Department of Physiological SciencesCenter of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Department of DentistryFaculty of Health Sciences, University of Brasília, Brasília, Brazil.
Appl Physiol Nutr Metab. 2024 Feb 1;49(2):135-147. doi: 10.1139/apnm-2023-0089. Epub 2023 Oct 16.
We aimed to systematically review the literature on the effects of probiotic consumption on the risk of preeclampsia (PE) development. Eight databases, clinical trial registries, and grey literature were searched until February 2022. Studies were included if they (1) were randomized clinical trials (RCTs), (2) included pregnant women aged ≥ 18 years old, (3) used probiotics products, and (4) were written in the Latin alphabet. A random-effects meta-analysis was performed using the risk ratio as the effect measure with 95% confidence intervals (CI) for PE. The search strategy identified 359 records, from which six RCTs were included. The six RCTs evaluated pregnant women with comorbidities and enrolled 593 women that received probiotics and 625 receiving placebo. None of the included RCTs analyzed healthy women. Probiotics increased by 12% the PE risk (RR 1.12, 95% CI, CI = 0.83-1.53, = 0.46, χ= 3.31, df = 5 ( = 0.65), = 0%). The certainty of the evidence, evaluated through the Grading of Recommendations Assessment, Development and Evaluation approach, was rated as very low. In conclusion, probiotics supplementation may slightly increase PE rates in pregnant women with comorbidities. The risk may be higher in obese women and for periods of ingestion longer than eight weeks. However, the evidence certainty is very low. PROSPERO registration No.CRD42021278611.
我们旨在系统地回顾关于益生菌摄入对先兆子痫（PE）发展风险影响的文献。截至 2022 年 2 月，我们检索了 8 个数据库、临床试验注册处和灰色文献。如果研究符合以下标准，则被纳入：（1）随机临床试验（RCT）；（2）纳入年龄≥18 岁的孕妇；（3）使用益生菌产品；（4）用拉丁字母书写。使用风险比作为效果量，采用 95%置信区间（CI）进行 PE 的随机效应荟萃分析。搜索策略确定了 359 条记录，其中包括 6 项 RCT。这 6 项 RCT 评估了患有合并症的孕妇，并纳入了 593 名接受益生菌和 625 名接受安慰剂的女性。没有一项纳入的 RCT 分析了健康女性。益生菌使 PE 风险增加 12%（RR 1.12，95%CI，CI=0.83-1.53，P=0.46，χ²=3.31，df=5（P=0.65），I²=0%）。通过 Grading of Recommendations Assessment, Development and Evaluation 方法评估证据质量，被评为极低。总之，益生菌补充剂可能会略微增加患有合并症的孕妇的 PE 发生率。对于肥胖女性和摄入时间超过 8 周的女性，风险可能更高。然而，证据确定性非常低。PROSPERO 注册号：CRD42021278611。
