Background: Gestational diabetes mellitus was associated with increased risks of complications during pregnancy and delivery. The efficacy of probiotics for preventing atopic disease among overweight and obese pregnant women has not been a unified conclusion. Therefore, we aimed to determine the efficacy and safety of probiotics supplementation for overweight and obese pregnant women. Methods: We searched the Cochrane Library, Embase, PubMed, and Web of Science for randomized controlled trials from the earliest publication date available to September 23, 2020, regardless of language or publication status. Two reviewers independently extracted data with a standardized form. When disagreements arose, a third investigator was consulted. Data was pooled using the generic inverse variance method and expressed as mean differences and relative risk with 95% confidence interval (CI). Heterogeneity was measured and quantified by I-2 statistic. Results: There were no significant differences between probiotics and placebo on GDM (RR = 1.03; 95% CI, 0.81-1.30; P = 0.821; I-2 = 38.7%, P = 0.180), excess gestational weight gain (RR = 0.92; 95% CI, 0.79 -1.06; P = 0.223; I-2 = 91.2%, P = 0.001) and neonatal birth weight (WMD = 28.47; 95% CI, -34.80-91.73; P = 0.383; I-2 = 4.5%, P = 0.381). In addition, probiotics might increase the risk of preeclampsia including superimposed (RR = 1.91; 95% CI, 1.03-3.55; P = 0.001; I-2 = 0.0%, P = 0.994). Conclusions: Probiotics had no better efficacy for prevention of atopic disease in overweight or obese pregnant women. In contrast, excessive probiotics supplementation might increase the risk of preeclampsia. More data will be necessary to determine the prevention efficacy of probiotics with consideration of real-world and other epidemiological settings. (C) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Growing evidence underlines the pivotal role of infant gut colonization in the development of the immune system. The possibility to modify gut colonization through probiotic probiotic supplementation during pregnancy and early infancy in preventing atopic diseases. PubMed, Embase and Cochrane Library were searched for randomized-controlled trials evaluating the use of probiotics during pregnancy or early infancy for prevention of allergic diseases. Fixed-effect models were used, and random-effects models where significant heterogeneity was present. Results were expressed as risk ratio (RR) with 95% confidence interval (CI). Seventeen studies, reporting data from 4755 children (2381 in the probiotic group and 2374 in the control group), were included in the meta-analysis. Infants treated with probiotics had a significantly lower RR for eczema compared to controls (RR 0.78 [95%CI: 0.69-0.89], p=0.0003), especially those supplemented with a mixture of probiotics (RR 0.54 [95%CI: 0.43-0.68], p<0.00001). No significant difference in terms of prevention of asthma (RR 0.99 [95%CI: 0.77-1.27], p=0.95), wheezing (RR 1.02 [95%CI: 0.89-1.17], p=0.76) or rhinoconjunctivitis (RR 0.91 [95%CI: 0.67-1.23], p=0.53) was documented. The results of the present meta-analysis show that probiotic supplementation prevents infantile eczema, thus suggesting a new potential indication for probiotic use in pregnancy and infancy. This article is protected by copyright. All rights reserved