Introduction: Mental health disorders (i.e., depression, anxiety) affecting women during the perinatal period have long-lasting negative effects on both mother and child. Gut microbiota dysbiosis has been linked with the development of mental health disorders. Supplementation with prebiotics, probiotics, and synbiotics has been proposed to rebuild gut microbiota composition. This systematic review (PROSPERO 2019 CRD42019137158) evaluated the evidence on the effectiveness of prebiotics, probiotics, and synbiotics taken during pregnancy to reduce the risk of developing maternal mental health disorders in the perinatal period.
Methods: Comprehensive literature searches of 7 databases were conducted, from database inception to April 2019, to identify randomized controlled trials (RCTs) and observational studies that assessed the objective. Two independent reviewers conducted study selection, data extraction/analysis, and risk of bias assessment.
Results: From the 1,639 studies identified through the search strategy, two RCTs of low risk of bias were included in the review. One RCT compared mental health scores of pregnant women that were given probiotic yogurt versus conventional yogurt; probiotic yogurt did not have a significantly different effect on mental health scores. The second RCT compared depression and anxiety scores of pregnant women given probiotic capsules versus placebo; women in the probiotics group had significantly lower depression and anxiety scores postpartum. No RCTs were identified that assessed the effect of prebiotics and synbiotics on perinatal mental health disorders. Three ongoing RCTs were identified and will be included in a review update upon their publication.
Conclusion: This systematic review summarized the limited and inconclusive evidence about the effectiveness of probiotics during pregnancy and highlights the lack of evidence on prebiotics and synbiotics supplementation for similar purposes. There is a huge knowledge gap and more research is needed to assess the effect of prebiotics, probiotics, and synbiotics on maternal mental health in the perinatal period.
Stuart Lau– BSc Student, McGill University
Omolara Sanni– Postdoctoral Fellow, University of Alberta
Anita Kozyrskyj– Adjunct Professor, University of Alberta
Liz Dennett– Research Librarian, University of Alberta
Jens Walter– Associate Professor, University of Alberta
Maria Ospina– Assistant Professor, University of Alberta