Cranberry Supplements for Urinary Tract Infection Prophylaxis in Pregnant Women: A Systematic Review of Clinical Trials and Observational Studies on Efficacy, Acceptability, Outcomes Measurement Methods, and Studies' Feasibility.

Abstract

Cranberry supplements are commonly used to prevent urinary tract infections (UTIs).However, their usefulness is uncertain in pregnant women.We aimed to comprehensively summarize the current knowledge on cranberry supplements' efficacy and acceptability during pregnancy in addition to the outcomes measurementmethods and studies' feasibility. To achieve it, wesearched PubMed, PMC, and Europe PMC databases plus screened citations followed bycritical appraisal of included eligible English-written primary studies that(1) focused on pregnant women supplemented with any cranberry supplements; (2) provided data on cranberry supplements' efficacy, acceptability, outcomes measurementmethods, and studies' feasibility;(3) included human subjects; and (4) published worldwide.Two randomized clinical trials (RCTs) and one nested cohort study, including 1156 pregnant women in total, contributed to our analysis.A tendency toward UTI reduction was demonstrated, although the results' validity was impacted by significantjuice-induced gastrointestinal intolerance(23%; 44 of 188 subjects).Changing the form of supplementation from cranberry juice to capsules reduced the issue,causing side effects inone of 49subjects (2%). Nevertheless, both RCTs still experienced significant recruitment andretention problems, which wereat 33% and59% onaverage, respectively.Newly acquired safety data on 919 more subjects suggests no increased risks of all malformations, vaginal bleeding, and neonatal complications. Investigating cranberry capsules' efficacy as a non-antibacterial option for UTI prevention in pregnant women has become a feasible and important direction with the current advancement in understanding cranberry supplements' actions, recommended doses plus regimens, and their safety in the population. We reviewed the challenges and discovered knowledge gaps and the implementation strategies for future studies.