{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:11:52Z","timestamp":1790799112688,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T00:00:00Z","timestamp":1734825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Altman research institute"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objective: This study aimed to investigate the efficacy of oral probiotic supplementation in preventing vulvovaginal infections (VVIs) in pregnant women, specifically focusing on abnormal vaginal flora (AVF), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC). Methods: A multicenter-prospective-randomized, double-blind, placebo-controlled trial was conducted during 2016\u20132019. Women with normal vaginal flora (Nugent score &lt; 4 and no candida) were divided into a research group, receiving 2 capsules\/day of oral probiotic formula containing Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus, Lacticaseibacillus paracasei, Lacticaseibacillus rhamnosus, and Streptococcus thermophilus, or a control group, receiving a placebo until delivery. Once a month and following complaints, a vaginal smear was taken to assess vaginal flora. Vaginal colonization with the specific lactobacilli from the probiotic capsules was detected using the matrix-assisted laser desorption\/ionization time-of-flight mass spectrometry. The primary outcome was the rate of women who developed VVI. Results: Forty-nine and fifty-one women were analyzed in the probiotic and placebo cohorts, respectively. There was no difference in the rate of VVI between probiotic and placebo groups (14 (29%) versus 14 (27%), respectively; p = 0.80). No woman had vaginal colonization with lactobacilli from the probiotic capsule. Conclusions: The tested oral probiotic product did not reduce the rate of VVI in pregnant women with normal vaginal flora.<\/jats:p>","DOI":"10.3390\/nu16244406","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T09:13:38Z","timestamp":1734945218000},"page":"4406","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of Oral Probiotic Supplementation in Preventing Vulvovaginal Infections During Pregnancy: A Randomized and Placebo-Controlled Clinical Trial"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3102-0739","authenticated-orcid":false,"given":"Enav","family":"Yefet","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tzafon Medical Center, Poriya 1528001, Israel"},{"name":"Women\u2019s Health Center, Clalit Health Services, Afula 1834111, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Suleiman","sequence":"additional","affiliation":[{"name":"The Holy Family Medical Center, Nazareth 1641100, Israel"},{"name":"Department of Obstetrics and Gynecology, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-1053","authenticated-orcid":false,"given":"Raul","family":"Colodner","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2918-4965","authenticated-orcid":false,"given":"Shlomo","family":"Battino","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Center, Clalit Health Services, Afula 1834111, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malak","family":"Wattad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Kuzmin","sequence":"additional","affiliation":[{"name":"The Holy Family Medical Center, Nazareth 1641100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohar","family":"Nachum","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Emek Medical Center, Afula 1834111, Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine, Technion\u2014Israel Institute of Technology, Haifa 3109600, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1056\/NEJM200002243420802","article-title":"Metronidazole to Prevent Preterm Delivery in Pregnant Women with Asymptomatic Bacterial Vaginosis. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units","volume":"342","author":"Carey","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00404-013-3064-9","article-title":"The Role of Lactobacilli and Probiotics in Maintaining Vaginal Health","volume":"289","author":"Borges","year":"2014","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/S0140-6736(07)60917-9","article-title":"Vulvovaginal Candidosis","volume":"369","author":"Sobel","year":"2007","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00006254-200005001-00001","article-title":"Bacterial Vaginosis in Pregnancy","volume":"55","author":"McGregor","year":"2000","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/S0002-9378(98)80028-8","article-title":"Epidemiology and Outcomes Associated with Moderate to Heavy Candida Colonization during Pregnancy. Vaginal Infections and Prematurity Study Group","volume":"178","author":"Cotch","year":"1998","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1439-0507.2012.02185.x","article-title":"Guideline Vulvovaginal Candidosis (2010) of the German Society for Gynecology and Obstetrics, the Working Group for Infections and Infectimmunology in Gynecology and Obstetrics, the German Society of Dermatology, the Board of German Dermatologists and the German Speaking Mycological Society","volume":"55","author":"Mendling","year":"2012","journal-title":"Mycoses"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/S1701-2163(16)32919-X","article-title":"Screening and Management of Bacterial Vaginosis in Pregnancy","volume":"30","author":"Yudin","year":"2008","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4774783","DOI":"10.1155\/2022\/4774783","article-title":"Effects of Pro\/Prebiotics Alone over Pro\/Prebiotics Combined with Conventional Antibiotic Therapy to Treat Bacterial Vaginosis: A Systematic Review","volume":"2022","author":"Afifirad","year":"2022","journal-title":"Int. J. Clin. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of Diagnosing Bacterial Vaginosis Is Improved by a Standardized Method of Gram Stain Interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Yefet, E., Bar, L., Izhaki, I., Iskander, R., Massalha, M., Younis, J.S., and Nachum, Z. (2023). Effects of Probiotics on Glycemic Control and Metabolic Parameters in Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis. Nutrients, 15.","DOI":"10.3390\/nu15071633"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ansari, A., Son, D., Hur, Y.M., Park, S., You, Y.