.

出版信息

Nutrients. 2021 Mar 30;13(4):1137. doi: 10.3390/nu13041137.

DOI:10.3390/nu13041137
PMID:33808265
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8067242/
Abstract

Recent evidence indicates that maternal dietary intake, including dietary supplements, during pregnancy and lactation may alter the infant gut or breastmilk microbiota, with implications for health outcomes in both the mother and infant. To review the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota a systematic literature search was conducted. A total of 967 studies published until February 2020 were found, 31 were eligible and 29 randomized control trials were included in the qualitative synthesis. There were 23 studies that investigated the effects of probiotic supplementation, with the remaining studies investigating vitamin D, prebiotics or lipid-based nutrient supplements (LNS). The effects of maternal nutritional supplementation on the infant gut microbiota or breastmilk microbiota were examined in 21 and 12 studies, respectively. Maternal probiotic supplementation during pregnancy and lactation generally resulted in the probiotic colonization of the infant gut microbiota, and although most studies also reported alterations in the infant gut bacterial loads, there was limited evidence of effects on bacterial diversity. The data available show that maternal probiotic supplementation during pregnancy or lactation results in probiotic colonization of the breastmilk microbiota. There were no observed effects between probiotic supplementation and breastmilk bacterial counts of healthy women, however, administration of probiotic to nursing women affected by mastitis was associated with significant reductions in breastmilk loads. Maternal LNS supplementation during pregnancy and lactation increased bacterial diversity in the infant gut, whilst vitamin D and prebiotic supplementation did not alter either infant gut bacterial diversity or counts. Heterogeneity in study design precludes any firm conclusions on the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota, warranting further research.

摘要

最近的证据表明,母亲在怀孕和哺乳期的饮食摄入,包括膳食补充剂,可能会改变婴儿的肠道或母乳微生物群,这对母婴的健康结果都有影响。为了综述母亲在怀孕和哺乳期营养补充对婴儿肠道或母乳微生物群的影响,我们进行了系统的文献检索。共发现截至 2020 年 2 月发表的 967 项研究,其中 31 项符合纳入标准,29 项随机对照试验被纳入定性综合分析。有 23 项研究调查了益生菌补充的影响,其余研究调查了维生素 D、益生元或基于脂质的营养补充剂(LNS)。分别有 21 项和 12 项研究检查了母亲营养补充对婴儿肠道微生物群或母乳微生物群的影响。母亲在怀孕和哺乳期补充益生菌通常会导致婴儿肠道微生物群的定植,尽管大多数研究还报告了婴儿肠道细菌负荷的改变,但关于对细菌多样性的影响的证据有限。现有数据表明,母亲在怀孕或哺乳期补充益生菌会导致母乳微生物群中益生菌的定植。在健康女性中,益生菌补充与母乳细菌计数之间没有观察到效果,但是给患有乳腺炎的哺乳期妇女服用益生菌会导致母乳负荷显著减少。母亲在怀孕和哺乳期补充 LNS 会增加婴儿肠道中的细菌多样性,而维生素 D 和益生元补充不会改变婴儿肠道细菌多样性或数量。研究设计的异质性使得无法对母亲在怀孕和哺乳期的营养补充对婴儿肠道或母乳微生物群的影响得出任何确切的结论,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/cac276080f37/nutrients-13-01137-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/50ebe3529242/nutrients-13-01137-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/9fd5d2d10e4c/nutrients-13-01137-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/313d7f5e796c/nutrients-13-01137-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/7d9494c6da80/nutrients-13-01137-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/cac276080f37/nutrients-13-01137-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/50ebe3529242/nutrients-13-01137-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/9fd5d2d10e4c/nutrients-13-01137-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/313d7f5e796c/nutrients-13-01137-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/7d9494c6da80/nutrients-13-01137-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b2/8067242/cac276080f37/nutrients-13-01137-g005.jpg

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The meconium microbiota shares more features with the amniotic fluid microbiota than the maternal fecal and vaginal microbiota.胎粪微生物群与羊水微生物群的特征更相似,而与母体粪便和阴道微生物群的特征差异较大。
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