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Durmaz A, Gun Kakasci C. Pregnant women's attitudes towards complementary and alternative medicine and the use of phytotherapy during the COVID-19 pandemic: A cross-sectional study. PLoS One 2024; 19:e0296435. [PMID: 38165916 PMCID: PMC10760753 DOI: 10.1371/journal.pone.0296435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Approximately 80% of individuals worldwide use various holistic complementary and alternative medicine (HCAM) methods, including herbal products, to prevent diseases and improve their general health. In this study, it was aimed to investigate complementary and alternative therapy (CAM) and the use of phytotherapy by pregnant women in the COVID-19 pandemic period. METHODS This is a cross-sectional and descriptive study. The study included 381 women who applied to a public hospital in Türkiye and used herbal products during this pregnancy. Purposive sampling method was used. The study data were collected through "Identifying Information Form", "Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ)" and "Information Form on the Use of Phytotherapy". In the analysis of the study data, descriptive statistics, the one-way ANOVA and multinomial logistic regression analyses were used. RESULTS The study was completed with 381 pregnant women. The average age, parity and gestational age of the pregnant women were 28.33±6.09, 2.17±0.95, 29.11±8.87, respectively. It was determined that 37.3% of pregnant women did not know the ingredients of the herbal products they used and 38.8% found them safer than the drugs. HCAMQ total mean score of the pregnant women was calculated as 34.62±16.22. It was found that the pregnant women used garlic the most (65.6%), followed by cumin (38.6%), curcuma (36.2%), and ginger (34.4%). HCAMQ total mean score was found to be lower in the pregnant women who found herbal products safer than drugs (p<0.001), who were not aware of the content of the herbal product they used (p<0.001), and who used herbal products so as to protect against COVID-19 (p = 0.041), to increase their physical resistance (p = 0.022), and to facilitate childbirth (p = 0.002). It was determined that among the pregnant women who knew the content of the herbal products they used (Odds Ratio (OR) 1.122; 1.095-1.149 95%CI; p<0.001) and who did not know (OR 1.114; 1.085-1.144 95%CI; p<0.001), as negative attitude towards HCAM increased, their status of finding traditional drugs safer increased. Among the pregnant women who used herbal products to protect against COVID-19 (OR 1.142; 1.111-1.174 95%CI; p<0.001) and to increase their physical resistance (OR 1.120; 1.094-1.147 95%CI; p<0.001), as negative attitude towards HCAM increased, their status of finding conventional drugs safer increased. CONCLUSION In today's world where the use of herbal products and CAM has become widespread, it is important to raise the awareness of pregnant women about the benefits and harms of these practices about which there is inadequate evidence.
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Affiliation(s)
- Aysegul Durmaz
- Department of Midwifery, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Cigdem Gun Kakasci
- Department of Midwifery, Faculty of Health Sciences, Suleyman Demirel University, Isparta, Türkiye
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Taye AD, Bizuneh GK, Kasahun AE. Ethnobotanical uses, phytochemistry and biological activity of the genus Euclea: A review. Front Pharmacol 2023; 14:1170145. [PMID: 37153774 PMCID: PMC10154578 DOI: 10.3389/fphar.2023.1170145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/05/2023] [Indexed: 05/10/2023] Open
Abstract
Euclea (Ebenaceae) is a genus of flowering shrubs and trees widely distributed in Africa, the Comoro Islands, and Arabia. This review aimed to evaluate the ethnobotanical uses, phytochemistry, and biological activities of the genus Euclea on available research reports. This was achieved through PubMed, Medline, Google Scholar, Science Direct, Taylor and Francis Online, Wiley Online Library which provides access to scientific and medical research. The extensive literature survey revealed that plants that belong to this genus are used as folkloric medicine for the treatment of diabetes mellitus, toothache, diarrhea, cancer, malaria, leprosy, and genital and oral diseases in the case of HIV/AIDS-related diseases. To date, more than 40 secondary metabolites have been isolated and identified from these plants, especially from E natalensis and E. divinorum. Among these, naphthoquinones, terpenes, and flavonoids are potential secondary metabolites with profound biological activities. Euclea plant extracts and their bioactive compounds possess outstanding pharmacological properties, especially antimalarial, antidiabetic, anticancer, antimicrobial, and antioxidant properties.
