Among secondary endpoints , a significant reduction of maternal insulin ( both in women with or without diabetes ) was observed in the probiotics group .
INTERPRETATION Probiotics during pregnancy do not reduce the incidence of GDM , with a very little ( statistically but not clinical ly significant ) reduction of fasting plasma glucose
AIM To perform a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) to evaluate the effect of  probiotics in pregnancy on the  incidence of gestational diabetes ( GDM ) and fasting plasma glucose ( FPG ) .
Effect of antenatal dietary interventions in maternal obesity on pregnancy weight-gain and birthweight: Healthy Mums and Babies (HUMBA) randomized trial.
BACKGROUND Pregnancy interventions that improve maternal and infant outcomes are urgently needed in population s with high rates of obesity . We undertook the Healthy Mums and Babies ( HUMBA ) r and omized controlled trial to assess the effect of dietary interventions and or probiotics in a multiethnic population of pregnant women with obesity , living in an area of high deprivation . OBJECTIVES To determine whether a culturally tailored dietary intervention and or daily probiotic capsules in pregnant women with obesity reduces the co- primary outcomes of ( 1 ) excessive gestational weight gain ( mean > 0.27 kg/week ) and ( 2 ) birthweight . STUDY DESIGN We conducted a 2 × 2 factorial , r and omized controlled trial in women without diabetes at pregnancy booking , body mass index ≥30 kg/m2 , and a singleton pregnancy . At 12 + 0 to 17 + 6 weeks ' gestation , eligible women were r and omized to a dietary intervention ( 4 tailored educational sessions at ≤28 weeks ' gestation by a community health worker trained in key aspects of pregnancy nutrition plus text messaging until birth ) or to routine dietary advice ; and to daily capsules containing either ( Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 , minimum 6.5 × 109 colony forming units ) , or placebo , until birth . Analysis was by intention to treat with adjustment for maternal baseline body mass index . Infant outcomes were additionally adjusted for ethnicity , sex , and gestational age at birth . RESULTS In total , 230 women were recruited between April 2015 and June 2017 ( dietary intervention N = 116 vs routine dietary advice N = 114 ; probiotics N = 115 vs placebo N = 115 ) . Baseline characteristics and demographic variables were similar across all groups . There was no significant difference between intervention groups , for the co- primary outcomes of ( 1 ) proportion of women with excessive gestational weight gain  ( dietary intervention vs routine advice : 79/107 [ 73.8 % ] vs 90/110 [ 81.8 % ] , adjusted relative risk [ relative risk , 0.92 ; 95 % confidence interval , 0.80 - 1.05 ] ; probiotics versus placebo : 89/108 [ 82.4 % ] and 80/109 [ 73.4 % ] , relative risk , 1.14 , 95 % confidence interval , 0.99 - 1.31 ) or ( 2 ) birthweight ( dietary intervention vs routine advice : 3575 vs 3612 g , adjusted mean difference , -24 g , 95 % confidence interval , -146 to 97 ; probiotics vs placebo : 3685 vs 3504 g , adjusted mean difference , 107 g , 95 % confidence interval , -14 to 228 ) . Total maternal weight gain , a secondary outcome , was lower with dietary intervention compared with routine dietary advice ( 9.7 vs 11.4 kg , adjusted mean difference , -1.76 , 95 % confidence interval , -3.55 to 0.03 ) . There were no significant differences between intervention groups in other secondary maternal or neonatal outcomes . CONCLUSION Although dietary education and or probiotics did not alter rates of excessive gestational weight gain or birthweight in this multiethnic , high-deprivation population of pregnant women with obesity , dietary education was associated with a modest reduction in total weight gain with potential future benefit for the health of mothers and their offspring if sustained
Among secondary endpoints , a significant reduction of maternal insulin ( both in women with or without diabetes ) was observed in the probiotics group .
INTERPRETATION Probiotics during pregnancy do not reduce the incidence of GDM , with a very little ( statistically but not clinical ly significant ) reduction of fasting plasma glucose
AIM To perform a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) to evaluate the effect of  probiotics in pregnancy on the  incidence of gestational diabetes ( GDM ) and fasting plasma glucose ( FPG ) .