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Probiotics In Pregnancy: Safety, Benefits And Side Effects

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Discussion about the safety and benefits of using probiotics in pregnancy has gained a lot of popularity in current times. Probiotics are the live microorganisms present in fermented foods, such as yogurt. These microorganisms are similar to those already present in different parts of the body, such as the mouth, intestines, urinary tract, and vagina. Research has established the role of probiotic supplementation in improving overall health (1). However, is it safe to use probiotics during pregnancy? Read on to learn more about the safety, benefits, and possible risks of using probiotics during pregnancy.

Are Probiotics Safe During Pregnancy?

According to the American Pregnancy Association (APA), probiotics are probably safe during pregnancy (2). The reason is that probiotic use is associated with health issues, such as systemic infection, bacteremia, and fungemia (3) (4).

  • Systemic infection refers to the infection that spreads to the entire body.
  • Bacteremia and fungemia refer to harmful bacteria and fungi in the blood.

However, clinical evidence suggests that systemic absorption is rare when probiotics are used by healthy individuals. Also, the risk of bacteremia and fungemia is generally low. Hence, there is no general risk of probiotic use for pregnant and breastfeeding women, especially when probiotic supplementation is done under expert guidance.

How Do Probiotics Work?

About 100 trillion microorganisms inhabit the gut of a healthy human (5). These microorganisms collectively form the gut microbiota or microbiome, whose composition and activity can affect your overall health (6). Experts suggest that the effect of these microorganisms depends on the probiotic strains and species, meaning different probiotics will have different effects. Overall, probiotics may help (7):

  • Eliminate bad bacteria and help healthy bacteria flourish to maintain gut microbiome balance
  • Produce substances that confer desirable health effects
  • Modulate immune response and strengthen immunity

What Are The Health Benefits Of Probiotics In Pregnancy?

Here are some potential health benefits of probiotics for you and your baby.

  1. Improve gut health: Proper digestion and nutrient absorption during pregnancy are vital for healthy fetal development. Clinical studies show that probiotics (beneficial bacteria) can promote digestive health and combat gastrointestinal issues, such as constipation and irritable bowel syndrome (8). The World Gastroenterology Organisation suggests consuming a probiotic mixture or preparation containing adequate numbers of well-studied species for a healthy gut (9).
  1. Promote metabolic health: A 2018 meta-analysis study showed that probiotic supplementation could positively affect glucose metabolism among pregnant women with or without gestational diabetes mellitus (GDM) (10). Another study showed that probiotic supplementation may “improve glycemic control, blood lipid profiles, and inflammation and oxidative stress in pregnant women with GDM (11).
  1. Strengthen immunity: A pregnant woman’s immunity is naturally lowered in pregnancy, raising their risk of infections. Research shows that probiotics can modulate gut microbiota and strengthen innate and adaptive immunity (12). This beneficial effect could help expectant mothers fight infections better.
  1. Prevent atopic diseases: Research highlights that probiotics during pregnancy can be beneficial for reducing the incidence of atopic dermatitis (eczema) and necrotizing enterocolitis (NEC) (13). It’s the reason that the World Allergy Organization (WAO) recommends “probiotic supplementation in pregnant/lactating women and infants with a family history of allergic disease (14). However, more clinical trials are warranted to confirm that probiotics can help in the prevention of eczema due to allergy-related reasons.
  1. Alleviate depression and anxiety: Several pregnant women experience anxiety and depression (perinatal depression) during pregnancy. Research highlights that prenatal probiotics can help tackle gut dysbiosis (imbalance of gut microbiota), which may help reduce stress and symptoms of anxiety and depression (15). However, more research is needed to confirm these effects of probiotics.
  1. Treat vaginosis: Vaginosis is a bacterial infection that may compromise vaginal health and raise the risk of preterm birth (5). Some evidence suggests that probiotics may help treat bacterial vaginosis. However, more clinical trials are needed to support this consideration.

Besides these effects, probiotics may help maintain healthy gut microbiota, which could be disturbed due to nausea or morning sickness during pregnancy. The health benefits of probiotics may vary based on their species and strain. Lactobacillus, Bifidobacterium, and Saccharomyces are the genera of probiotics most studied for their beneficial effects in humans.

What Are The Side Effects Of Probiotics In Pregnancy?

Probiotics are marketed as dietary supplements that don’t undergo US FDA’s testing and approval process as set for drugs (5). Hence, their safe use during pregnancy warrants cognizance of their potential side effects (4) (7).

