Probiotics in Obstetrics and Gynecology

Microbiome is a term is used to signify the collective genomes of microorganisms in specific areas while microbiota refers to the community of microorganisms. The microbiome is known to encode over three million genes, thus influencing the host’s immunity, phenotype, and health. The gut microbiota also plays a role in the development of metabolic disorders.

Probiotics are beneficial microorganisms which are naturally found in yogurt and other fermented foods. They can also be taken as supplements as they have proven advantages in warding off atopic dermatitis, type 2 diabetes, obesity, and gastrointestinal tract disorders.

Nearly, 40% of pregnant women suffer from anemia, which if untreated, can lead to childbirth related complications and can have a deleterious impact on the offspring. Moreover, probiotic intake can aid in reducing the rate of spontaneous preterm birth and prolonged gestation, along with eczema and atopic eczema in pregnant women.

An article published in the AOGS elaborated on the advantages of Lactobacillus plantarum 299v (Lp299v) plus 4.2 mg iron, 12 mg ascorbic acid, and 30 μg folic acid intake among non-anemic, pregnant women. The findings underscored that intake of a Lp299v and iron combination may improve the iron status more rapidly compared to iron supplementation alone.

Pregnant women with iron deficiency are generally prescribed iron supplements. Iron can also be delivered from dietary sources, as intramuscular or intravenous injections, or as blood or red cell concentrate transfusion. Iron absorption pathways and the type of iron obtained are greatly influenced by the gut microbiota composition.

The environmental oxidized iron has low solubility; hence, organisms tend to develop efficient modalities to compete for the available resources. These are nullified by microbial dysbiosis. Lactobacillus strains produce lactic acid which increases the dietary bioavailability of iron. Thus, this strain can be utilized for optimization of iron bioavailability. 

Evidence from animal studies inform that this specific strain of Lp299v increases the hemoglobin content and hematocrit values in anemic subjects. In gynecology, probiotics use has been tried in bacterial vaginosis – with probiotics combined with estrogen; for reinstating the vaginal ecosystem in postmenopausal women; and as an adjuvant therapy for vaginal infections. 

Recent reports suggest that the use of probiotics can serve as a potentially attractive novel therapeutic modality against endometriosis. Furthermore, probiotics supplementation was found to be safe for women.

Source: Acta Obstetriciaet Gynecologica Scandinavica. 2021 Sep;100(9):1547-1548. doi: 10.1111/aogs.14196.