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Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial

John Thompson, Edwin A. Mitchell, C Barthow, J Crane, F Hood, J Kang, R Maude, Emily M Mitchell, R Murphy, R F Slykerman, T Stanley, P Stone, K Wickens, Probiotic in Pregnancy Study Group, P Abels, G Purdie, J Rowden

Open Access
  • University of Auckland ROR
  • University of Otago ROR
  • Victoria University of Wellington ROR
  • National Institutes of Health ROR

EBioMedicine, 24, 159-165

DOI 10.1016/j.ebiom.2017.09.013 PMID 28943228

Abstract

Background

Probiotics may help to prevent symptoms of anxiety and depression through several putative mechanisms.

Objective

The aim of this study was to evaluate the effect of Lactobacillus rhamnosus HN001 (HN001) given in pregnancy and postpartum on symptoms of maternal depression and anxiety in the postpartum period. This was a secondary outcome, the primary outcome being eczema in the offspring at 12 months of age.

Design, Setting,

Participants

A randomised, double-blind, placebo-controlled trial of the effect of HN001 on postnatal mood was conducted in 423 women in Auckland and Wellington, New Zealand. Women were recruited at 14–16 weeks gestation.

Intervention

Women were randomised to receive either placebo or HN001 daily from enrolment until 6 months postpartum if breastfeeding.

Outcome

Measures

Modified versions of the Edinburgh Postnatal Depression Scale and State Trait Anxiety Inventory were used to assess symptoms of depression and anxiety postpartum.

Trial Registration

Australia NZ Clinical Trials Registry: ACTRN12612000196842.

Findings

423 women were recruited between December 2012 and November 2014. 212 women were randomised to HN001 and 211 to placebo. 380 women (89.8%) completed the questionnaire on psychological outcomes, 193 (91.0%) in the treatment group and 187 (88.6%) in the placebo group. Mothers in the probiotic treatment group reported significantly lower depression scores (HN001 mean = 7·7 (SD = 5·4), placebo 9·0 (6·0); effect size -1·2, (95% CI -2·3, -0·1), p = 0·037) and anxiety scores (HN001 12·0 (4·0), placebo 13·0 (4·0); effect size -1·0 (-1·9, -0·2), p = 0·014) than those in the placebo group. Rates of clinically relevant anxiety on screening (score > 15) were significantly lower in the HN001 treated mothers (OR = 0·44 (0·26, 0·73), p = 0·002).

Interpretation

Women who received HN001 had significantly lower depression and anxiety scores in the postpartum period. This probiotic may be useful for the prevention or treatment of symptoms of depression and anxiety postpartum.

Topics

Pregnancy > Maternal Mental Health > Probiotic Depression PreventionPostpartum > Depression and Anxiety > Lactobacillus rhamnosus InterventionResearch Methodology > RCT > Probiotic Pregnancy Mental Health Trial
Slykerman Hood Wickens Lactobacillus rhamnosus HN001 pregnancy postpartum depression anxiety, probiotic intervention pregnancy randomized double-blind placebo-controlled mental health, L. rhamnosus HN001 postpartum depression anxiety symptom reduction EPDS score, gut-brain axis probiotic pregnancy maternal mental health immune modulation, EBioMedicine 2017 Lactobacillus rhamnosus pregnancy depression anxiety RCT, Edinburgh Postnatal Depression Scale STAI state anxiety probiotic versus placebo, postpartum mental health probiotic supplementation pregnancy randomized controlled trial, microbiome-gut-brain axis pregnancy intervention depression prevention probiotic, New Zealand pregnancy probiotic trial 423 women postpartum depression anxiety outcome, maternal probiotic HN001 gestational supplementation postpartum psychiatric symptoms
PMID 28943228 28943228 DOI 10.1016/j.ebiom.2017.09.013 10.1016/j.ebiom.2017.09.013

Cite this article

Slykerman, R. F., Hood, F., Wickens, K., Thompson, J. M. D., Barthow, C., Murphy, R., Kang, J., Rowden, J., Stone, P., Crane, J., Stanley, T., Abels, P., Purdie, G., Maude, R., Mitchell, E. A., & Probiotic in Pregnancy Study Group (2017). Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial. *EBioMedicine*, *24*, 159-165. https://doi.org/10.1016/j.ebiom.2017.09.013

Keywords

Adult, Anxiety/prevention & Control/psychology, Depression, Postpartum/prevention & Control/psychology, Double-Blind Method, Female, Humans, Lacticaseibacillus Rhamnosus/physiology, Male, Maternal Nutritional Physiological Phenomena, New Zealand, Pregnancy, Probiotics/administration & Dosage/therapeutic Use, Treatment Outcome, Anxiety, Depression, Microbiome-gut-brain Axis, Probiotic, Randomised Controlled Trial