Knowledge, Attitude, and Practices Towards the Use of Psychobiotics for Maternal Health and Well-Being

Introduction

Maternal morbidity is one of the major global health concerns wherein about two-third of the complications are well-documented which can be prevented and treated. One of the agenda of ‘Sustainable Development Goals’ 2030 (SDG-30) aims to reduce maternal mortality rate (MMR). Its objective is to ‘Ensure healthy lives and promote wellbeing for all at all ages.’ To ensure decline in MMR, in year 2015 World Health Organisation (WHO) published ‘Strategies towards ending preventable maternal morbidity’ especially maternal health morbidity due to economic disparity as low-middle income countries reported higher maternal morbidity rates as compared to higher income nations (Maternal Health Task Force, 2018; WHO, 2019; WHO, 2015; United Nations Statistics Division, 2016; Geller et al, 2018). In India, MMR declined from 130/100,000 live births to 113/ 100,000 live births between the years 2016-2018, but it needs more attention and efforts to achieve the SDG-2030 target. Although just like global organizations, the Government of India has been constantly forging maternal health-care services among the population yet there is need to address and overcome the massive challenges such as, economic disparities, lack of education, policies and resources, which widens-up the gap between service providers/policy makers and the expectant mothers and their neonates (UNICEF, n.d.). To fight the challenge of increasing maternal morbidity rate, Indian government have adopted antenatal care services as an initiative to safeguard maternal and new-born child health and wellbeing.

Previous studies conducted on preventive and sustainable maternal and child health have reported that pregnancy period triggers metabolic and inflammatory alterations in mother’s body which can be prevented from predisposing towards complications by adopting appropriate health-related interventions. The ‘Gut Microbiome’ based intervention is one of the finest approaches to intervene altered metabolic and inflammatory response of the mother during or after pregnancy as maternal gut microbiome and gut-brain axis gets more sensitize during the peri-natal and post-natal period which can significantly contributes towards the pregnancy outcomes and wellbeing of both mother and child. Imbalance of gut-brain axial may enhance the maternal complications and foetus developmental suppressions especially neurological development depressions, while on the contrary, maintaining maternal health-care, nutrient rich diet and gut-eubiosis by incorporating prebiotics, probiotics, dietary fibres and fermented foods which can be a source of probiotics, can significantly reduce the maternal and foetal health complications during or post-pregnancy. Additionally, it has been reported that lifestyle and dietary modifications can significantly channelise gut-brain axis and therefore, contribute towards boosting maternal gut-microbiome by promoting gut-eubiosis especially during peri and post-natal period (Wang et al, 2017; Dawe et al, 2020; Edwards et al, 2017; Mayer et al, 2014; Borre et al, 2014).

Pregnancy is a period of metabolic fluctuations, hormonal changes, increased dietary demands and elevated risk of inflammation and infections along with the incorporation of prescribed medications and additional supplements during or post-pregnancy acquires the potential to affect maternal and foetal gut-microbiome. Thus, incorporation of probiotics in maternal nutritional intake became a striking area for health-care professionals and researchers especially during or post-pregnancy which can significantly be adopted to overcome from the maternal and foetal complications during the peripartum period.