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July 2021

Pre-eclampsia Risk: Talk to Your Pregnant Patients about Probiotics

A new, high-quality meta-analysis of 4 studies in overweight and obese individuals shows that taking probiotic supplements during pregnancy increases the relative risk for pre-eclampsia by 85%. Providers need to be aware of this finding.

A recent meta-analysis evaluated the use of lactobacillus taken with or without bifidobacteria probiotics for preventing gestational diabetes. While there was no strong evidence that taking probiotics can reduce the risk of gestational diabetes, there was a clear link between using probiotics and an increased risk of pre-eclampsia. Based on this meta-analysis, for every 33 patients that took probiotics, 1 additional patient developed pre-eclampsia. While this link isn't fully understood and it is unclear which patients are most likely to be affected, providers should counsel their patients about this concern.

Probiotics are used for a wide range of conditions with varying evidence of benefit. They’re often promoted for use in pregnancy to prevent certain conditions in the unborn baby, including eczema and allergies. But evidence supporting these uses is limited. Even so, probiotics are generally considered safe for healthy people and giving them a try isn’t often considered a risk. This new evidence suggests otherwise. If your pregnant patients want to try probiotics for any reason, explain that while this evidence is new, pre-eclampsia might be a risk.

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