Neonatal and Pediatric Medicine
Open Access

Prebiotics; Pregnancy; Newborn; Gut microbiota; Lactation

Introduction

Pregnancy is a complex period in a woman’s life with many associated metabolic changes and potential complications. In recent years, many advances have been made in a short period of time regarding the management of healthy and morbid pregnancies to improve the quality of life during this period. During this time, the intestinal microbiota underwent major changes. Pregnancy is also associated with changes in nutritional needs, endocrine system and gut microbiota. Nutritional intervention is therefore a viable and costeffective adjunctive method to address these changes and achieve better outcomes. With this in mind, doctors often recommend vitamins, while other bioactive compounds are overlooked [1]. However, some women often resort to strict postpartum diets. In nutrition counseling for pregnant women, it is important to provide professionals with a variety of supportive strategies beyond the usual nutritional supplements and promote healthy eating patterns from the beginning of this period in the woman’s life. To achieve better outcomes in the quality of life of mothers and their offspring, it is important to emphasize the use of prebiotics as potential modulators of the gut microbiota. It may also help prevent or control certain pregnancy-related complications such as pre-eclampsia or infections, and prevent future diseases such as asthma or allergies in children. Contains beneficial bacteria such as Bifidobacterium and Streptococcus. All these genera transiently colonize the intestinal mucosa and support host flora metabolism. What is less well known, however, is the combination of these bioactive compounds with their favorable substrates, known as ‘prebiotics’. According to the International Scientific Association of Prebiotics and Probiotics (ISAPP), they are dietary components, including complex carbohydrates, which are selectively utilized by host microorganisms rather than human cells to provide health benefits [2].

What are prebiotics and which varieties exist

The term “prebiotics” was first coined by professors Emeritus Marcel Roberfroid and Glenn Gibson in a 1995 publication, where they explained the selective growth of colonic bifidobacterials boosted by the intact fibrous oligosaccharide inulin. They explained prebiotics as “nondigestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of one or a limited number of bacterial species already resident in the colon, and thus attempt to improve host health” [3]. Unusable by human cell enterocytes, prebiotics are therefore microbe food, usually consisting of plant dietary fibers with complex carbohydrates (short and long chain β-fructans [fructooligosaccharides, FOS and inulin], lactulose, and galactooligosaccharides, GOS) which can help the host flora, promoting their growth and/or boost supplemented probiotic effects. It is worthy of note that prebiotics can limit the growth of potential pathogenic bacteria as well. In 2008, the definition was refined to “dietary prebiotics”, which were described as “a selectively fermented ingredient that results in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon host health” [4]. This new definition relies on the nature of these bioactive ingredients, which are not only carbohydrates but also some polyphenols such as flavonols.The classification of prebiotics includes five groups: Noncarbohydrate oligosaccharides including fructans (FOS and inulin), GOS, resistant starch and glucose-derived oligosaccharides (such as polydextrose), pectin-derived oligosaccharides, and polyphenols (such as cocoaflavonols). All of these primarily stimulate lactobacilli and bifidobacteria, as well as intestinal bacteria, Bacteroidetes and Firmicutes. In addition, the term “synbiotics” is also used today. It refers to dietary supplements that contain both prebiotics and probiotics and Substrate Mixtures” [5].

Prebiotics for healthy pregnant women

A 2018 meta-analysis collected little evidence for the efficacy of prebiotics, but when combined with probiotics, taking these compounds during pregnancy increased or decreased the risk of preterm birth. It was concluded that no. Despite this argument, other goals can be pursued to balance the benefits of prebiotics versus no prebiotics during pregnancy [6].

The main reason for recommending prebiotics during pregnancy is the changing nutritional needs of pregnant women. Sheridan et al. During this phase of a woman’s life, i.e. between early and late pregnancy, the gut microbiota undergoes profound changes, with an increase in the relative abundance of Proteobacteria and Actinomycetes, and a general decrease in bacterial diversity. Aiming to promote healthy microbiota in this population, they suggested that these microbial changes could be addressed by designing more robust human studies using probiotic and prebiotic applications [7].