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Affiliation(s)
- Abebe Dagne Taye
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Gizachew Kassahun Bizuneh
- Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Gizachew Kassahun Bizuneh,
| | - Asmamaw Emagn Kasahun
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Use of Medicinal Plants during Pregnancy, Childbirth and Postpartum in Southern Morocco. Healthcare (Basel) 2022; 10:healthcare10112327. [DOI: 10.3390/healthcare10112327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/08/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022] Open
Abstract
Southern Morocco, particularly the Guelmim-Oued Noun region, is rich in a wide diversity of plant species. Pregnant women in this region use medicinal plants during pregnancy and childbirth for various purposes; however, the use of these plants has never been documented. The objectives of this study are threefold: to estimate the prevalence of medicinal plant uses by pregnant women in the province of Guelmim, Morocco, to describe the traditional practices of self-medication and to determine the associated factors. This is a multicenter cross-sectional study with descriptive and analytical approaches. Data were collected using an interview questionnaire, which was administered to pregnant women at health care centers and hospitals in the province of Guelmim. A total of 560 women participated in this study. The prevalence of medicinal plant use was 66.96%. Artemisia herba-alba Asso, Thymus maroccanus Ball., Trigonella foenum-graecum L., Aloysia citriodora Palau, Lepidium sativum L. and Cuminum cyminum L. were the plants with the highest UV. Pain, the induction and facilitation of childbirth, flu syndrome and anemia were the most listed reasons for use. The use of medicinal plants was significantly associated with the level of education (chi-square = 15.651; p = 0.004), and pregnancy monitoring (chi-square = 5.283; p = 0.028). In the province of Guelmim, the prevalence of the use of medicinal plants by women during pregnancy and childbirth is high. Further research is necessary in order to explore potential associated risks and complications.
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Abdurahman A, Alchalidi A, Lina L, Nora N, Mutia C. Analysis of the Use of Herbal Therapy to Reduce Labor Pain (Literature Review). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background:. labor pain can stress the mother and cause pain impulses to multiply and potentially weaken uterine muscle contractions. Pain can cause distress to the baby. One way to reduce pain is by giving herbal therapy or aromatherapy. Aromatherapy is one of the non-pharmacological methods to reduce labor pain. Aromatherapy often used to reduce labor pain is Lavender, Rose, Jasmine, Citrus Aurantium.
AIM: This study aims to determine the use of herbal therapy to reduce labor pain.The purpose of this study is to analyze the challenges in implementing health education in elementary schools in Banda Aceh
Methods: the design in this study was a literature review article. Search for articles using relevant ones obtained from data based on Pubmed, Proquest, Ebsco, ScienceDirect, and Google Scholar in the past ten years (2011–2021) received 121 articles.
Results: The study results show several challenges in implementing health education. Lack of understanding about School Health Services, School Health Services is not considered a strategic program, Low attention from policymakers, School Health Services Program has not been understood as part of the national target, Implementation of UKS program in schools is only a formality, Implementation and development School Health Services program is not evenly distributed. Barriers to the Implementation of School Health Services in Elementary School are the lack of optimal inter-sectoral cooperation, lack of trained personnel, high workload, and the impact of conflicting health issues, causing various School Health Services activities to be hampered in their Implementation
CONCLUSION: Utilization of herbal therapies such as Lavender, Mawar, Jasmine, Citrus, Aurantium has been proven to reduce labor pain which can be used in various methods such as inhalation, bath, massage, and foot soak. The easy use of aromatherapy can be an alternative to reduce labor pain.
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Wake GE, Fitie GW. Magnitude and Determinant Factors of Herbal Medicine Utilization Among Mothers Attending Their Antenatal Care at Public Health Institutions in Debre Berhan Town, Ethiopia. Front Public Health 2022; 10:883053. [PMID: 35570953 PMCID: PMC9098925 DOI: 10.3389/fpubh.2022.883053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundWorld health organization defined herbal medicines as the practice of herbs, herbal materials, herbal preparations, and finished herbal products. Globally women are the primary utilizer of herbal medicine and even they consume it during their pregnancy period. The World health organization reported that the majority of the global population used traditional medicine. This study aimed to assess the magnitude and determinant factors of herbal medicine utilization among pregnant mothers attending their antenatal care at public health institutions in Debre Berhan town, Ethiopia.MethodologyInstitution-based cross-sectional study was conducted among pregnant mothers who attended their antenatal care at public health institutions in Debre Berhan town, Ethiopia from 12 February 2021 to 12 April 2021. A systematic random sampling method was used to get selected pregnant mothers. Epi data version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. P-value ≤0.05 was used as a cut point of statistical significance in multivariable binary logistic regression.ResultsA total of 422 pregnant mothers were included with a 100% response rate and 277 (65.6%) of them used an herbal medicine during their current pregnancy. Educational level up to primary school [AOR 2.21, 95% CI: 1.17 – 4.18], monthly family income of <2,800 ETB [AOR 1.72, 95% CI: 1.01–2.92], and lack of awareness of the complication of herbal medicine utilization [AOR 10.3, 95% CI: 6.27–16.92] were determinant factors of herbal medicine utilization.ConclusionThe utilization of herbal medicine among pregnant mothers in this study is high and almost all of them did not disclose their utilization of herbal medicine to their healthcare providers. The ministry of health should integrate traditional medicine with conventional medicines. Midwives and obstetricians should openly discuss regarding benefits and complications of herbal medicine utilization for those pregnant mothers during their antenatal care counseling sessions as routine care.
