Effect of Probiotic Yoghurt on Plasma Glucose in Overweight and Obese Pregnant Women: A Randomized Controlled Trial

Abstract

Abstract: Introduction & Objectives: There isn’t enough evidence about effectiveness of probiotics for preventing gestational hyperglycemia. This trial examined effects of probiotic yoghurts containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on the amount of 5×108 CFU / g, on maternal plasma glucose (primary outcome) and on some maternal and infant complications (secondary outcomes) in overweight and obese women. Materials and Methods: This randomized controlled triple-blind, randomized, clinical trial was conducted on 130 pregnant women recruited from five public health centers in Tabriz. Women with BMI ≥ 25 and fasting plasma glucose < 92 mg/dl at 22 weeks’ gestation were allocated, using stratified block randomization, into probiotic or conventional yoghurt group with a 1:1 allocation ratio, consuming100 g/d from 24 weeks’ gestation to delivery. Allocation sequence was generated by a computer random number generator. Randomization was stratified by BMI category (BMI = 25.0-29.9; BMI ≥ 30 kg/m2) and restricted with randomly varying blocks of four and six. Blood glucose level, measured at 28 weeks’ gestation- 4 weeks after commencement of the treatments. The women and their infants were followed-up until one month after birth. Results one from each group had intra-uterine fetal death and were not analyzed for other outcomes. The women’s mean BMI was 29.7 (SD3.7). The groups were comparable in terms of the baseline socio-demographic and reproductive characteristics. Four weeks after treatment, plasma glucose levels were significantly lower in the probiotic than conventional yoghurt group at fasting (adjusted difference -4.0; 95% confidence interval -6.9, -1.1 (adjusted for BMI and baseline FPG)) and 2-h OGTT (-13.1; -21.7, -4.8). At the 1-h OGTT, the difference was not statistically significant (-9.1; -19.3, 1.2). There were significantly lower infant bilirubin at 3-5 days after birth (-2.2; -3.3, -1.2) and a lower risk of gestational diabetes (odds ratio 0.5; 0.2, 1.5) and preterm birth (0.3; (0.1, 1.2) in the probiotic group; but no differences between the groups on other maternal and infant outcomes. Conclusion: Based on the results, it seems that the probiotics supplementation containing Lactobacillus acidophilus La5 and Bifidobacterium Lactis Bb12 for 4 weeks, has some beneficial effects on glucose metabolism of overweight and obese pregnant women, also with less certainty on prevention of hyperbilirubinemia in their infants. More studies in different setting with higher number of participants, considering infant bilirubin as primary outcome, and assessment of more biomarker and definitive long-term outcomes in mothers and infants are recommended to judge about possible mechanism of the effects and clinical significance of probiotic intake during pregnancy for overweight and obese pregnant women and their infants.