A review of the literature regarding nutritional supplements and their effect on vaginal flora and preterm birth.
OBJECTIVE
The aim of this review was to evaluate recently published review articles which examine the use of nutritional supplements to prevent preterm birth (PTB) by modifying vaginal bacteria.


RESULTS
Probiotics, vitamin D and vitamin C were all identified as nutritional supplements that have the potential to alter bacterial flora and consequently reduce PTB and treat or prevent genital infections. Evidence shows that probiotics may reduce the incidence of PTB as well as being effective at treating bacterial vaginosis, a known cause for PTB. Low vitamin D levels may be associated with bacterial vaginosis, although no evidence was identified which demonstrated that vitamin D supplementation reduced the risk of having bacterial vaginosis or PTB.There is little evidence regarding vitamin C supplementation, although it does suggest a possible benefit with regard to preterm rupture of membranes; however, this did not appear to reduce rates of PTB.


CONCLUSIONS
Although there is evidence that taking probiotics in pregnancy may reduce the incidence of PTB, it is mainly derived from small, poor quality studies. Vitamin D and vitamin C may have potential benefits, but these remain to be proven. Large randomized controlled trials are needed to more accurately evaluate the potential benefits of these low-cost interventions for reducing PTB and its consequences.
aWomen's Health Research Unit, The Blizard Institute, Queen Mary University bBarts and the London School of Medicine, London, UK.
Natalie A M
NA
Cooper
Rachel
R
Moores
D001205:Ascorbic Acid / Q000627:therapeutic use; D001206:Ascorbic Acid Deficiency / Q000178:diet therapy / Q000503:physiopathology / Q000517:prevention & control; D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D006801:Humans; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D019936:Probiotics / Q000627:therapeutic use*; D012306:Risk; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology / Q000517:prevention & control*; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000178:diet therapy / Q000503:physiopathology / Q000517:prevention & control
D014807:Vitamin D; D001205:Ascorbic Acid