Probiotic safety in pregnancy: a systematic review and meta-analysis of randomized controlled trials of Lactobacillus, Bifidobacterium, and Saccharomyces spp.
Our objective in this study was to review systematically the evidence for safety of Lactobacillus, Bifidobacterium and Saccharomyces spp. during pregnancy and to conduct a meta-analysis of randomized controlled trials (RCTs). Eleven databases were searched from inception to September 2007 for RCTs of probiotic use during pregnancy. Two independent reviewers searched databases. Random-effects models combined data. Eleven studies on Lactobacillus and/or Bifidobacterium examined 1505 patients for four outcomes with no data heterogeneity; no miscarriage data were reported. Five studies reported Caesarean section outcomes (OR 0.88; 95% CI 0.65 to 1.19). Six studies reported birth weight (weighted difference 45 g; 95% CI -181 to 271). Three studies reported gestational age (weighted difference 0.4 weeks; 95%CI -0.4 to 1.2). No malformations were reported in the probiotic group. No RCTs were available for Saccharomyces during pregnancy. Lactobacillus and Bifidobacterium had no effect on the incidence of Caesarean section, birth weight, or gestational age. The safety of Saccharomyces during pregnancy is unknown.
Dugoua
Jean-Jacques
JJ
Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON; Motherisk Program, Hospital for Sick Children, Toronto ON.
Machado
Marcio
M
Toronto Health Economics and Technology Assessment Collaborative (THETA), University of Toronto, Toronto ON.
Zhu
Xu
X
Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON.
Chen
Xin
X
Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON.
Koren
Gideon
G
Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON; Motherisk Program, Hospital for Sick Children, Toronto ON; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON.
Einarson
Thomas R
TR
Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON; Motherisk Program, Hospital for Sick Children, Toronto ON; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON.
D001644:Bifidobacterium; D005260:Female; D006801:Humans; D007778:Lactobacillus; D011247:Pregnancy; D011256:Pregnancy Outcome; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012440:Saccharomyces