Oral Probiotics to Prevent Recurrent Vulvovaginal Infections During Pregnancy-Multicenter Double-Blind, Randomized,...

Area of Science:

• Obstetrics and Gynecology
• Microbiology
• Pharmacology

Background:

• Vulvovaginal infections (VVIs), including abnormal vaginal flora (AVF), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC), are common during pregnancy.
• These infections are associated with serious complications and maternal discomfort.
• Secondary prevention strategies for VVIs in pregnant women are crucial.

Purpose of the Study:

• To evaluate the effectiveness of oral probiotics in the secondary prevention of VVIs in pregnant women.
• To determine if oral probiotics can reduce the recurrence rate of VVIs after initial treatment.

Main Methods:

• A multicenter, prospective, randomized, double-blind, placebo-controlled trial.
• Pregnant women with treated VVIs received either oral probiotics (containing specific Lactobacillus and Bifidobacterium strains) or a placebo daily until delivery.
• Vaginal microbiota and VVI recurrence were monitored monthly or upon symptom onset; specific probiotic strain colonization was assessed using MALDI-TOF-MS.

Main Results:

• No significant difference in the overall rate of VVI recurrence was observed between the probiotic group (67%) and the placebo group (48%) (p = 0.19).
• Time to first infection and pregnancy outcomes did not differ between the groups.
• No vaginal colonization by the administered probiotic strains was detected in any participant.

Conclusions:

• The tested oral probiotic formulation did not demonstrate efficacy in reducing the recurrence of VVIs in pregnant women.
• Further research may be needed to explore alternative probiotic strains or delivery methods for VVI prevention in pregnancy.
• Current oral probiotic supplementation showed no benefit for secondary prevention of VVIs in this study population.