Probiotic interventions to reduce antepartum Group B streptococcus colonization: A systematic review and...

Area of Science:

• Microbiology
• Obstetrics and Gynecology
• Preventive Medicine

Background:

• Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and mortality.
• Antenatal GBS colonization poses risks to newborns during delivery.
• Current prevention strategies primarily rely on intrapartum antibiotic prophylaxis, which has limitations.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of probiotic interventions in reducing antenatal GBS colonization.
• To evaluate the safety and effectiveness of probiotics as a primary prevention strategy for GBS.

Main Methods:

• Systematic review and meta-analysis of published studies.
• Inclusion of studies on probiotic interventions containing Lactobacillus or Streptococcus species.
• Analysis of clinical trials involving antenatal participants with known or unknown GBS status.

Main Results:

• The meta-analysis included six clinical trials (n=709) and found that antenatal probiotics decreased the probability of a positive GBS result by 44% (OR=0.56, p=0.02).
• In vitro studies demonstrated that probiotics exhibit antagonistic activity against GBS through acidification, immune modulation, and adhesion.
• Only one of the ten reviewed clinical trials had a low risk of bias.

Conclusions:

• Probiotics represent a moderately effective intervention for reducing antenatal GBS colonization.
• Probiotic interventions appear safe and effective for primary prevention of antenatal GBS colonization.
• Further well-controlled trials with diverse populations are necessary to elucidate influencing variables and confirm clinical utility.