Some gastrointestinal symptoms such as nausea, vomiting, constipation and heartburn are very common in pregnant women. However, although they often arise physiologically, due to high concentrations of estrogen and progesterone that change the composition and function of the intestinal microbiota, such symptoms end up affecting the quality of life of the pregnant woman, and may also impact on her intestinal function. Given this scenario, there are some hypotheses of supplementations that can positively influence the improvement of these symptoms. Therefore, the study below evaluated whether, at the beginning of pregnancy, probiotics are beneficial for dysbiosis, which can influence the enteric nervous system and gastrointestinal function.
The study
The duration of the study was 16 days, and consisted of two cycles of six daily probiotics, mainly Lactobacillus, and 2 days without probiotics. Gastrointestinal function and quality of life of individuals were monitored daily. Also, a subset of patients contributed fecal samples for metagenomic sequencing of the microbiota and quantification of bacterial genes.
The results indicate that probiotic supplementation significantly reduced the severity of nausea, vomiting, constipation and improved the quality of life of women. However, the abundance of phylums Akkermansia
and A. muciniphila
were associated with periods of vomiting.
Bile Acids and Gastrointestinal Symptoms
In addition, elevated levels of fecal bsh (bile salt hydrolase), which generates free bile acids, were associated with low vomiting scores. However, the consumption of probiotics increased the amounts of fecal bsh (about 5 to 6 times).
However, such a relationship was not observed for bile acid 7α-desidroxilase, responsible for converting primary bile acids into secondary bile acids. Elevated secondary bile acids are genotoxic and cause cancer. In contrast, bsh-encoded bile salt hydrolase deconjugates bile acids and is present in Lactobacillus
and Bifidobacterium
, which are routinely used as probiotics. Therefore, it is concluded that probiotics probably produce free bile acids to facilitate intestinal mobility and metabolism.
Clinical practice
Despite being an area of research that requires further studies, the study showed that probiotics can produce free bile acids, which facilitate bowel mobility and metabolism, thus reducing the symptoms of pregnant women, especially early in pregnancy. However, when talking about phylums, one should pay not to be sure of which have been shown to be prejucial or beneficial to treatment. The abundance of phylums
Akkermansia
and A. muciniphila
were associated with vomiting periods, while
Lactobacillus
and
Bifidobacterium
bring positive effects.
Bibliographic references
Reading Suggestion:
Omega-3 Consumption in Pregnancy: What are the effects?
Watch the video on the Science Play:
Probiotics and Prebiotics: How and When to Prescribe?
Probiotics
Article at Gravide
z: Liu AT, Chen S, Jena PK, Sheng L, Hu Y, Wan Y-JY. Probiotics Improve Gastrointestinal Function and Life Quality in Pregnancy. Nutrients. 2021; 13(11):3931. https://doi.org/10.3390/nu13113931
