Abstract
Background: Ingestion of prebiotics during pregnancy and lactation may have immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases. Objective: We sought to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk. Methods: We undertook a double-blind randomized controlled trial in which pregnant women were allocated to consume prebiotics (14.2 g daily of galacto-oligosaccharides and fructo-oligosaccharides in the ratio 9:1) or placebo (8.7 g daily of maltodextrin) powder from less than 21 weeks’ gestation until 6 months postnatal during lactation. Eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was medically diagnosed infant eczema by age 1 year, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by age 1 year. Results: A total of 652 women were randomized between June 2016 and November 2021 (329 in the prebiotics group and 323 in the placebo group). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by age 1 year (prebiotics 31.5% [103 of 327 infants] vs placebo 32.6% [105 of 322 infants]; adjusted relative risk, 0.98; 95% CI, 0.77-1.23; P = .84). Secondary outcomes and safety measures also did not significantly differ between groups. Conclusions: We found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of medically diagnosed infant eczema by age 1 year in infants who are at hereditary risk of allergic disease.
Keywords
Allergy prevention, eczema, infant, lactation, maternal diet, prebiotics, pregnancy, randomized controlled trial
Document Type
Journal Article
Date of Publication
1-1-2025
Volume
155
Issue
1
PubMed ID
39173718
Publication Title
Journal of Allergy and Clinical Immunology
Publisher
Elsevier
School
School of Nursing and Midwifery
Funding Information
This trial was supported by a National Health and Medical Research Council (NHMRC) project grant (grant no. ID1099480) and a Telethon-Perth Children’s Hospital Research Fund grant. D.J.P. was supported by the NHMRC Medical Research Futures Fund Career Development Fellowship (ID1144544) (2018-2021) and the Telethon Kids Institute Ascend Fellowship (2022-2026). T.R.S. was supported by an NHMRC Investigator Grant (grant no. ID1173576). S.L.P. was supported by a fellowship from the Nova Institute for Health. Substantial in-kind support has been provided by Telethon Kids Institute and Joondalup Health Campus.
Funding received from the National Health and Medical Research Council (NHMRC)
1099480, 1144544, 1173576
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Content Type
Full object
First Page
144
Last Page
152
Recommended Citation
Palmer, D. J., Cuthbert, A. R., Sullivan, T. R., Pretorius, R. A., Garssen, J., Rueter, K., Jenmalm, M. C., Keelan, J. A., Silva, D., & Prescott, S. L. (2025). Effects of pregnancy and lactation prebiotics supplementation on infant allergic disease: A randomized controlled trial. Journal of Allergy and Clinical Immunology, 155(1), 144-152. https://doi.org/10.1016/j.jaci.2024.08.009
Comments
Palmer, D. J., Cuthbert, A. R., Sullivan, T. R., Pretorius, R. A., Garssen, J., Rueter, K., Jenmalm, M. C., Keelan, J. A., Silva, D., & Prescott, S. L. (2025). Effects of pregnancy and lactation prebiotics supplementation on infant allergic disease: A randomized controlled trial. Journal of Allergy and Clinical Immunology, 155(1), 144-152. https://doi.org/10.1016/j.jaci.2024.08.009