Many pregnancies face adversity with hypertension and metabolic problems such as gestational diabetes mellitus, obesity or metabolic syndrome. All these complications can have an impact on the health of the mother and also on the health of the newborn. In fact, these complications have been linked to childhood allergy, asthma, or skin problems. Many studies agree that prebiotics and probiotics in pregnancy, in addition to symbiotics, have health benefits in terms of preventing adverse pregnancy outcomes.
Therefore , dysbiosis is a key factor involved in the increased risk of preeclampsia, diabetes, infection, preterm labor, and (subsequently) infant atopy. Maternal dysbiosis has been shown to go hand in hand with neonatal dysbiosis, which causes colic in infants. Therefore, administration of pro- and prebiotics during pregnancy and lactation was recommended as a safe option to optimize these life spans and prevent adverse effects.
What are prebiotics and probiotics?
In 2008, the definition of prebiotics was refined, being defined as “a selectively fermented ingredient that results in specific changes in the composition and/or activity of the gastrointestinal microbiota, thereby conferring benefit(s) on host health.” This more recent definition is due to the nature of these bioactive components, not only being carbohydrates (fiber), but also some polyphenols., such as flavonols.
Probiotics are living microorganisms which can be consumed in certain foods such as yogurt, kefir, kombucha, tempeh and miso soup, or taken as supplements. These products typically harbor beneficial bacteria that can transiently colonize the intestinal mucosa and aid in the metabolism of the host’s flora.
Prebiotics and probiotics in pregnancy
Gestational Obesity
Obesity in pregnancy implies a maternal BMI ≥30. Obese women may suffer from dysbiosis and metabolic impairment. This condition can increase the risk of other pregnancy complications, such as gestational diabetes, hypertension, preeclampsia, and others.
The consequences for the fetus may be preterm birth, neonatal death, and increased risk of metabolic disorders later in life. The use of probiotics generated reduced symptoms of allergic asthma, prevention of food allergies, decreased severity of atopic dermatitis, less fat mass, better immune response and reduced risk of obesity. The use of Prebiotics can cause an improvement in maternal metabolic health by producing short-chain fatty acids.
Gestational diabetes
The management of gestational diabetes mellitus is also contemplated from the perspective of dysbiosis. Some authors propose that fibers are intestinal modulators involved in relieving insulin resistance and other related pathological events, such as oxidative stress in women with gestational diabetes. According to a meta-analysis this type of intervention demonstrated significant improvements in glucose and lipid metabolism, as well as having an anti-inflammatory and antioxidant effect, reducing the risk of fetal hyperbilirubinemia, fetal macrosomia and limiting newborn weight.
Hypertension and Preeclampsia
Preeclampsia is a type of complication characterized by hypertension and proteinuria, leading to renal and multisystem damage, also entailing a danger to the fetus. The use of pro- and prebiotics stimulates gut-derived metabolites, such as butyrate, which attenuate inflammation. In this way, The microbial ecosystem is also a key to cardiovascular health during pregnancy and therefore can aid in the treatment and prevention of hypertensive disorders of pregnancy, including hypertension and preeclampsia.
Bacterial vaginosis
Consumption of symbiotics seems to effectively prevent recurrent urinary tract infections in women. In the case of bacterial vaginosis, they suggest that a combination of probiotics and prebiotics should be applied instead of using antibiotics, which is risky for a pregnant woman. Systematic reviews found that pre/probiotics have even higher cure rates than antibiotics. This also provides greater protection to the mother and fetus.
Perinatal Mental Health
Currently, there are clinical trials exploring the role of gut microbiota modulators in mental health in the general population, suggesting a complex but evident relationship between the gut and brain. Perinatal mood disorders are common disabling conditions that can be treated through the so-called gut-brain axis. According to systematic reviews, promising evidence shows a lower incidence of anxiety and depressive symptoms in the perinatal period were reported when supplementing with pro, pre- and symbiotic during pregnancy.
Clinical practice
When we study about the consumption of prebiotics and probiotics in pregnancy, understand that pregnancy is a complex period in a woman’s life. There are many metabolic changes and possible complications, mainly affecting nutritional needs, the endocrine system and the intestinal microbiota. Thus, nutritional interventions are a viable and economical way to address these changes and achieve better results with pregnant women.
To obtain better results in the quality of life of the mother and child, it is important to highlight the use of prebiotics and probiotics in pregnancy, as promising modulators of the intestinal microbiota. These strategies can also be helpful in preventing or combating certain complications associated with pregnancy, such as gestational diabetes, preeclampsia, or infections, among others, and for preventing future illnesses such as asthma or allergies in children.
referencesBody
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Watch the video on Science Play with Ana Carolina Franco: GLP-1 in the treatment of obesity: how can prebiotics help?
Article: García-Montero C, Fraile-Martinez O, Rodriguez-Martín S, Saz JV, Rodriguez RA, Moreno JMP, Labarta JR, García-Honduvilla N, Alvarez-Mon M, Bravo C, De Leon-Luis JA, Ortega MA. The Use of Prebiotics from Pregnancy and Its Complications: Health for Mother and Offspring—A Narrative Review. Foods. 2023; 12(6):1148. https:// doi.org/10.3390/foods12061148
