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Abstract

Spontaneous preterm birth is associated with vaginal microbial dysbiosis. As certain strains of lactobacilli help restore homeostasis in non-pregnant women, the goal was to determine the effect of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 administered orally, twice daily for 12 weeks on the vaginal microbiota, cytokines and chemokines of low-risk pregnant women. A double-blind, placebo-controlled, randomized trial comparing probiotic lactobacilli to placebo daily was performed in 86 asymptomatic pregnant women who had an Intermediate or Bacterial Vaginosis Nugent score at 13 weeks. After drop outs, 32 women receiving probiotics and 34 receiving placebo completed the study. The Nugent score returned to normal in 30% of the women in both groups at 28 weeks and was maintained until 35 weeks. The majority of subjects had normal pregnancy outcomes. Ninety-three bacterial species were detected at 13 weeks, with Lactobacillus iners, Lactobacillus crispatus, Gardnerella vaginalis and Atopobium vaginae being the most abundant across pregnancy. There was no difference in the Shannon diversity index between the probiotic and placebo groups at 13, 28 or 35 weeks. Almost all subjects consumed fermented foods and many of the organisms in the vagina are also known to be present in fermented foods. Interleukin-4 in the placebo group and Interleukin-10 in both probiotic and placebo groups increased slightly at 28 weeks but were not different at 35 weeks when compared to 13 weeks. In conclusion, this study showed no adverse issues resulting from 12 week use of probiotic Lactobacillus strains GR-1 and RC-14 during pregnancy in women at low risk for premature birth. The vaginal microbiota demonstrated flux irrespective of this oral probiotic administration.

Keywords: bacterial vaginosis; chemokines; cytokines; microbiota; pregnancy; probiotics.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus reuteriNormal Pregnancy OutcomesNeutral
Small
Lactobacillus reuteriStable Vaginal MicrobiotaNeutral
Small
Lactobacillus reuteri RC-14Absence of Adverse Pregnancy ComplicationsNeutral
Small
Lactobacillus reuteri RC-14Normal Pregnancy OutcomesNeutral
Small
Lactobacillus reuteri RC-14No Significant Impact on Vaginal MicrobiotaNeutral
Small
Lactobacillus rhamnosusAltered Vaginal MicrobiotaNeutral
Small
Lactobacillus rhamnosusChange in Vaginal Microbiota CompositionNeutral
Small
Lactobacillus rhamnosusSuccessful Pregnancy OutcomeNeutral
Small
Lactobacillus rhamnosus GR-1Increased Interleukin-10 LevelsNeutral
Small
Lactobacillus rhamnosus GR-1No Adverse EffectsNeutral
Moderate
Lactobacillus rhamnosus GR-1Normalized Nugent ScoreNeutral
Small
Lactobacillus rhamnosus LBV96Maintained Vaginal MicrobiotaNeutral
Small
Lactobacillus rhamnosus LBV96No Change in Cytokines or Chemokines LevelsNeutral
Small
Lactobacillus rhamnosus LBV96Unchanged Vaginal Microbiota DiversityNeutral
Small
Lactobacillus rhamnosus Lr-32No Adverse EffectsNeutral
Moderate
Lactobacillus rhamnosus R0011Increased Interleukin-10 LevelsNeutral
Small
Lactobacillus rhamnosus R0011No Adverse Health EffectsNeutral
Large
Lactobacillus rhamnosus R0011Normalized Nugent ScoreNeutral
Small

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