{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:42:32Z","timestamp":1792172552806,"version":"4.4.0"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005089","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["2025\u2010I\u2010PY\u2010010"],"award-info":[{"award-number":["2025\u2010I\u2010PY\u2010010"]}],"id":[{"id":"10.13039\/501100005089","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pregnancy is associated with susceptibility to vaginal dysbiosis, including Group B Streptococcus (GBS), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC). Probiotic supplementation has emerged as a potential strategy to restore vaginal microecology, yet its effectiveness during pregnancy remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>To evaluate whether probiotic supplementation during pregnancy increases the likelihood of clearance of GBS colonization, BV, and VVC. We systematically searched PubMed, Embase, Cochrane CENTRAL, and Web of Science from inception to 16 April 2025. Eligible studies were randomized or non\u2010randomized studies comparing probiotic supplementation with placebo or no treatment in pregnant women, reporting outcomes related to vaginal microbiota, pathogen decolonization, or infection resolution. Two reviewers independently screened studies and extracted data. Randomized controlled trials (RCT) were evaluated using the Cochrane ROB\u20101 tool, and the single non\u2010RCT was assessed using ROBINS\u2010I. Meta\u2010analyses were performed for co\u2010primary outcomes, with subgroup analyses by timing, comparator type (placebo\u2010controlled vs. no\u2010treatment control), and duration of intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093705) were included. For the co\u2010primary outcomes, a statistically significant increase in the odds of GBS decolonization was observed (OR 1.38, 95% CI 1.08\u20131.76;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20092%). This association was no longer statistically significant in analyses restricted to RCTs (OR\u2009=\u20091.28, 95% CI 0.93\u20131.76;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20099%) and remained non\u2010significant when further restricted to placebo\u2010controlled RCTs (OR\u2009=\u20091.32, 95% CI 0.94\u20131.85;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200931%). No significant effects were found for BV (OR 0.91) or VVC (OR 0.65). An exploratory pooled analysis across infection types showed no significant overall improvement in infection clearance (OR 1.13, 95% CI 0.94\u20131.36;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200916%). Subgroup analysis indicated greater efficacy in interventions initiated during the third trimester or lasting \u22644\u2009weeks, though interaction tests were not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Probiotic supplementation during pregnancy may increase the likelihood of GBS decolonization. However, this association was not statistically significant in sensitivity analyses restricted to randomized and placebo\u2010controlled trials. No consistent benefit was observed for BV or VVC. Standardized probiotic regimens and harmonized diagnostic frameworks are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70234","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:39:57Z","timestamp":1777379997000},"page":"999-1016","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Probiotic supplementation during pregnancy for vaginal microbiota improvement and pathogen clearance: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3344-2969","authenticated-orcid":false,"given":"Zimo","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, State Key Laboratory of Common Mechanism Research of Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roujie","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, State Key Laboratory of Common Mechanism Research of Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1738-6216","authenticated-orcid":false,"given":"Tianshu","family":"Sun","sequence":"additional","affiliation":[{"name":"Clinical Biobank National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5753-5426","authenticated-orcid":false,"given":"Lan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, State Key Laboratory of Common Mechanism Research of Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","first-page":"90","article-title":"A systematic review and meta\u2010analysis on the efficacy of probiotics for bacterial vaginosis","volume":"26","author":"Liu HF","year":"2022","journal-title":"Eur Rev Med Pharmacol 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