Use Of Probiotics In Pregnancy And Lactation Periods And Effects On Health

Öz

Pregnancy and lactation are special processes that increase nutritional requirements. The maternal diet should ensure that maternal and nutrient depots have enough energy and nutrients to meet the needs of the developing fetus and lactation. During the breastfeeding period, the nutritional composition of the mother has little effect on the mother's diet, especially when the protein, fat, carbohydrates and other nutritional factors are lacking in the maternal diet. However, this does not adversely affect the baby, causing inadequate maternal storage and ultimately damaging the mother. For this reason, breastfeeding is also an important period in terms of balanced nutrition. If necessary, they should be supported by the supplements. Probiotics are living microorganisms that, when taken in sufficient quantities, affect the health of the environment in a positive way. There are many studies showing that the use of probiotics have positive effects on both mother and baby. There are positive effects on health problems such as preterm labor, gestational diabetes, bacterial vaginosis. In infancy and childhood, significant effects are seen against diseases such as atopic dermatitis, allergic diseases, necrozian enterocolitis. Although it is considered that pregnancy and lactation use is risky, increasing researches suggest that the use of probiotics is recommended by health professionals and adopted by society. This article reviews and interprets current literature on the use, positive effects and safety of pregnancy and lactation from the possible health effects of probiotics.

Anahtar Kelimeler

• Probiotics,pregnancy,lactation,nutrition

Gebelik ve Laktasyon Döneminde Probiyotiklerin Kullanımı ve Sağlık Üzerine Etkileri

Öz

Gebelik ve laktasyon, beslenme gereksiniminin arttığı özel süreçlerdir. Maternal diyet; annenin ve besin ögesi depolarının, gelişen fetüsün ve laktasyonunun gereksinimini karşılamak için yeterli enerji ve besinlere sahip olmasını sağlamalıdır. Emzirme döneminde anne sütünün besin ögesi bileşimi bebeği korumayı ön plana alarak annenin diyetinden az etkilenmekte özellikle protein, yağ, karbonhidrat ve diğer besin ögeleri anne diyetinde eksik bile olsa anne sütündeki miktar yeterli kalmaktadır. Ancak bebeği olumsuz etkilemeyen bu durum, annenin depolarında yetersizliğe ve sonuçta annenin zarar görmesine neden olur. Bu nedenle emzirme süreci de dengeli beslenme açısından önemli bir dönemdir. Gerekli durumlarda takviyelerle desteklenmelidir. Probiyotikler, yeterli miktarda alındığında konağın sağlığını olumlu yönde etkileyen canlı mikroorganizmalardır. Probiyotik kullanımının hem anne hem de bebek üzerinde olumlu etkilerinin olduğunu gösteren birçok çalışma vardır. Annede preterm doğum, gestasyonel diyabet, bakteriyel vajinozis gibi sağlık sorunları üzerinde olumlu etkileri görülmektedir. Bebeklik ve çocuklukta ise atopik dermatit, alerjik hastalıklar, nekrozitan enterokolit gibi hastalıklara karşı önemli etkileri görülmektedir. Gebelikte ve laktasyonda kullanımlarının riskli olduğu düşünülse de artan araştırmalar sonucunda probiyotik kullanımının sağlık profesyonelleri tarafından önerildiği ve toplum tarafından benimsendiği görülmektedir. Bu yazıda, probiyotiklerin olası sağlık etkilerinden yola çıkarak gebelik ve laktasyon döneminde kullanımları, olumlu etkileri ve güvenilirlikleri üzerine güncel literatür bilgileri derlenmiş ve yorumlanmıştır.

Anahtar Kelimeler

• Probiyotikler,gebelik,laktasyon,beslenme

Kaynakça

1. Samur G, Gebelik ve Laktasyon Döneminde Beslenme. Turkiye Klinikleri J Nutr Diet 2015;1(1):20-5.
2. Samur G. Gebelik ve Emziklilik Döneminde Beslenme. 2008.
3. Okesene-Gafa K, Li M, Taylor RS, Thompson JM, Crowther CA, McKinlay CJ, et al., A randomised controlled demonstration trial of multifaceted nutritional intervention and or probiotics: the healthy mums and babies (HUMBA) trial. BMC Pregnancy Childbirth 2016;16(1):373.
4. FAO/WHO J. Working Group Report on Drafting Guidelines for the Evalu- ation of Probiotics in Food 2002.
5. Binns N, Probiotics, Prebiotics and the Gut Microbiota. ILSI Europe Con- cise Monograph Series 2013:1-32.
6. Halkjaer SI, Nilas L, Carlsen EM, Cortes D, Halldorsson TI, Olsen SF, et al., Effects of probiotics (Vivomixx(R)) in obese pregnant women and their newborn: study protocol for a randomized controlled trial. Trials 2016;17(1):491.
7. Karamali M, Dadkhah F, Sadrkhanlou M, Jamilian M, Ahmadi S, Tajaba- di-Ebrahimi M, et al., Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: A randomized, doub- le-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41.
8. Myhre R, Brantsaeter AL, Myking S, Gjessing HK, Sengpiel V, Meltzer HM, et al., Intake of probiotic food and risk of spontaneous preterm delivery. Am J Clin Nutr 2011;93(1):151-7.

