Feasibility of Oral Prenatal Probiotics against Maternal Group B Streptococcus Vaginal and Rectal Colonization

Abstract

ObjectiveTo examine the effect of an oral prenatal probiotic on group B Streptococcus (GBS) colonization and to demonstrate the feasibility of a larger randomized controlled trial. DesignThis pilot study was an open‐label, two‐group quasi‐experiment. SettingAn urban central city nurse‐midwifery and wellness center serving a diverse population. ParticipantsTen pregnant participants received the oral probiotic (Florajen3) taken once daily, and 10 participants served as controls. MethodsA questionnaire on dietary practices, vaginal cleansing, sexual history, and symptoms and GBS colony count samples were taken at 28‐, 32‐, and 36‐weeks gestation. ResultsParticipants in the probiotic group reported no adverse events or minor side effects; one half reported improved gastrointestinal symptoms. Although two women in each group had positive qualitative prenatal GBS cultures at 36 weeks, the probiotic group participants had lower quantitative GBS colony counts. The eight GBS negative averaged 90% probiotic adherence compared with two GBS positive women who averaged 68%. Yogurt ingestion was inversely related (p= .02) to GBS colonization. ConclusionsPrenatal probiotic therapy has the potential to reduce GBS colonization. The potential of the probiotic intervention appears to be linked to daily adherence. A controlled clinical trial with a larger, adequately powered sample is feasible and justified.