Supplementation from weeks 14-16 of the pregnancy onwards resulted in a significantly lower prevalence of gestational diabetes (GDM), according to data published in the British Journal of Nutrition.
“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. Our data suggest that the probiotic HN001 at a dose of [6 billion] cfu/d may lower the rate of GDM from 13.8 to 8.2 %, a 40 % reduction using the IADPSG* guidelines or a 68 % reduction from 6.5 to 2.1 % using the [New Zealand] guidelines,” wrote researchers from the University of Otago, the University of Auckland, and Victoria University.
Study details
The New Zealand-based scientists recruited 423 pregnant women to participate in their double-blind, randomized, placebo-controlled parallel trial. Women with a personal or partner history of atopic disease were randomly assigned to receive either L. rhamnosus HN001 (Fonterra) supplements or placebo from 14–16 weeks’ gestation, and gestational diabetes was assessed between weeks 24 and 30.
Data from the 373 women who completed the study, there was a trend towards lower rates of GDM in the probiotic group, while statistical significance was achieved when the scientists limited their analysis to women over 35 or women with a history of GDM.
“The gut microbiota is profoundly altered during the three trimesters of pregnancy towards a less diverse state, with the most depleted microbial richness found in women with GDM,” wrote the researchers. “In contrast to obesity-related gut microbiota, the last-trimester gut microbiota has been associated with greater amounts of energy lost in stool compared with the first trimester, indicating that the impact of gut microbiota alterations during pregnancy on host adiposity and host glucose metabolism is not necessarily identical. We speculate that HN001 supplementation altered the composition and function of the gut microbiota in favor of improved insulin sensitivity and inflammation in the host, which reduced the propensity towards GDM.”
Safety
“The lack of any deleterious effect on birth outcomes supports HN001 as a safe intervention to take from early pregnancy (14–16 weeks’ gestation), which may also be beneficial to the infant, as reflected by the Apgar score. These findings are important given the small amount of data available on effects of early-pregnancy probiotic interventions.”
“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 Westernized,” they concluded.
Source: British Journal of Nutrition
Published online ahead of print, doi: 10.1017/S0007114517000289
“Early pregnancy probiotic supplementation with Lactobacillus rhamnosus HN001 may reduce the prevalence of gestational diabetes mellitus: a randomised controlled trial”
Authors: K.L. Wickens et al.
* IADPSG = International Association of Diabetes and Pregnancy Study Groups