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Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial

  • 2017-10
  • EBioMedicine 24
    • R. Slykerman
    • Fiona Hood
    • K. Wickens
    • John F. Thompson
    • C. Barthow
    • R. Murphy
    • Janice Kang
    • Judy Rowden
    • P. Stone
    • Julian Crane
    • T. Stanley
    • P. Abels
    • G. Purdie
    • Robyn M. Maude
    • E. Mitchell

Abstract

Background: Probiotics may help to prevent symptoms of anxiety and depression through several putative mechanisms.

Objective: The aim of this study was to evaluate the effect of Lactobacillus rhamnosus HN001 (HN001) given in pregnancy and postpartum on symptoms of maternal depression and anxiety in the postpartum period. This was a secondary outcome, the primary outcome being eczema in the offspring at 12months of age.

Design, setting, participants: A randomised, double-blind, placebo-controlled trial of the effect of HN001 on postnatal mood was conducted in 423 women in Auckland and Wellington, New Zealand. Women were recruited at 14-16weeks gestation.

Intervention: Women were randomised to receive either placebo or HN001 daily from enrolment until 6months postpartum if breastfeeding.

Outcome measures: Modified versions of the Edinburgh Postnatal Depression Scale and State Trait Anxiety Inventory were used to assess symptoms of depression and anxiety postpartum.

Trial registration: Australia NZ Clinical Trials Registry: ACTRN12612000196842.

Findings: 423 women were recruited between December 2012 and November 2014. 212 women were randomised to HN001 and 211 to placebo. 380 women (89.8%) completed the questionnaire on psychological outcomes, 193 (91.0%) in the treatment group and 187 (88.6%) in the placebo group. Mothers in the probiotic treatment group reported significantly lower depression scores (HN001 mean=7·7 (SD=5·4), placebo 9·0 (6·0); effect size -1·2, (95% CI -2·3, -0·1), p=0·037) and anxiety scores (HN001 12·0 (4·0), placebo 13·0 (4·0); effect size -1·0 (-1·9, -0·2), p=0·014) than those in the placebo group. Rates of clinically relevant anxiety on screening (score>15) were significantly lower in the HN001 treated mothers (OR=0·44 (0·26, 0·73), p=0·002).

Interpretation: Women who received HN001 had significantly lower depression and anxiety scores in the postpartum period. This probiotic may be useful for the prevention or treatment of symptoms of depression and anxiety postpartum.

Funding source: Health Research Council of New Zealand (11/318) and Fonterra Co-operative Group Ltd.

Keywords: Anxiety; Depression; Microbiome-gut-brain axis; Probiotic; Randomised controlled trial.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lacticaseibacillus rhamnosusReduced Anxiety ScoresBeneficial
Small
Lacticaseibacillus rhamnosusReduced Clinically Relevant AnxietyBeneficial
Moderate
Lacticaseibacillus rhamnosusReduced Depression SymptomsBeneficial
Small
Lacticaseibacillus rhamnosus R0011Reduced Clinically Relevant Postpartum AnxietyBeneficial
Moderate
Lactobacillus rhamnosusReduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosusReduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosusReduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus CLR1505Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus CLR1505Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus CLR1505Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus CRL 1505Reduced Clinically Relevant Postpartum AnxietyBeneficial
Moderate
Lactobacillus rhamnosus CRL 1505Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus DSM33560Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus DSM33560Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus DSM33560Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus DSM 6594Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus DSM 6594Reduced Clinically Relevant Postpartum AnxietyBeneficial
Moderate
Lactobacillus rhamnosus DSM 6594Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus GR-1Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus GR-1Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus GR-1Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus HA-111Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus HA-111Reduced Clinically Relevant Postpartum AnxietyBeneficial
Moderate
Lactobacillus rhamnosus HA-111Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus HA-114Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus HA-114Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus HA-114Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus HA-500Reduced Anxiety ScoresBeneficial
Small
Lactobacillus rhamnosus HA-500Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus HA-500Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus LBV96Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus LBV96Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus LBV96Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus LBV 96Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus LBV 96Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus LBV 96Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus MAK79L08RReduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus MAK79L08RReduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus MAK79L08RReduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus NH001Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus NH001Reduced Clinically Relevant Postpartum AnxietyBeneficial
Moderate
Lactobacillus rhamnosus NH001Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus PXN 54Reduced Clinically Relevant Postpartum AnxietyBeneficial
Moderate
Lactobacillus rhamnosus PXN 54Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus R0011Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus R0011Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus R0011Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus R0343NDReduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus R0343NDReduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus R0343NDReduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus SD-5217Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus SD-5217Reduced Depression SymptomsBeneficial
Small
Lactobacillus rhamnosus UALr-18Reduced Anxiety SymptomsBeneficial
Small
Lactobacillus rhamnosus UALr-18Reduced Clinically Relevant AnxietyBeneficial
Moderate
Lactobacillus rhamnosus UALr-18Reduced Depression SymptomsBeneficial
Small

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