There is not enough evidence to recommend any intervention for preventing excessive weight gain during pregnancy, due to the significant methodological limitations of included studies and the small observed effect sizes. More high-quality randomised controlled trials with adequate sample sizes are required to evaluate the effectiveness of potential interventions.
Probiotics and dietary counselling contribute to glucose regulation during and after pregnancy: a randomised controlled trial.
Balanced glucose metabolism ensures optimal fetal growth with long-term health implications conferred on both mother and child. We examined whether supplementation of probiotics with dietary counselling affects glucose metabolism in normoglycaemic pregnant women. At the first trimester of pregnancy 256 women were randomised to receive nutrition counselling to modify dietary intake according to current recommendations or as controls; the dietary intervention group was further randomised to receive probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12; diet/probiotics) or placebo (diet/placebo) in a double-blind manner, whilst the control group received placebo (control/placebo). Blood glucose concentrations were lowest in the diet/probiotics group during pregnancy (baseline-adjusted means 4.45, 4.60 and 4.56 mmol/l in diet/probiotics, diet/placebo and control/placebo, respectively; P = 0.025) and over the 12 months' postpartum period (baseline-adjusted means 4.87, 5.01 and 5.02 mmol/l; P = 0.025). Better glucose tolerance in the diet/probiotics group was confirmed by a reduced risk of elevated glucose concentration compared with the control/placebo group (OR 0.31 (95 % CI 0.12, 0.78); P = 0.013) as well as by the lowest insulin concentration (adjusted means 7.55, 9.32 and 9.27 mU/l; P = 0.032) and homeostasis model assessment (adjusted means 1.49, 1.90 and 1.88; P = 0.028) and the highest quantitative insulin sensitivity check index (adjusted means 0.37, 0.35 and 0.35; P = 0.028) during the last trimester of pregnancy. The effects observed extended over the 12-month postpartum period. The present study demonstrated that improved blood glucose control can be achieved by dietary counselling with probiotics even in a normoglycaemic population and thus may provide potential novel means for the prophylactic and therapeutic management of glucose disorders.