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

Debra J. Palmer; Alana R. Cuthbert; Thomas R. Sullivan; Rachelle Ann Pretorius; Johan Garssen; K. Rueter; Maria C. Jenmalm; Jeffrey Keelan; Desiree T Silva; Susan L. Prescott

doi:10.1016/j.jaci.2024.08.009

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

Journal article

Open access

Peer reviewed

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

Debra J. Palmer, Alana R. Cuthbert, Thomas R. Sullivan, Rachelle Ann Pretorius, Johan Garssen, K. Rueter, Maria C. Jenmalm, Jeffrey Keelan, Desiree T Silva and Susan L. Prescott

Journal of Allergy and Clinical Immunology

2024

DOI: https://doi.org/10.1016/j.jaci.2024.08.009

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Abstract

gut microbiota

maternal nutrition

immunology

Infant nutrition

Allergy

Immunology

Obstetrics and gynaecology

Nutrition and dietetics

Women's and maternal health

Neonatal and child health

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 We sought to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk. Methods We undertook a double-blind randomized controlled trial in which pregnant women were allocated to consume prebiotics (14.2 g daily of galacto-oligosaccharides and fructo-oligosaccharides in the ratio 9:1) or placebo (8.7 g daily of maltodextrin) powder from less than 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 medically diagnosed infant eczema by age 1 year, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by age 1 year. Results A total of 652 women were randomized between June 2016 and November 2021 (329 in the prebiotics group and 323 in the placebo group). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by age 1 year (prebiotics 31.5% [103 of 327 infants] vs placebo 32.6% [105 of 322 infants]; adjusted relative risk, 0.98; 95% CI, 0.77-1.23; P = .84). Secondary outcomes and safety measures also did not significantly differ between groups. Conclusions We found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of medically diagnosed infant eczema by age 1 year in infants who are at hereditary risk of allergic disease.

Details

Title: Effects of pregnancy and lactation prebiotics supplementation on infant allergic disease: a randomized controlled trial.
Authors/Creators: Debra J. Palmer - The Kids Research Institute Australia
Alana R. Cuthbert - South Australian Health and Medical Research Institute
Thomas R. Sullivan - South Australian Health and Medical Research Institute
Rachelle Ann Pretorius - Murdoch University, School of Medical, Molecular and Forensic Sciences
Johan Garssen
K. Rueter - Princess Margaret Hospital for Children
Maria C. Jenmalm
Jeffrey Keelan - The University of Western Australia
Desiree T Silva - The University of Western Australia
Susan L. Prescott - Murdoch University
Publication Details: Journal of Allergy and Clinical Immunology
Publisher: Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.
Identifiers: 991005701669607891
Murdoch Affiliation: School of Medical, Molecular and Forensic Sciences
Language: English
Resource Type: Journal article

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