Data published in Acta Obstetricia et Gynecologica Scandinavica indicated that Lactiplantibacillus plantarum 299v (Lp299v) plus low dose of iron (4.2 mg), folic acid, and ascorbic acid was associated with a prevalence of iron deficiency of 59% at week 35 of the pregnancy, compared to 78% in the placebo group.
In addition, the prevalence of iron deficiency anemia was only 7.4% in the probiotic group, compared to 21% in the placebo group, report researchers from Probi AB, Lund University, and the University of Gothenburg.
“To the best of our knowledge, this is the first study which evaluates a new, more physiological approach to improve iron status during pregnancy using probiotics,” wrote the researchers, led by Ulrika Axling, PhD, of Probi AB.
A major public health problem
According to global estimates, as many as 40% of pregnant women may suffer from anemia, which is caused by iron deficiency. The Swedish researchers not that this makes iron deficiency a “major public health problem”.
Iron deficiency anemia during pregnancy may increase the risk of preterm birth, lead to low birth weight infants, increased risks of infant mortality, and is associated with neuro-developmental disorders in the babies.
“We have previously shown that the Lp299v strain together with a low dose of iron increase iron absorption. With this study, we proved that this translates into an improved iron status in pregnant women,” said Dr Axling.
“Iron deficiency is especially common during pregnancy and high-dose iron supplements are often recommended. Since these typically come with side effects such as stomach pain and constipation, there is a need for new solutions. This probiotic product could offer a novel and safe approach for improving iron status during pregnancy.”
Dr Axling and her co-workers recruited 326 healthy, non-anemic, pregnant Swedish women and randomly assigned them to receive Lp299v (10 billion CFUs) plus low-dose iron (4.2 mg), folic acid (30 micrograms), and vitamin C 12 mg) or placebo two times per day from gestational week 10 to 12 until the end of pregnancy (or until a midwife advised that the women received iron therapy).
The results showed that, in addition to the significant reductions in the prevalence of iron deficiency and iron deficiency anemia in the probiotic group, Lp299v was also associated with significantly smaller decreases in hemoglobin levels during pregnancy, compared to the placebo.
No differences between the groups were reported for gestational length and birth weight, while there were also no differences between the groups in the proportion of women reporting adverse events.
Commenting on the potential mechanism(s) of action, Dr Axling and her co-workers noted that this is not yet fully elucidated but “may be related to the presence of Lp299v in the first section of the small intestine, where iron absorption takes place, and the increase in available Fe3+ species and DcytB [an emzyme that plays a role in iron absorption in the intestine].
“The absorption of the iron included in the capsule as well as that of dietary iron could be influenced by Lp299v and therefore the women were advised to consume the capsules in connection with a meal.”
The researchers concluded that L. plantarum 299v combined with low-dose iron, folic acid, and vitamin C from early pregnancy is “safe and improves iron status during pregnancy”.
Source: Acta Obstetricia et Gynecologica Scandinavica
Published online ahead of print, doi: 10.1111/aogs.14153
“The effect of Lactiplantibacillus plantarum 299v together with a low dose of iron on iron status in healthy pregnant women: A randomized clinical trial”
Authors: U. Axling et al.