Effects of pregnancy and lactation prebiotics supplementation on infant allergic disease: a randomized controlled trial.

Allergy prevention eczema infant lactation maternal diet prebiotics pregnancy randomized controlled trial

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
20 Aug 2024
Historique:
received: 21 04 2024
revised: 29 07 2024
accepted: 08 08 2024
medline: 23 8 2024
pubmed: 23 8 2024
entrez: 22 8 2024
Statut: aheadofprint

Résumé

Ingestion of prebiotics during pregnancy and lactation may have immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases. The aim of this trial was to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk. We undertook a double-blind, randomized controlled trial in which pregnant women were allocated to consume prebiotics (14.2g daily of galacto-oligosaccharides and fructo-oligosaccharides in ratio 9:1) or placebo (8.7g daily maltodextrin) powder from <21 weeks gestation until 6-months postnatal during lactation. Eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was infant medically diagnosed eczema by 1-year of age, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by 1-year of age. 652 women were randomized between June 2016 and November 2021 (n=329 prebiotics, n=323 placebo). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by 1-year of age (prebiotics 31.5% (103/327 infants) compared to placebo 32.6% (105/322 infants); adjusted relative risk 0.98 (95% CI 0.77, 1.23; p=0.84). Secondary outcomes and safety measures also did not significantly differ between groups. We found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of infant medically diagnosed eczema by 1-year of age in infants who are at hereditary risk of allergic disease.

Sections du résumé

BACKGROUND BACKGROUND
Ingestion of prebiotics during pregnancy and lactation may have immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases.
OBJECTIVE OBJECTIVE
The aim of this trial was to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk.
METHODS METHODS
We undertook a double-blind, randomized controlled trial in which pregnant women were allocated to consume prebiotics (14.2g daily of galacto-oligosaccharides and fructo-oligosaccharides in ratio 9:1) or placebo (8.7g daily maltodextrin) powder from <21 weeks gestation until 6-months postnatal during lactation. Eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was infant medically diagnosed eczema by 1-year of age, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by 1-year of age.
RESULTS RESULTS
652 women were randomized between June 2016 and November 2021 (n=329 prebiotics, n=323 placebo). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by 1-year of age (prebiotics 31.5% (103/327 infants) compared to placebo 32.6% (105/322 infants); adjusted relative risk 0.98 (95% CI 0.77, 1.23; p=0.84). Secondary outcomes and safety measures also did not significantly differ between groups.
CONCLUSION CONCLUSIONS
We found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of infant medically diagnosed eczema by 1-year of age in infants who are at hereditary risk of allergic disease.

Identifiants

DOI: 10.1016/j.jaci.2024.08.009 PMID: 39173718
pubmed: 39173718
pii: S0091-6749(24)00859-5
doi: 10.1016/j.jaci.2024.08.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Debra J Palmer (DJ)

Telethon Kids Institute, The University of Western Australia, Nedlands, WA Australia; School of Medicine, The University of Western Australia, Crawley, WA, Australia. Electronic address: debbie.palmer@uwa.edu.au.

Alana R Cuthbert (AR)

SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.

Thomas R Sullivan (TR)

SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; School of Public Health, The University of Adelaide, Adelaide, SA, Australia.

Rachelle A Pretorius (RA)

Telethon Kids Institute, The University of Western Australia, Nedlands, WA Australia; School of Medicine, The University of Western Australia, Crawley, WA, Australia.

Johan Garssen (J)

Division of Pharmacology Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands; Nutricia Research, Utrecht, The Netherlands.

Kristina Rueter (K)

School of Medicine, The University of Western Australia, Crawley, WA, Australia; Department of Immunology and Dermatology, Perth Children's Hospital, Nedlands, WA, Australia.

Maria C Jenmalm (MC)

Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.

Jeffrey A Keelan (JA)

School of Medicine, The University of Western Australia, Crawley, WA, Australia; School of Biomedical Sciences, The University of Western Australia, Crawley, WA, Australia.

Desiree Silva (D)

Telethon Kids Institute, The University of Western Australia, Nedlands, WA Australia; School of Medicine, The University of Western Australia, Crawley, WA, Australia; Joondalup Health Campus, Joondalup, WA, Australia; Edith Cowan University, Perth, WA, Australia.

Susan L Prescott (SL)

Telethon Kids Institute, The University of Western Australia, Nedlands, WA Australia; School of Medicine, The University of Western Australia, Crawley, WA, Australia; Department of Immunology and Dermatology, Perth Children's Hospital, Nedlands, WA, Australia; Nova Institute for Health, Baltimore, Maryland, United States.

Classifications MeSH