Table 1.
Characteristics of randomized control trials included in this meta-analysis.
| First Author | Study Design | Sample Size | Study Population | Washout Period |
Probiotics Intervention | Requirement of Hypoglycemic Agents during Intervention |
Compliance (%) Side Effects |
Outcomes Measured | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Year, Reference |
Country Dx of GDM |
Total | Gravida Status | Age (Years) | Probiotics Antibiotics | Probiotic Species |
Vehicle Dosage (CFU) Frequency Duration |
|||||
| I | C | Gestational Age | I | C | ||||||||
| Babadi 2019, [51] |
P, RCT, DB Iran 2-h 75 g OGTT |
48 24 24 |
Primigravida 24–28 weeks |
28.3 ± 4.3 | 29.0 ± 4.2 | NR NR |
B. bifidum
L. acidophilus L. casei L. fermentum |
Capsule 2 × 109 CFU/g each Once daily 6 weeks |
No | >90% No |
Genetic Glycemic Lipid Inflammatory Oxidative stress Weight gain |
|
| Badehnoosh 2018, [20] |
P, RCT, DB Iran 2-h 75 g OGTT |
60 30 30 |
Primigravida 24–28 weeks |
28.8 ± 5.4 | 27.8 ± 3.7 | NR NR |
B. bifidum
L. acidophilus L. casei |
Capsule 2 × 109 CFU/g each Once daily 6 weeks |
Yes—5 women (3-I and 2-C) |
100% NR |
Inflammatory Glycemic Oxidative stress Pregnancy 3 |
|
| Dolatkhah 1 2015, [46] Hajifaraji 2 2018, [47] |
P, RCT, DB Iran 2-h 75 g OGTT |
56 29 27 |
Primigravida 24–28 weeks |
28.1 ± 6.2 | 26.5 ± 5.2 | 2 weeks 4 weeks |
B. BB-12 L. acidophilus LA-5 L. delbrueckii Bulgaricus LBY-27 Streptococcus thermophilus STY-31 |
Capsule 4 biocap > 4 × 109 CFU Once daily 8 weeks |
Yes—4 women (2-I and 2-C) |
100% No |
Glycemic Inflammatory Oxidative stress Weight gain |
|
| Jafarnejad 2016, [52] |
P, RCT, DB Iran 2-h 75 g OGTT |
72 37 35 |
Primigravida, Multigravida ~26 weeks |
32.4 ± 3.1 | 31.9 ± 4.0 | 10 days NR |
B. breve, B. longum B. infantis, L. acidophilus L. plantarum, L. paracasei L. delbrueckii subsp. Bulgaricus Streptococcus thermophilus |
VSL#3 capsule 112.5 × 109 CFU/capsule Twice daily 8 weeks |
Yes—7 women (2-I and 5-C) |
NR No |
Glycemic Inflammatory |
|
| Jamilian 2019,[53] |
P, RCT, DB Iran 2-h 75 g OGTT |
57 29 28 |
Primigravida 24–28 weeks |
31.2 ± 5.9 | 29.9 ± 3.7 | 3 months NR |
B. bifidum
L. acidophilus L. casei L. fermentum |
Capsule 8 × 109 CFU/g Once daily 6 weeks |
Yes—3 women (1-I and 2-C) |
100% NR |
Glycemic Lipid Inflammatory Oxidative stres Pregnancy 3 |
|
| Karamali 2016, [54] |
P, RCT, DB Iran 2-h 75 g OGTT |
60 30 30 |
Primigravida 24–28 weeks |
31.8 ± 6.0 | 29.7 ± 4.0 | NR NR |
B. bifidum
L. acidophilus L. casei |
Capsule 2 × 109 CFU/g each Once daily 6 weeks |
No | >90% No |
Glycemic Lipid Weight gain |
|
| Kijmanawat 2019, [56] |
P, RCT, DB Thailand 2-h 75 g OGTT |
57 28 29 |
Primigravida 24–28 weeks |
32.5 ± 5.0 | 30.7 ± 5.1 | 2 weeks 4 weeks |
B. bifidum
L. acidophilus |
Capsule 1 × 109 CFU/each Once daily after meal 4 weeks |
No | >90% No |
Glycemic Weight gain Neonatal |
|
| Lindsay 2015, [57] |
P, RCT, DB Ireland 3-h 100 g OGTT |
100 48 52 |
Primigravida 18–34 weeks Included both IGT and GDM |
33.5 ± 5.0 | 32.6 ± 4.5 | NR NR |
L. salivarius UCC118 | Capsule 100 mg at 109 CFU Once daily after meal 4–6 weeks |
Yes—15 women (9-I and 6-C) |
NR NR |
Glycemic Lipid Pregnancy 3 |
|
| Sahhaf Ebrahimi 2019, [55] | P, RCT, DB Iran 2-h 75 g OGTT |
84 42 42 |
NR 24–28 weeks |
31.6 ± 6.0 | 31.6 ± 5.5 | 1 week NR |
B. lactis
L. acidophilus |
Yogurt 300 g/day (106 CFU) Once daily 8 weeks |
No | NR NR |
Glycemic Neonatal |
|
Dx, diagnosis; GDM, Gestational diabetes mellitus; OGTT, oral glucose tolerance test; IGT, impaired glucose tolerance; I, intervention/probiotics group; C, control/placebo group; CFU, colony forming unit; P, parallel; RCT, randomized control trial; DB, double-blind; NR, not reported; B., Bifidobacterium; L., Lactobacillus. 1,2 Both articles used the same population but published different outcomes. 3Pregnancy (maternal and neonatal outcomes).