Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial
Abstract
Background: Perinatal probiotics supplementation has been shown to be effective in the primary prevention
of atopic dermatitis (AD) in early childhood, although the long term effects of probiotics on AD and other
allergic diseases is less certain. We have previously reported a significant reduction in the cumulative
incidence of AD at 2 years after maternal probiotic supplementation. In this study we present the effects
of perinatal probiotics given to women from a general population on allergy related diseases in their offspring
at 6 years.
Methods: Four hundred and fifteen pregnant women were randomised to receive probiotic or placebo milk in
a double-blinded trial from 36 week gestation until 3 months postpartum. Probiotic milk contained Lactobacillus
rhamnosos GG, L. acidophilus La-5 and Bifidobacterium animalis subsp. lactis Bb-12. At 6 years, children were
re-assessed for AD, atopic sensitisation, asthma and allergic rhinoconjunctivitis (ARC).
Results: At 6 years, 81 and 82 children were assessed for AD in the probiotic and placebo groups, respectively.
In a multiple imputation analysis, there was as trend towards a lower cumulative incidence of AD in the
probiotic group compared to the placebo group (OR 0.64, 95 % CI 0.39-1.07, p = 0.086; NNT = 10). This finding
was statistically significantly in the complete case analysis (OR 0.48, 95 % CI 0.25-0.92, p = 0.027, NNT = 6). The
prevalence of asthma and atopic sensitisation, and the cumulative incidence of ARC were not significantly
affected by the probiotic regime at 6 years of age.
Conclusions: Maternal probiotic ingestion alone may be sufficient for long term reduction in the cumulative
incidence of AD, but not other allergy related diseases.
Trial registration: ClinicalTrials.gov identifier: NCT00159523
Keywords: Allergy, Asthma, Atopic dermatitis, Paediatrics, Prevention, Probiotics, Rhinitis