Probiotics supplementation during pregnancy or infancy on multiple food allergies and gut microbiota: a systematic review and meta-analysis

Abstract

Context: Probiotics show promise in preventing and managing food allergies, but the impact of supplementation during pregnancy or infancy on children's allergies and gut microbiota remains unclear.

Objective: This study aimed to assess the effects of maternal or infant probiotic supplementation on food allergy risk and explore the role of gut microbiota.

Data sources: A systematic search of databases (PubMed, Cochrane Library, Embase, and Medline) identified 37 relevant studies until May 20, 2023.

Data extraction: Two independent reviewers extracted data, including probiotics intervention details, gut microbiota analysis, and food allergy information.

Data analysis: Probiotics supplementation during pregnancy and infancy reduced the risk of total food allergy (relative risk [RR], 0.79; 95% CI, 0.63-0.99), cow-milk allergy (RR, 0.51; 95% CI, 0.29-0.88), and egg allergy (RR, 0.57; 95% CI, 0.39-0.84). Infancy-only supplementation lowered cow-milk allergy risk (RR, 0.69; 95% CI, 0.49-0.96), while pregnancy-only had no discernible effect. Benefits were observed with over 2 probiotic species, and a daily increase of 1.8 × 109 colony-forming units during pregnancy and infancy correlated with a 4% reduction in food allergy risk. Children with food allergies had distinct gut microbiota profiles, evolving with age.

Conclusions: Probiotics supplementation during pregnancy and infancy reduces food allergy risk and correlates with age-related changes in gut microbial composition in children.

Systematic review registration: PROSPERO registration no. CRD42023425988.

Keywords: children; food allergy; gut microbiota; meta-analysis; probiotics supplementation.

Figure 1

Flow diagram of the literature search process.

Figure 2

Forest plots of randomized controlled trials for probiotic supplementation during pregnancy and infancy on (a) total food allergy, (b) cow-milk allergy, (c) egg allergy, and (d) peanut allergy and (e) forest plot of randomized controlled trials for probiotic supplementation on tolerance towards food. Abbreviation: M-H, Mantel-Haenszel.

Figure 3

Forest plots of randomized controlled trials for probiotic supplementation during infancy on (a) total food allergy, (b) cow-milk allergy, (c) egg allergy, and (d) peanut allergy. Abbreviation: M-H, Mantel-Haenszel.

Figure 4

Differentially abundant microbial taxa in children with age progression. Blue cells indicate increases and orange cells indicate decreases.

Figure 5

Schematic mechanisms by which probiotic and gut bacteria modulate food allergy in children. Abbreviations: DC, dendritic cell; FcεRI, Fc-epsilon receptor I; GPR, G protein–coupled receptor; IFN-γ, interferon-γ; IgA, immunoglobulin A; IgE, immunoglobulin E; IL, interleukin; SCFA, short-chain fatty acid; Th, T-helper; Tregs, regulatory T cells.