The use of oral probiotics in pregnant women as a new paradigm for healthy motherhood: A prospective study

Background. There is currently a growing interest in the benefits of taking probiotics during pregnancy, but evidence supporting their positive impact remains scarce. The study evaluated the effect of probiotics on the incidence of urogenital infections and bacterial vaginosis in pregnant women, pregnancy complications, and delivery outcomes.

Aim. To evaluate the effect of an oral probiotic on the course and outcomes of pregnancy.

Materials and methods. A prospective study included 60 pregnant women divided into three groups. All patients underwent pH-metry of the vaginal contents at registration. Group 1 included 15 pregnant women with a pH level of 3.8–4.5 (control group). Forty-five pregnant women with a pH > 4.5 without growth of opportunistic flora, who underwent a study of the vaginal microflora using the Femoflor-16 test were divided into two subgroups: Group 2 (n = 25) received the synbiotic Enterolactis Duo, containing lyophilized live Lacticaseibacillus paracasei DG, or DSM 34154, as well as inulin at a dose of 4 g and Group 3 (n = 20) patients did not receive the probiotic. Before the start of therapy and 2 months after the therapy, the change of the symptoms, the level of vaginal pH, as well as the course of pregnancy, and delivery outcomes were evaluated. In addition, as part of a comprehensive assessment of intestinal function, the frequency and consistency of stool were analyzed.

Results. In 15 (60.0%) patients with increased vaginal pH who took a probiotic (Group 2), normalization of the microflora was observed after 21 days, characterized by an increase in Lactobacillus spp. and a decrease in pH to < 4.5. Symptoms, such as vaginal dryness and discomfort, did not differ significantly between the groups, except for a decrease in the severity of itching in the group taking the probiotic. There were no significant differences in the incidence of delivery complications (preeclampsia, premature rupture of membranes, chorioamnionitis, etc.) between the groups, probably due to a small sample. In Group 2, statistically significant (p < 0.05) clinical signs of improvement were observed: stool frequency normalized to 5–6 times a week, constipation relieved, and normal stool (types 3–4 according to the Bristol Stool Form Scale [BSFS]) prevailed.

Conclusion. The study suggests that oral probiotics may help normalize vaginal microbiota in pregnant women with elevated vaginal pH. In addition, the data indicate their potential to improve intestinal motor function. The observed decrease in constipation among patients taking a probiotic underscores its positive effect on stool regulation. However, more studies in a larger sample are needed to confirm the effect of probiotics on the incidence of labor complications and other pregnancy outcomes and the persistence of the effect on stool normalization. The results of this study emphasize the importance of further research on the role of probiotics in obstetrics and gynecology.