  1. Gastrointestinal issues: Probiotic supplement use at first may cause mild gastrointestinal issues, such as nausea, flatulence, bloating, and diarrhea in sensitive individuals. If you experience any of these symptoms, consult your doctor for guidance.
  1. Infections: Systemic infection, bacteremia, and fungemia are issues that probiotic use raises, mostly in individuals with weakened immunity. Since a mother’s immunity naturally weakens during pregnancy, using probiotic supplements without guidance might raise these concerns.
  1. Food allergies: Probiotics may trigger allergies in some sensitive individuals. Some probiotics may contain ingredients, such as soy and milk, which may also trigger allergic reactions. Therefore, read the product label carefully before picking a probiotic for yourself.

You may prefer buying probiotic supplements under medical guidance. An expert can suggest a strain-specific probiotic supplement that can help get desired outcomes while minimizing the risk of adverse effects.

What Are The Natural Probiotic Food Sources For Expecting Mothers?

Most healthy women do not need probiotic supplements since you can get them from natural sources. Below are some of the natural sources of probiotics that you may consider (16).

  • Yogurt
  • Cheese
  • Buttermilk
  • Tempeh
  • Kefir
  • Miso
  • Kombucha
  • Sauerkraut
  • Kimchi
  • Sourdough bread
  • Certain pickles

You may also consider adequate consumption of prebiotics with probiotics. Prebiotics are a type of fiber, which promotes the growth of beneficial microorganisms in the gut. Most vegetables and fruits contain prebiotics. Other sources include legumes, cereals and grains, and nuts and seeds (17). You may also talk to your healthcare provider about synbiotics. Synbiotics are products that contain both probiotics and prebiotics (7).

Probiotics are live microorganisms that can confer several health benefits during pregnancy. Generally, not all pregnant women require probiotic supplements, especially when you can naturally get them from different fermented foods. However, if your doctor suggests you opt for one, look for a trustworthy brand that clearly states the probiotic’s group, species, and strain.

References:

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  1. Colin Hill et al.; (2014); Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic.
    https://pubmed.ncbi.nlm.nih.gov/24912386/
  2. Probiotics During Pregnancy.
    https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/probiotics-during-pregnancy/
  3. Jackie Elias et al.; (2011); Are probiotics safe for use during pregnancy and lactation?.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056676/
  4. Shira Doron and David R. Snydman; (2015); Risk and Safety of Probiotics.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490230/
  5. Health benefits of taking probiotics.
    https://www.health.harvard.edu/vitamins-and-supplements/health-benefits-of-taking-probiotics
  6. Probiotics (Fact Sheet for Health Professionals).
    https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/
  7. Probiotics: What You Need To Know.
    https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
  8. Thad Wilkins and Jacqueline Sequoia; (2017); Probiotics for Gastrointestinal Conditions: A Summary of the Evidence.
    https://www.aafp.org/afp/2017/0801/p170.html
  9. Probiotics and prebiotics.
    https://www.worldgastroenterology.org/guidelines/probiotics-and-prebiotics/probiotics-and-prebiotics-english
  10. Jia Zheng et al.; (2018); The effects of probiotics supplementation on metabolic health in pregnant women: An evidence-based meta-analysis.
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197771
  11. Jiayue Zhang et al.; (2019); Effects of Probiotic Supplement in Pregnant Women with Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
    https://www.hindawi.com/journals/jdr/2019/5364730/
  12. Maldonado Galdeano C. et al.; (2019); Beneficial Effects of Probiotic Consumption on the Immune System.
    https://www.karger.com/Article/FullText/496426
  13. Linghan Kuang and Yongmei Jiang; (2019); Effect of probiotic supplementation in pregnant women: a meta-analysis of randomized controlled trials.
    https://pubmed.ncbi.nlm.nih.gov/31856928/
  14. Helen T. Wang et al.; (2019); The Role of Probiotics in Preventing Allergic Disease.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406271/
  15. Pamela D. Browne et al.; (2019); Probiotics in pregnancy: protocol of a double-blind, randomized controlled pilot trial for pregnant women with depression and anxiety (PIP pilot trial).
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637581/
  16. How to get more probiotics.
    https://www.health.harvard.edu/staying-healthy/how-to-get-more-probiotics
  17. Prebiotic diet – FAQs.
    https://www.monash.edu/medicine/ccs/gastroenterology/prebiotic/faq#3
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Swati Patwal

Swati Patwal is a clinical nutritionist and toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Then she worked as a nutrition faculty and clinical nutrition coach in different organizations. Her interest in scientific writing... more