Gestational Diabetes Risk May Be Reduced With Probiotics

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<i>Lactobacillus rhamnosus</i> HN001 supplementation did not have any adverse maternal or infant post-birth effects.
Lactobacillus rhamnosus HN001 supplementation did not have any adverse maternal or infant post-birth effects.

Pregnant women who received Lactobacillus rhamnosus HN001 supplementation between 14 weeks and 16 weeks of gestation had a significantly reduced prevalence of gestational diabetes mellitus (GDM) compared with patients receiving placebo, according to recent research published in the British Journal of Nutrition.

Kristin L. Wickens, PhD, from the University of Otago in Wellington, New Zealand, and colleagues performed a randomized placebo-controlled trial in 212 pregnant patients between 14 weeks and 16 weeks of gestation who received 6 x109 colony-forming units of daily Lactobacillus rhamnosus HN001 (HN001) and 211 patients who received placebo. After follow-up, there were 184 women in the HN001 group and 189 women in the placebo group.

 

At 24 to 30 weeks, researchers assessed whether patients had developed GDM using 2 measurements: International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria (fasting plasma glucose ≥5.1 mmol/L, or 1-hour post 75-g glucose level at ≥10 mmol/L, or at 2-hour ≥8.5 mmol/L) and the New Zealand criteria (fasting plasma glucose ≥5.5 mmol/L or 2-hour post 75-g glucose at ≥9 mmol/L).

“As far as we are aware, this is the first study to report a role for probiotics in preventing GDM among women not selected on the basis of risk for GDM,” the researchers wrote.

According to IADPSG criteria, there was an overall lower rate of GDM in patients who received HN001 compared with placebo (relative risk [RR] 0.59; 95% CI, 0.32-1.08; P =.08) in women age ≥35 (RR 0.31; 95% CI, 0.12-0.81; P =.009). Women with a previous history of GDM (RR 0.00; 95% CI, 0.00-0.66; P =.004) also had reduced rates of GDM in the HN001 group.

Patients had significantly lower prevalence of GDM in the HN001 group (2.1%; 95% CI, 0.6%-5.2%) compared with the placebo group (6.5%; 95% CI, 3.5%-10.9%) using the New Zealand criteria as well.

The researchers noted their analysis showed HN001 did not have any measured adverse maternal or infant post-birth effects, including duration of gestation, neonatal intensive care unit admission, Caesarean section delivery, and gut microbiota.

“Promoting good health in pregnancy through weight control programmes or diet has been largely ineffective, partly due to poor adherence with the interventions,” they wrote. “If our results for probiotics are confirmed in other larger trials, the promise of a simple, cheap and safe intervention is an attractive option to reduce the prevalence of GDM, which is increasing not only in affluent countries but also in less-affluent countries as they become more Westernised.”

Reference

Wickens KL, Barthow CA, Murphy R, et al. Early pregnancy probiotic supplementation with Lactobacillus rhamnosus HN001 may reduce the prevalence of gestational diabetes mellitus: a randomised controlled trial [published online April 3, 2017]. Br J Nutr. doi:10.1017/S0007114517000289

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