Prebiotic supplementation could benefit gut microbiota of pregnant women – China RCT

23-Feb-2023 - Last updated on 23-Feb-2023 at 03:05 GMT

Prebiotics could improve the composition of gut microbiota in pregnant women, but did not show robust effects on glucose and lipid metabolism. ©Getty Images

Prebiotics could improve the composition of gut microbiota in pregnant women, but did not show robust effects on glucose and lipid metabolism, a new RCT has reported.

During pregnancy, disruptions to the gut microbiota and abnormal glucose metabolism can lead to complications such as gestational diabetes.

Although prebiotics have shown potential to regulate gut microbiota, their effects on pregnant women remain unclear.

To explore the feasibility and safety of galactooligosaccharides (GOS)-containing prebiotic supplementation during pregnancy, a double-blinded randomised clinical trial involving women with singleton pregnancy was conducted.

The study included 52 women in their first trimester, aged between 18 and 40 years, who were recruited from Peking University First Hospital in Beijing, China, from August 2020 to December 2021.

The participants were divided into four groups according to their body mass index (BMI), and randomly assigned to the control group or intervention group.

Those in the intervention group received GOS supplements, while the control group took placebo containing fructooligosaccharides (FOS) daily.
During the follow-up sessions at 11-13 weeks and 24-28 weeks of gestation, blood and stool samples were collected from the participants for analysis.

The 16S rRNA sequencing technology was adopted to detect the composition, diversity and differential flora of gut microbiota, while IL-6 levels were used as inflammatory markers.

Glucose and lipid metabolism were evaluated based on fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and gestational weight gain (GWG).

The findings showed no significant difference in the incidence rate of gestational diabetes, as well as levels of FPG, TG, TC, HDL-C, LDL-C, GWG and IL-6, between the GOS and placebo groups.

For newborns whose mothers were in either group, there was no marked difference in gestational week, birth weight, birth length, head circumference, chest circumference, sex, and delivery mode.

A questionnaire was used to record possible adverse symptoms during the study.

“One participant in the GOS group had abdominal distension and another had nausea, but these symptoms have little to do with the intake of prebiotics, and may be related to appetite and hormone changes.

“Prebiotic supplementation during pregnancy can be considered to be safe and well-tolerated, as seen from the minimal adverse reactions. In our study, GOS supplementation began in early pregnancy. It may have more significant effects if the duration of the intervention was increased, such as starting the supplementation before pregnancy or even earlier,” said the authors.

Supplements welcomed by pregnant mums

Women with gestational diabetes have a reportedly higher likelihood of developing type 2 diabetes in the long term, and their children may have greater risk of childhood obesity.

The gut microbiota is known to play a part in maternal metabolic health.

Unlike probiotics, GOS is a type of prebiotics that are not digested and absorbed by the host, and can selectively promote the metabolism and proliferation of beneficial bacteria in the gut, particularly Lactobacillus and Bifidobacterium.

In the questionnaire, participants of the study mentioned that the intake of dietary supplements was “convenient and easy to implement”.

The authors added that pregnant women can also obtain essential nutrients by including foods that contain prebiotics in their diet.

“Prebiotics can usually be added to common foods. They are mainly used for fermented dairy products such as yoghurt and cheese, and non-fermented dairy products like milk formula for pregnant women,” the authors said.

Due to the limited participants and potential differences in microbiota of people from different regions, the effect of prebiotics on serum indicators needs to be further investigated.

“Our findings provide an important basis for clinical trials with higher quality and larger sample size in future to evaluate the effects of prebiotics supplementation in early pregnancy on gut microbiota, glucose metabolism, and immunity of pregnant women and newborns,” concluded the authors.

Source: PubMed Central

https://doi.org/10.3389/fendo.2023.1034266

“Effects of galactooligosaccharides on maternal gut microbiota, glucose metabolism, lipid metabolism and inflammation in pregnancy: A randomized controlled pilot study”

Authors: Jiayang Wan, et al