-A., Kim, S.M., Lee, G., Kang, S., Chung, Y., and Lim, S. (2023). Lactobacillus Probiotics Improve Vaginal Dysbiosis in Asymptomatic Women. Nutrients, 15.","DOI":"10.3390\/nu15081862"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Koirala, R., Gargari, G., Arioli, S., Taverniti, V., Fiore, W., Grossi, E., Anelli, G.M., Cetin, I., and Guglielmetti, S. (2020). Effect of Oral Consumption of Capsules Containing Lactobacillus Paracasei LPC-S01 on the Vaginal Microbiota of Healthy Adult Women: A Randomized, Placebo-Controlled, Double-Blind Crossover Study. FEMS. Microbiol. Ecol., 96.","DOI":"10.1093\/femsec\/fiaa084"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Silvano, A., Meriggi, N., Renzi, S., Seravalli, V., Torcia, M.G., Cavalieri, D., and Di Tommaso, M. (2023). Vaginal Microbiome in Pregnant Women with and without Short Cervix. Nutrients, 15.","DOI":"10.3390\/nu15092173"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pino, A., Rapisarda, A.M.C., Vaccalluzzo, A., Sanfilippo, R.R., Coman, M.M., Grimaldi, R.L., Caggia, C., Randazzo, C.L., Russo, N., and Panella, M.M. (2022). Oral Intake of the Commercial Probiotic Blend Synbio\u00ae for the Management of Vaginal Dysbiosis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12010027"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s12602-014-9176-0","article-title":"Local Probiotic Therapy for Vaginal Candida Albicans Infections","volume":"7","author":"Kovachev","year":"2015","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1001\/archfami.5.10.593","article-title":"Ingestion of Yogurt Containing Lactobacillus Acidophilus Compared with Pasteurized Yogurt as Prophylaxis for Recurrent Candidal Vaginitis and Bacterial Vaginosis","volume":"5","author":"Shalev","year":"1996","journal-title":"Arch. Fam. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/j.1365-2672.1960.tb00188.x","article-title":"A Medium for the Cultivation of Lactobacilli","volume":"23","author":"Rogosa","year":"1960","journal-title":"J. Appl. Bacteriol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"M568","DOI":"10.1111\/j.1750-3841.2011.02369.x","article-title":"Rapid and Accurate Bacterial Identification in Probiotics and Yoghurts by MALDI-TOF Mass Spectrometry","volume":"76","author":"Angelakis","year":"2011","journal-title":"J. Food Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1021\/cr010376a","article-title":"Ion Formation in MALDI: The Cluster Ionization Mechanism","volume":"103","author":"Karas","year":"2003","journal-title":"Chem. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3920\/BM2018.0129","article-title":"Impact of Oral Administration of Four Lactobacillus Strains on Nugent Score\u2013Systematic Review and Meta-Analysis","volume":"10","author":"Laue","year":"2019","journal-title":"Benef. Microbes."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/1471-0528.15675","article-title":"Effects of Oral Probiotic Supplements on Vaginal Microbiota during Pregnancy: A Randomised, Double-Blind, Placebo-Controlled Trial with Microbiome Analysis","volume":"127","author":"Husain","year":"2020","journal-title":"BJOG"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"608.e1","DOI":"10.1016\/j.ajog.2016.06.021","article-title":"Effect of Probiotics on Vaginal Health in Pregnancy. EFFPRO, a Randomized Controlled Trial","volume":"215","author":"Gille","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Yang, S., Reid, G., Challis, J.R.G., Gloor, G.B., Asztalos, E., Money, D., Seney, S., and Bocking, A.D. (2020). Effect of Oral Probiotic Lactobacillus Rhamnosus GR-1 and Lactobacillus Reuteri RC-14 on the Vaginal Microbiota, Cytokines and Chemokines in Pregnant Women. Nutrients, 12.","DOI":"10.3390\/nu12020368"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1186\/1745-6215-12-239","article-title":"A Randomised Controlled Trial of Probiotics for the Prevention of Spontaneous Preterm Delivery Associated with Bacterial Vaginosis: Preliminary Results","volume":"12","author":"Moreira","year":"2011","journal-title":"Trials"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.tjog.2016.06.003","article-title":"Oral Lactobacillus Rhamnosus GR-1 and Lactobacillus Reuteri RC-14 to Reduce Group B Streptococcus Colonization in Pregnant Women: A Randomized Controlled Trial","volume":"55","author":"Ho","year":"2016","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Yefet, E., Colodner, R., Strauss, M., Gam Ze Letova, Y., and Nachum, Z. (2020). A Randomized Controlled Open Label Crossover Trial to Study Vaginal Colonization of Orally Administered Lactobacillus Reuteri RC-14 and Rhamnosus GR-1 in Pregnant Women at High Risk for Preterm Labor. Nutrients, 12.","DOI":"10.3390\/nu12041141"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1373\/clinchem.2014.221770","article-title":"MALDI-TOF MS for the Diagnosis of Infectious Diseases","volume":"61","author":"Patel","year":"2015","journal-title":"Clin. Chem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"218","DOI":"10.2174\/1874285801812010218","article-title":"Contraception: Influence on Vaginal Microbiota and Identification of Vaginal Lactobacilli Using MALDI-TOF MS and 16S rDNA Sequencing","volume":"12","author":"Fosch","year":"2018","journal-title":"Open Microbiol. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lyra, A., Ala-Jaakkola, R., Yeung, N., Datta, N., Evans, K., Hibberd, A., Lehtinen, M.J., Forssten, S.D., Ibarra, A., and Pesonen, T. (2023). A Healthy Vaginal Microbiota Remains Stable during Oral Probiotic Supplementation: A Randomised Controlled Trial. Microorganisms, 11.","DOI":"10.3390\/microorganisms11020499"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/jam.12544","article-title":"In Vitro Evaluation of Antimicrobial Activity of Lactobacillus Rhamnosus IMC 501(\u00ae), Lactobacillus Paracasei IMC 502(\u00ae) and SYNBIO(\u00ae) against Pathogens","volume":"117","author":"Coman","year":"2014","journal-title":"J. Appl. Microbiol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/24\/4406\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:58:03Z","timestamp":1760115483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/24\/4406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,22]]},"references-count":30,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["nu16244406"],"URL":"https:\/\/doi.org\/10.3390\/nu16244406","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,22]]}}}