Validation of the In-utero Transmission of Probiotics

Overview

This pilot project aims at confirming the in-utero transmission of probiotics, from the mother to the baby. Women aged 18 to 42 years, with a single pregnancy, considered low risk will be approached for this study. Women will take the investigational products between 34 weeks of pregnancy up to 10 days post-partum. Investigational products are probiotics (5 bacterial strains) compared to placebo.

Full Title of Study: “Validation of the In-utero Transmission of Probiotics From the Mother to the Baby: A Randomized Crossover Pilot Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Basic Science
    • Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: August 28, 2023

Detailed Description

Rational: Studies have shown that probiotics given to babies can reduce perinatal complications. A change of practice should therefore be introduced in the management of premature newborns. However, one could assume that probiotic administration before birth could be as effective if not more. Indeed, one could hypothesise that when the newborn is exposed to probiotics earlier, the protective effect is potentially increased. Objective: This pilot project aims at confirming the in-utero transmission of probiotics, from the mother to the baby. Population: Women aged 18 to 42 years, with a single pregnancy, considered low risk will be approached for this study Products under study: Probiotics containing 5 bacterial strains (total of 12 million colony-forming unit / day) vs. Placebo. Procedure: At 32-33 weeks, participants will complete questionnaires (medical, obstetrical, socio-demographic data) and will be randomized (double-blind) in one of the 2 following groups: Group A: taking probiotics every day from the 34th week of pregnancy until delivery; taking placebo for 10 days after delivery. Group B: taking placebo every day from the 34th week of pregnancy until delivery; taking probiotics for 10 days after delivery. Follow-up: All women will complete a logbook to monitor the study products intake and monitor side effects until the end of the study (10 days postpartum). Samples: maternal stool samples, vaginal secretions, stool (and meconium) as well as breast milk (and colostrum) will be taken at different times of the study to confirm the presence of probiotics and transmission between the mother and the baby.

Interventions

  • Biological: Natural products: Probiotics
    • Probiotics intake every day (1.5 gram) from 34 weeks of gestation to delivery OR from delivery to 10 days postpartum
  • Other: Placebo
    • Placebo intake every day (1.5 gram) from 34 weeks of gestation to delivery OR from delivery to 10 days postpartum

Arms, Groups and Cohorts

  • Active Comparator: prenatal probiotic
    • will take probiotics every day from the 34th week of pregnancy until delivery; taking placebo for 10 days after delivery
  • Active Comparator: postnatal probiotic
    • will take placebo every day from the 34th week of pregnancy until delivery; taking probiotics for 10 days after delivery

Clinical Trial Outcome Measures

Primary Measures

  • in-utero transmission of probiotic
    • Time Frame: at birth
    • presence (yes or no) of probiotic (specific bacterial strains) in neonate meconium

Secondary Measures

  • transmission of probiotic to colostrum
    • Time Frame: at birth
    • presence(yes or no) of probiotic (specific bacterial strains) in colostrum
  • transmission of probiotic to maternal milk
    • Time Frame: 10 days postpartum
    • presence (yes or no) of probiotic (specific bacterial strains) in breastmilk
  • transmission of probiotic to maternal vaginal tract
    • Time Frame: 37 weeks of gestation
    • presence (yes or no) of probiotic (specific bacterial strains) in maternal vaginal swab
  • transmission of probiotic to maternal gut
    • Time Frame: 37 weeks of gestation
    • presence (yes or no) of probiotic (specific bacterial strains) in maternal stools
  • postnatal transmission of probiotic to the neonate
    • Time Frame: 10 days postpartum
    • presence (yes or no) of probiotic (specific bacterial strains) in neonate stools

Participating in This Clinical Trial

Inclusion Criteria

  • Women with a single pregnancy – Women with a low risk pregnancy – Women wishing to breastfeed at birth – Women randomized between 32 0/7 – 33 6/7 weeks of gestation Exclusion Criteria:

  • History of obstetric complications (prematurity <37 weeks, preeclampsia , gestational diabetes treated with insulin) – Obstetric or fetal complications known for current pregnancy such as threaten preterm labor (premature rupture of membranes or preterm labor), chorioamnionitis, placenta previa, active vaginal bleeding, cervical cerclage, fetal distress or anomalies, corticosteroid therapy – Risk factors for obstetric complications during current pregnancy such as gestational diabetes, type I / II diabetes and high blood pressure (systole ≥140 and diastole ≥90) – Antibiotic use within 2 weeks before randomisation – Intake of probiotics or foods enriched with active cultures (fermented milk, kefir, kombucha …) within 2 weeks before randomisation – Women positive for Group B Streptococcus during previous pregnancies – Weakened immune system (AIDS, lymphoma, chemoradiotherapy or corticotherapy, immunosuppressive pathology) – Allergy or intolerance to lactose, soy or yeast. – Women under Coumadin – Women who plan to give birth outside the participating center – Women who do not plan to breastfeed or extract their milk in the first 10 days after delivery.

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: 42 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Centre de recherche du Centre hospitalier universitaire de Sherbrooke
  • Collaborator
    • Lallemand Health Solutions
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Jean-Charles Pasquier, MD, Principal Investigator, CIUSSS-Estrie-CHUS hospital

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