臨床婦人科産科76巻5号

2022年05月発行

今月の臨床 妊娠時の栄養とマイナートラブル豆知識―妊娠生活を快適に過ごすアドバイス 妊婦と栄養

乳酸菌と早産予防

著者： 米田哲¹ 齋藤滋¹

所属機関： ¹富山大学学術研究部医学系産科婦人科学教室

ページ範囲：P.416 - P.421

●腟内に存在する乳酸菌は，その自浄作用から細菌性腟症の発症を抑制し，上行性感染を予防することにより自然早産予防効果があるとされている．

●近年，ラクトフェリンは，腟内の乳酸菌を増殖させる作用があると報告されており，今後，注目したい．

●妊娠維持に必須の制御性T細胞の誘導に関与していると考えられる酪酸菌含有のプロバイオティクス（酪酸菌，乳酸菌，糖化菌）は，自然早産を予防する可能性を秘めている．

参考文献

1）Nordqvist M, et al : Timing of probiotic milk consumption during pregnancy and effects on the incidence of preeclampsia and preterm delivery : a prospective observational cohort study in Norway. BMJ Open 8 : e018021, 2018

2）Yoneda S, et al : Antibiotic therapy increases the risk of preterm birth in preterm labor without intra-amniotic microbes, but may prolong the gestation period in preterm labor with microbes, evaluated by rapid and high sensitive PCR system. Am J Reprod Immunol 75 : 440-450, 2016

3）Yoneda S, et al : 17OHP-C in patients with spontaneous preterm labor and intact membranes : is there an effect according to the presence of intra-amniotic inflammation? Am J Reprod Immunol 80 : e12867, 2018

4）Yoneda S, et al : Accurate prediction of the stage of histological chorioamnionitis before delivery by amniotic fluid IL-8 level. Am J Reprod Immunol 73 : 568-576, 2015

5）Yoneda N, et al : Polymicrobial amniotic fluid infection with Mycoplasma/Ureaplasma and other bacteria induces severe intra-amniotic inflammation associated with poor perinatal prognosis in preterm labor. Am J Reprod Immunol 75 : 112-125, 2016

6）Ito M, et al : Japan Environment and Children's Study（JECS）Group : Fermented foods and preterm birth risk from a prospective large cohort study : the Japan Environment and Children's study. Environ Health Prev Med 24 : 25, 2019

7）Capoccia R, et al : Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Curr Opin Infect Dis 26 : 231-240, 2013

8）Superti F, et al : Warding off recurrent yeast and bacterial vaginal infections : lactoferrin and Lactobacilli. Microorganisms 8 : 130, 2020

9）van de Wijgert J, et al : Lactobacilli-containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis : a systematic review and recommendations for future trial designs. BJOG 127 : 287-299, 2020

10）Kirihara N, et al : Effect of probiotics on perinatal outcome in patients at high risk of preterm birth. J Obstet Gynaecol Res 44 : 241-247, 2018

11）Atarashi K, et al : Induction of colonic regulatory T cells by indigenous Clostridium species. Science 331 : 337-341, 2011

12）Shiozaki A, et al : Intestinal microbiota is different in women with preterm birth : results from terminal restriction fragment length polymorphism analysis. PLoS One 9 : e111374, 2014