Probiotics in pregnancy: Inequities in knowledge exchange, attitudes, and use of probiotics in a socio-demographically diverse, cross-sectional survey sample of pregnant Canadians

Background Pregnancy interventions, potentially including consumption of nutraceuticals like probiotics, represent possible avenues for preventing non-communicable diseases. However, evidence syntheses indicate that probiotic interventions, while effective in managing some pregnancy complications (e.g., gestational diabetes), do not confer health benefits to uncomplicated pregnancies. Messaging around probiotics in pregnancy is mixed, such that people with low-risk pregnancies may nevertheless feel pressure to spend limited resources on (costly) probiotics. To tailor knowledge exchange and support safe, equitable access to pregnancy probiotics when their prescription may be warranted, we need to understand who takes probiotics during pregnancy and under what conditions. Methods We used chi-square and logistic regression analyses of anonymous, cross-sectional survey data from 341 pregnant Canadians of diverse socio-demographic backgrounds to assess which respondents, by socio-demographic characteristics and pre-pregnancy/pregnancy health indicators, were relatively likely to: perceive probiotics as beneficial to pregnancy health and/or report taking probiotics during pregnancy. Results Forty-seven percent of respondents perceived probiotics as beneficial to pregnancy health; 51 % reported consuming them. Probiotic attitudes and consumption were socio-demographically-patterned: higher-income, post-secondary-educated respondents disproportionately perceived probiotics as healthy and consumed them. There was no evidence of variation in probiotics attitudes or use by pregnancy health indicators. Conclusion Socio-economic factors may be more important determinants of pregnancy probiotic use in this sample than indications for pregnancy complications. Clear guidelines on pregnancy probiotics that reflect current evidence are needed. Equitable access to probiotics should be facilitated for pregnant people likely to benefit from interventions (i.e., those with certain complications), supporting long-term health equity.