Article type
Abstract
"Background: Previous systematic reviews (SRs) showed inconsistent conclusions on whether probiotic administration can improve the health status of pregnant women, and the quality needs to be evaluated critically.
Objectives: We aimed to develop an umbrella review of systematic reviews to summarize the evidence for probiotic supplementation of adverse perinatal outcomes.
Methods: A comprehensive literature search was conducted in 4 electronic databases from inception to June 2023, including Pubmed, Cochrane Database of Systematic Reviews, Web of Science and Embase. We included all SRs and meta-analysis assessing any probiotic supplementations on adverse perinatal outcomes. Four overview authors independently screened literature, extracted data and evaluated quality. We utilized corrected covered area to quantify the degree of overlap for some meta-analysis with overlapping associations. Meta-analysis with overlapping associations were reanalyzed using random effects models from original studies.
Results: This study critically appraised 15 estimates derived from 23 published meta-analyses and 49 randomized controlled trials. Low certainty evidence indicates that probiotics reduced the risk of incidence of newborns’ hyperbilirubinemia (RR 0.51, 95%CI 0.37 to 0.72). Quality of evidence was rated low to moderate for no association for the risk of Gestational diabetes mellitus (RR 0.84, 95%CI 0.66 to 1.08), Cesarean Section (RR 0.94, 95%CI 0.87 to 1.01), Preterm Delivery (RR 1.10, 95%CI 0.85 to 1.43), Pre-eclampsia (RR 1.16, 95%CI 0.86 to 1.56), Neonatal Intensive Care Unit (RR 0.92, 95%CI 0.73 to 1.16), macrosomia (RR 0.86, 95%CI 0.55 to 1.34), induction of labor (RR 1.10, 95%CI 0.88 to 1.37), newborns’ hypoglycemia (RR 0.97, 95%CI 0.74 to 1.27), Stillbirth (RR 0.62, 95%CI 0.17 to 2.27), Preterm premature rupture of the membranes (RR 1.37, 95%CI 0.63 to 2.98), PIH (RR 1.34, 95%CI 0.86 to 2.07) and Polyhydramnios (RR 0.85, 95%CI 0.41 to 1.73) with probiotics.
Conclusions: Overall, evidence suggests that there is a reduced risk of newborns’ hyperbilirubinemia with probiotic administration. However, probiotic supplementation was unable to demonstrate a clear effect in the prevention of other adverse perinatal outcomes. Given the little observed benefit, we urge caution in using probiotics during pregnancy.
"
Objectives: We aimed to develop an umbrella review of systematic reviews to summarize the evidence for probiotic supplementation of adverse perinatal outcomes.
Methods: A comprehensive literature search was conducted in 4 electronic databases from inception to June 2023, including Pubmed, Cochrane Database of Systematic Reviews, Web of Science and Embase. We included all SRs and meta-analysis assessing any probiotic supplementations on adverse perinatal outcomes. Four overview authors independently screened literature, extracted data and evaluated quality. We utilized corrected covered area to quantify the degree of overlap for some meta-analysis with overlapping associations. Meta-analysis with overlapping associations were reanalyzed using random effects models from original studies.
Results: This study critically appraised 15 estimates derived from 23 published meta-analyses and 49 randomized controlled trials. Low certainty evidence indicates that probiotics reduced the risk of incidence of newborns’ hyperbilirubinemia (RR 0.51, 95%CI 0.37 to 0.72). Quality of evidence was rated low to moderate for no association for the risk of Gestational diabetes mellitus (RR 0.84, 95%CI 0.66 to 1.08), Cesarean Section (RR 0.94, 95%CI 0.87 to 1.01), Preterm Delivery (RR 1.10, 95%CI 0.85 to 1.43), Pre-eclampsia (RR 1.16, 95%CI 0.86 to 1.56), Neonatal Intensive Care Unit (RR 0.92, 95%CI 0.73 to 1.16), macrosomia (RR 0.86, 95%CI 0.55 to 1.34), induction of labor (RR 1.10, 95%CI 0.88 to 1.37), newborns’ hypoglycemia (RR 0.97, 95%CI 0.74 to 1.27), Stillbirth (RR 0.62, 95%CI 0.17 to 2.27), Preterm premature rupture of the membranes (RR 1.37, 95%CI 0.63 to 2.98), PIH (RR 1.34, 95%CI 0.86 to 2.07) and Polyhydramnios (RR 0.85, 95%CI 0.41 to 1.73) with probiotics.
Conclusions: Overall, evidence suggests that there is a reduced risk of newborns’ hyperbilirubinemia with probiotic administration. However, probiotic supplementation was unable to demonstrate a clear effect in the prevention of other adverse perinatal outcomes. Given the little observed benefit, we urge caution in using probiotics during pregnancy.
"