# The Effect of Oral Supplementation with a Multi-Strain Probiotic Preparation on Group B Streptococcus (GBS) Carriage in Pregnant Women—A Pilot Study

## TL;DR

A pilot study found that taking a multi-strain probiotic during pregnancy may reduce Group B Streptococcus carriage, which could lower the risk of neonatal infection.

## Contribution

This study is the first to show that oral probiotic supplementation during pregnancy can reduce GBS carriage in a time-dependent manner.

## Key findings

- Oral probiotic supplementation was associated with a time-dependent reduction in GBS carriage during pregnancy.
- 90% of participants were GBS-negative by late pregnancy, with no adverse events reported.
- Among non-supplemented women, 30.4% became GBS-positive later in pregnancy.

## Abstract

Background/Objectives: Maternal rectovaginal carriage of Group B Streptococcus (GBS, Streptococcus agalactiae) is a major risk factor for vertical transmission and early-onset neonatal infection. Intrapartum antibiotic prophylaxis reduces early-onset disease but does not address antenatal carriage and may affect the maternal–neonatal microbiota. Microbiota-directed interventions, including probiotics, are being explored as complementary strategies. Methods: This prospective, single-centre, open-label pilot intervention study included 10 pregnant women (18–40 years) with singleton pregnancies and a positive vaginal and/or rectal GBS swab, without pre-gestational or gestational diabetes and without antibiotic use in the 4 weeks before enrolment. Participants received OMNi-BiOTiC® FLORA plus (multi-strain lactic acid bacteria, including Lactobacillus crispatus) orally at 2 × 2 g/day from the 15th to the 34th gestational week. Microbiological swabs were obtained at qualification (12–15 weeks), mid-pregnancy (22–25 weeks), and late pregnancy (34–35 weeks). Outcomes were described descriptively. Results: Among 56 screened pregnant women, 10 were GBS-positive (17.9%) and enrolled. All participants were GBS-positive at baseline. At 22–25 weeks, 5/10 (50%) had a negative GBS result. At 34–35 weeks, 9/10 (90%) were GBS-negative, while 1/10 (10%) remained colonised. Time to first negative result ranged from 7.6 to 20.2 weeks from supplementation start (median 8.6 weeks). No recurrences (negative-to-positive transitions) were observed between the second and third sampling points. No adverse events related to supplementation were reported. In contrast, among the 46 women who were GBS-negative at screening and did not receive probiotic supplementation, 14 (30.4%) were found to be GBS-positive at routine screening performed at 35–37 weeks of gestation. Conclusions: In this pilot single-arm study, oral supplementation with a multi-strain probiotic preparation during pregnancy was associated with a time-dependent reduction in rectovaginal GBS carriage and was well tolerated. These preliminary findings support the feasibility of larger randomised controlled trials incorporating microbiome profiling and neonatal outcomes.