9. Yeganegi M, Watson CS, Martins A, Kim SO, Reid G, Challis JR, et al., Effect of Lactobacillus rhamnosus GR-1 supernatant and fetal sex on lipopolysaccharide-induced cytokine and prostaglandin-regulating enzy- mes in human placental trophoblast cells: implications for treatment of bacterial vaginosis and prevention of preterm labor. Am J Obstet Gynecol 2009;200(5):532- 40.
10. Barrett HL, Dekker Nitert M, Conwell LS, Callaway LK, Probiotics for pre- venting gestational diabetes. Cochrane Database Syst Rev 2014(2):2-31.
11. Lindsay KL, Brennan L, Kennelly MA, Maguire OC, Smith T, Curran S, et al., Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Am J Obstet Gynecol 2015;212(4):496-507.
12. Wickens KL, Barthow CA, Murphy R, Abels PR, Maude RM, Stone PR, et al., Early pregnancy probiotic supplementation with Lactobacillus rham- nosus HN001 may reduce the prevalence of gestational diabetes mellitus: a randomised controlled trial. Br J Nutr 2017;117(6):804-13.
13. Taylor BL, Woodfall GE, Sheedy KE, O’Riley ML, Rainbow KA, Bramwell EL, et al., Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2017;9(5):461.
14. Lunder M, Reviewing clinical studies of probiotics as dietary supple- ments: probiotics for atopic and allergic disorders, urinary tract and res- piratory infections. Dietary Supplementes 2015:199-210.
15. Hanson L, Vandevusse L, Duster M, Warrack S, Safdar N, Feasibility of oral prenatal probiotics against maternal group B Streptococcus vaginal and rectal colonization. J Obstet Gynecol Neonatal Nurs 2014;43(3):294-304.
16. Gille C, Boer B, Marschal M, Urschitz MS, Heinecke V, Hund V, et al., Effect of probiotics on vaginal health in pregnancy. EFFPRO, a randomized controlled trial. Am J Obstet Gynecol 2016;215(5):608-15.
17. Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach JF, et al., Pro- biotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology 2012;23(3):402-14.
18. Barthow C, Wickens K, Stanley T, Mitchell EA, Maude R, Abels P, et al., The Probiotics in Pregnancy Study (PiP Study): rationale and design of a double-blind randomised controlled trial to improve maternal health du- ring pregnancy and prevent infant eczema and allergy. BMC Pregnancy Childbirth 2016;16(1):133.
19. Doege K, Grajecki D, Zyriax BC, Detinkina E, Zu Eulenburg C, Buhling KJ, Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood--a meta-analysis. Br J Nutr 2012;107(1):1-6.
20. Rautava S, Kainonen E, Salminen S, Isolauri E, Maternal probiotic supple- mentation during pregnancy and breast-feeding reduces the risk of ecze- ma in the infant. J Allergy Clin Immunol 2012;130(6):1355-60.
21. Bertelsen RJ, Brantsaeter AL, Magnus MC, Haugen M, Myhre R, Ja- cobsson B, et al., Probiotic milk consumption in pregnancy and infan- cy and subsequent childhood allergic diseases. J Allergy Clin Immunol 2014;133(1):165-71
22. Azad MB, Coneys JG, Kozyrskyj AL, Field CJ, Ramsey CD, Becker AB, et al., Probiotic supplementation during pregnancy or infancy for the preven- tion of asthma and wheeze: systematic review and meta-analysis. BMJ 2013;347:f6471.
23. AlFaleh K, Anabrees J, Probiotics for prevention of necrotizing enterocoli- tis in preterm infants. Cochrane Database Syst Rev 2014(4):2-9.
24. Costeloe K, Hardy P, Juszczak E, Wilks M, Millar MR, Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial. The Lancet 2016;387(10019):649-60.
25. Kuitunen M, Kukkonen AK, Savilahti E, Impact of maternal allergy and use of probiotics during pregnancy on breast milk cytokines and food antibo- dies and development of allergy in children until 5 years. Int Arch Allergy Immunol 2012;159(2):162-70.
26. Luoto R, Laitinen K, Nermes M, Isolauri E, Impact of maternal probio- tic-supplemented dietary counseling during pregnancy on colostrum adi- ponectin concentration: a prospective, randomized, placebo-controlled study. Early Hum Dev 2012;88(6):339-44.
27. Ilmonen J, Isolauri E, Poussa T, Laitinen K, Impact of dietary counselling and probiotic intervention on maternal anthropometric measurements du- ring and after pregnancy: a randomized placebo-controlled trial. Clin Nutr 2011;30(2):156-64.
28. Dugoua J-J, Machado M, Zhu X, Chen X, Koren G, Einarson TR, Pro- biotic Safety in Pregnancy: A Systematic Review and Meta-analysis of Randomized Controlled Trials of Lactobacillus, Bifidobacterium, and Saccharomyces spp. Journal of Obstetrics and Gynaecology Canada 2009;31(6):542-52.
29. Elias J, Bozzo P, Einarson A, Are probiotics safe for use during pregnancy and lactation. Canadian Family Physician 2011;57(3):299-301.