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Effect of probiotics on pregnancy outcomes in gestational diabetes: systematic review and meta-analysis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Gestational diabetes mellitus (GDM) is a prevalent complication during pregnancy associated with numerous adverse outcomes. There is emerging evidence suggesting the potential of probiotics as a therapeutic measure for GDM; however, existing studies have yielded contradictory results. This meta-analysis assessed the efficacy of probiotics on blood glucose management and pregnancy outcomes in patients with GDM.

Methods

A comprehensive search of the PubMed, Embase, and Cochrane databases was conducted up to August 22, 2023, to identify relevant studies. The primary outcomes focused on fasting blood glucose (FBG), fasting serum insulin (FSI), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI). The secondary outcomes included various maternal and neonatal outcomes.

Results

This meta-analysis included 15 randomized controlled trials (RCTs), encompassing 1006 patients with GDM. The results showed that, compared to a placebo, probiotics demonstrated a significant reduction in FBG (MD − 2.58, 95% CI − 4.38 to − 0.79, p < 0.01), FSI (MD − 2.29, 95% CI − 3.40 to − 1.18, p < 0.01), HOMA-IR (MD − 0.56, 95% CI − 0.81 to − 0.32, p < 0.01), and birth weight (MD − 101.20, 95% CI − 184.62 to − 17.77, p = 0.02). Furthermore, it resulted in fewer neonatal intensive care unit (NICU) admissions (RR 0.60, 95% CI 0.40–0.89, p = 0.01), instances of hyperbilirubinemia (RR 0.31, 95% CI 0.16–0.61, p < 0.01), and elevated QUICKI (MD 0.01, 95% CI 0.00–0.01, p < 0.01). No significant impact was observed in the other analyzed outcomes.

Conclusions

In conclusion, probiotics improve FBG, FSI, and HOMA-IR, and reduce the occurrence of neonatal hyperbilirubinemia, NICU admissions, and birth weight in the offspring of patients with GDM. However, the quality of the evidence, as per the GRADE approach, varies from high to low, necessitating further studies to consolidate these findings.

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Data availability

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): registration ID CRD42023456637.

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Acknowledgements

We would like to thank the library of Shenyang Pharmaceutical University for their help in retrieving literature.

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This research received no external funding.

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Authors and Affiliations

  1. School of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, Shenyang, China

    Rui Wu & Juanjuan Hu

  2. School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, China

    Jiasi Luan & Zuojing Li

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Contributions

RW, JSL, JJH, and ZJL all significantly contributed to the study's content and structure. RW and JJH reviewed each experiment for eligibility and extracted and tabulated the relevant data. RW and JSL analyzed the data. RW drafted the article. JJH checked the format of the article. RW, JSL, JJH, and ZJL commented on the article's content. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Zuojing Li.

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Wu, R., Luan, J., Hu, J. et al. Effect of probiotics on pregnancy outcomes in gestational diabetes: systematic review and meta-analysis. Arch Gynecol Obstet (2024). https://doi.org/10.1007/s00404-023-07346-5

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