Palmer Debra J, Cuthbert Alana R, Sullivan Thomas R, Pretorius Rachelle A, Garssen Johan, Rueter Kristina, Jenmalm Maria C, Keelan Jeffrey A, Silva Desiree, Prescott Susan L
Telethon Kids Institute, The University of Western Australia, Nedlands, Australia; School of Medicine, The University of Western Australia, Crawley, Australia.
SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia.
J Allergy Clin Immunol. 2025 Jan;155(1):144-152. doi: 10.1016/j.jaci.2024.08.009. Epub 2024 Aug 21.
Ingestion of prebiotics during pregnancy and lactation may have immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases.
We sought to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk.
We undertook a double-blind randomized controlled trial in which pregnant women were allocated to consume prebiotics (14.2 g daily of galacto-oligosaccharides and fructo-oligosaccharides in the ratio 9:1) or placebo (8.7 g daily of maltodextrin) powder from less than 21 weeks' gestation until 6 months postnatal during lactation. Eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was medically diagnosed infant eczema by age 1 year, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by age 1 year.
A total of 652 women were randomized between June 2016 and November 2021 (329 in the prebiotics group and 323 in the placebo group). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by age 1 year (prebiotics 31.5% [103 of 327 infants] vs placebo 32.6% [105 of 322 infants]; adjusted relative risk, 0.98; 95% CI, 0.77-1.23; P = .84). Secondary outcomes and safety measures also did not significantly differ between groups.
We found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of medically diagnosed infant eczema by age 1 year in infants who are at hereditary risk of allergic disease.
孕期和哺乳期摄入益生元可能对发育中的胎儿和婴儿免疫系统具有免疫调节益处，并提供一种潜在的饮食策略以降低过敏性疾病的风险。
我们试图确定孕期母亲补充膳食益生元是否可降低具有遗传风险的婴儿发生过敏结局的风险。
我们进行了一项双盲随机对照试验，将孕妇从妊娠21周前至产后6个月哺乳期分为两组，分别食用益生元（每日14.2克低聚半乳糖和低聚果糖，比例为9:1）或安慰剂（每日8.7克麦芽糊精）粉末。符合条件的女性的婴儿有一级亲属有医学诊断的过敏疾病史。主要结局是1岁时医学诊断的婴儿湿疹，次要结局包括1岁时的过敏原致敏、食物过敏和反复喘息。
2016年6月至2021年11月期间，共有652名女性被随机分组（益生元组329名，安慰剂组323名）。1岁时医学诊断为湿疹的婴儿百分比在两组之间无显著差异（益生元组31.5%[327名婴儿中的103名] vs安慰剂组32.6%[322名婴儿中的105名]；调整后的相对风险为0.98；95%CI为0.77-1.23；P = 0.84）。次要结局和安全指标在两组之间也无显著差异。
我们几乎没有发现证据表明孕期和哺乳期母亲补充益生元可降低具有遗传过敏风险的婴儿1岁时医学诊断的婴儿湿疹风险。
