Public Release: 

Impact of probiotics on metabolic health in women with gestational diabetes

Society for Maternal-Fetal Medicine

In a study to be presented on Feb. 5 in an oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™, in San Diego, researchers will report on the effect of a probiotic capsule intervention on maternal metabolic parameters and pregnancy outcomes among women with gestational diabetes.

Gestational diabetes mellitus (GDM) is among the most frequent metabolic complications of pregnancy. Research into new therapies for glucose control may be of significant benefit for future GDM management. Probiotics (live microorganisms that may confer a health benefit on the host), potentially represent a new and novel mechanism for influencing metabolic health during pregnancy. Only three randomized controlled trials to date have directly investigated the glycemic effects of probiotics in pregnancy, but none specifically investigated the effects among women with GDM.

The study, titled Impact of Probiotics in Women with Gestational Diabetes Mellitus on Metabolic Health: A Randomized Controlled Trial, investigated the effect of a daily probiotic supplement versus placebo on fasting glucose, other metabolic parameters and pregnancy outcome among women with a new diagnosis of either impaired glucose tolerance or GDM not treated with pharmacologic therapy. The women were given either a daily probiotic (strain Lactobacillus salivarious UCC118) or placebo capsule from GDM diagnosis until delivery. Among 100 women managed with diet and exercise alone, fasting plasma glucose decreased significantly within both the probiotic and placebo group. This was likely due to improved dietary habits following healthy lifestyle advice, which was delivered to all women as part of routine care.

The study concluded that a probiotic capsule intervention among women with abnormal glucose tolerance had no impact on control of sugars. However, a significant reduction of the normal pregnancy-related rise in total and LDL cholesterol compared to placebo was observed.

"This study indicates a potential role in probiotics to improve the metabolic profile of an obstetric group at risk of future metabolic syndrome and cardiovascular disease," explained Fionnuala McAuliffe, M.D., senior principal investigator, chair and professor of Obstetrics & Gynaecology at the University College Dublin. Karen Lindsay, Ph.D., who conducted the research trial will present the study at the SMFM annual meeting.

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Abstract 32: Impact of Probiotics in Women with Gestational Diabetes Mellitus on Metabolic Health: A Randomized Controlled Trial

Authors: Karen Lindsay1, Lorraine Brennan5, Maria Kennelly1, Orla Maguire3, Thomas Smith3, Sinead Curran2, Mary Coffey2, Mensud Hatunic2, Michael Foley1, Fergus Shanahan4, Fionnuala McAuliffe1 1University College Dublin, UCD Obstetrics and Gynaecology, Dublin 2, Ireland, 2National Maternity Hospital, Dublin, Ireland, 3St. Vincent's University Hospital, Dublin, Ireland, 4University College Cork, Cork, Ireland, 5University College Dublin, Dublin, Ireland

Objective: Probiotics are live microorganisms which may confer health benefits on the host. Recent trials of probiotics in healthy pregnancy demonstrate potential for improved glycaemic control. The aim of this study was to investigate the effects of a probiotic capsule intervention on maternal metabolic indices among women with GDM.

Study Design: This double-blind placebo-controlled randomized trial (registration ISRCTN97241163) recruited pregnant women with a new diagnosis of GDM following a 3-hour 100g GTT. Women were randomized to a daily probiotic (Lactobacillus salivarius UCC118) or placebo capsule from GDM diagnosis until delivery. Fasting blood samples were collected at baseline and 4-6 weeks post capsule commencement for analysis of glucose, insulin, c-peptide, HOMA and lipids. The primary outcome was change in fasting glucose among women not commenced on insulin therapy. Secondary outcomes were requirement for insulin and changes in other metabolic indices. A sample size of 100 was required to detect a 0.4mmol/l difference in fasting glucose with 80% power at the 0.05 level of significance.

Results: Of 115 women recruited and randomized, there were no differences between the groups in baseline characteristics or requirement for insulin therapy (9 probiotic, 6 placebo group; p=0.386). Among 100 women not treated with insulin, fasting plasma glucose decreased significantly within both the probiotic and placebo group, but the change between groups did not differ. The rise in total and LDL cholesterol was significantly attenuated in the probiotic versus placebo group. No differences were noted between groups in other metabolic indices.

Conclusion: A probiotic capsule intervention among women with abnormal glucose tolerance had no impact on glycaemic control. However, a significant attenuation of the normal pregnancy-induced rise in total and LDL cholesterol compared to placebo indicates a potential role of probiotics to improve the metabolic profile of an obstetric group at risk of future CVD. Within-group and between-group changes in maternal metabolic indices from pre- to postintervention.

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