Indeed, some authors classify pregnancy as a ‘stressor’ that impairs barrier function by increasing serologic markers (such as zonulin and lipopolysaccharide) that increase intestinal permeability, and diet restores barrier function. It argues that this should be addressed by allowing Supplements containing prebiotics. However, it should also be noted that microbial changes during pregnancy are part of the immunosuppression that occurs in the maternal uterus to accept paternal antigens and prevent embryo rejection. To achieve this, the mother needs to increase her IgA and phagocytic cell concentrations thanks to lactobacilli and lower vaginal pH. These favorable changes are associated with preventing vertical transmission at birth. Therefore, it seems important to protect the vaginal microbiota. A randomized, double-blind, placebo-controlled study of maternal her FOS programming in the third trimester found a significant increase in Bifidobacterium species. Bifidobacterium longum in the intervention group at the end of pregnancy. Another randomized controlled trial in Indonesian pregnant women investigated the administration of milk rich in prebiotics, probiotics, DHA, and micronutrients and found that fecal concentrations of organisms used as probiotics A notable increase in uric acid was observed.Therefore, this evidence suggests that probiotic colonization is successful when combined with prebiotics and other micronutrients [8].

Prebiotics for pregnancy complications

Many pregnancies face metabolic problems such as hypertension, gestational diabetes, obese pregnancies, and metabolic syndrome. All of these complications can also affect the health of the mother and the health of the newborn. In fact, these complications are related to allergies, asthma, or skin problems in infants. Numerous studies agree that probiotics, prebiotics and symbiotic have health benefits associated with preventing the negative effects of pregnancy. In this line, Sohn and Underwood identified comorbid abnormalities as important factors involved in increased risk of pre-eclampsia, diabetes, infections, preterm birth, and (later) infantile atrophy. This maternal gut microbiota has been shown to be associated with the neonatal gut microbiota that causes infant colic. Therefore, administration of probiotics and prebiotics during pregnancy and lactation is recommended as a safe option to optimize these periods and avoid undesirable consequences. We comment on some pregnancy complications that have been found with some results. Most of them still lack clinical rigor, but are merely suggestions that represent new horizons in the treatment of these diseases [9].

Obese pregnancy

Obesity during pregnancy results in a maternal maximal index of 30 or higher. Obese women can suffer from enterobacteriosis and metabolic disorders that can lead to fetal damage or even miscarriage. It may increase the risk of other pregnancy complications, such as thromboembolism. Effects on the fetus can lead to increased risk of premature birth, neonatal death, and subsequent metabolic disorders.

Wiedmer and Herter-Aeberli describe the intergenerational cycle of obesity: Maternal gut microbiota induce changes in maternal metabolites and the placental microbiome, affecting fetal programming. The risk of childhood obesity is very high. In this subject, there are typically more animal models examining prebiotic use than human studies evaluating probiotics alone. Mouse and rat models were summarized. Effects seen in offspring included reduced symptoms of allergic asthma, prevention of food allergies, reduced severity of atopic dermatitis, reduced fat mass, improved immune response, and reduced risk of obesity [10].

Conclusions

Several conclusions can be drawn from the routes taken throughout the manuscript. First, maternal nutritional status during pregnancy is important for early microbial colonization of the newborn. Therefore, if you bet on having a nutrition program during pregnancy, you are taking care of both mother and baby. , are viable and inexpensive items to add to a newborn’s diet. Some clinical evidence suggests that these bioactive compounds can prevent allergies, colic, and other ailments in newborns. A combination of prebiotics and probiotics is necessary to ensure proper colonization of the infant’s gut microbiota. Furthermore, maternal probiotic colonization is successful when combined with prebiotics and other micronutrients.

Conversely, the information provided here revolves around the beneficial effects of prebiotics and treats them separately as soon as the search criteria include only the word “prebiotic”. However, it should also be taken into account that there is therapeutic evidence in the scientific literature regarding dietary patterns and nutritional interventions based on the Mediterranean diet, which is known to contain many prebiotic-rich foods, fruits and vegetables. This is very important as expert opinion argues that nutrients and bioactive compounds have higher bioavailability in food matrices and can act synergistically when combined. Therefore, in healthy women, a healthy diet should be a priority, and supplementation with a prebiotic formula should be considered if diet alone can meet some needs.

Because these benefits can be observed over time, scientists should also be encouraged to conduct long-term studies from neonates through adolescence and even adolescence. Another issue in the literature is that each individual has a specific microbial makeup, and probiotic and prebiotic supplements must target each gut specifically.

When looking for scientific evidence for nutritional interventions in pregnant women, the current trend seems to be towards vitamin and mineral supplementation, but the focus is on how to reliably establish a healthy microbiome from prenatally there are few hypotheses. In this sense, not much is known about prebiotics. However, like other nutrients, they have no associated effects per se, but are essential elements in a healthy nutritional context. In addition, they are fundamental components of probiotic colonization for developing a competent intestinal immune system, both prenatally and postnatally in preventing many diseases in both mother and child it’s helpful.

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