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Balarastaghi S, Delirrad M, Jafari A, Majidi M, Sadeghi M, Zare-Zardini H, Karimi G, Ghorani-Azam A. Potential benefits versus hazards of herbal therapy during pregnancy; a systematic review of available literature. Phytother Res 2022; 36:824-841. [PMID: 35023227 DOI: 10.1002/ptr.7363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 11/03/2021] [Accepted: 12/10/2021] [Indexed: 11/07/2022]
Abstract
The use of herbal medicine has considerably grown worldwide in the past two decades. Studies have shown that the prevalence of herbal diet therapy in pregnancy ranged from 1% to 60% in different societies. Many clinical reports have shown that some herbal medicines may have toxic effects on pregnant women and their fetuses because active ingredients of some medicinal plants can readily pass through the biological barriers (e.g., placental barrier). In the present study, we aimed to systematically review the literature to discover potential benefits versus the hazards of herbal therapy during pregnancy. For this purpose, a comprehensive literature review was performed, and after the literature search and selection of the appropriate documents, the desired data were extracted and reported. From 35 articles with a total of 39,950 study population, the results showed that some medicinal plants could cause severe toxicity on mothers and fetuses, in addition to abortion during pregnancy. It was also shown that some plants may lead to developmental abnormalities or fetal death. Findings of this survey showed that some herbal medicines have toxic, teratogenic, and abortive potential, particularly in the first trimester of pregnancy because active ingredients of some medicinal plants are able to pass through the placental barrier and reach the fetus.
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Affiliation(s)
- Soudabeh Balarastaghi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Delirrad
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Abbas Jafari
- Department of Clinical Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Research Institute on Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Majidi
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahmood Sadeghi
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Zare-Zardini
- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Sciences, Farhangian University, Isfahan, Iran
| | - Gholamreza Karimi
- Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adel Ghorani-Azam
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Almoayad F, Assiri IA, Almarshoud HF, Safhi AM, Altahan HM, Benajiba N. Exploring the Use of Herbal Treatments During Pregnancy Among Saudi Women: An application of the knowledge-attitude-practice model. Sultan Qaboos Univ Med J 2021; 21:591-597. [PMID: 34888079 PMCID: PMC8631229 DOI: 10.18295/squmj.4.2021.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/18/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives Herbal treatments are commonly used by Saudi women during pregnancy. However, the inappropriate use of some herbs can have side-effects for both the mother and the fetus. Thus, a comprehensive understanding of their use during pregnancy is crucial. This study aimed to explore the use of herbal treatments by Saudi women during pregnancy using the knowledge-attitude-practice model. Methods This cross-sectional study was conducted from September 2019 and April 2020 in Riyadh, Saudi Arabia, on a convenience sample using an online Arabic-language questionnaire. Saudi women aged between 18-58 years who were pregnant or had been pregnant and were living in the Riyadh were included. Results A total of 400 individuals participated in this study. All participants lacked knowledge about the side-effects of herbal treatment but 63% knew about unsafe herbs in general. Most participants (66%) had a neutral attitude towards herbal treatments. Almost half of the participants (48%) did not use herbs during pregnancy and a similar number (47%) sometimes used herbal treatments during pregnancy. There was a significant positive correlation between attitude and practice and a negative correlation between knowledge and attitude as well as between knowledge and practice (P <0.0001 each). Conclusion While the participants' knowledge were generally poor, their attitudes and practices regarding the use of herbal treatments during pregnancy were good. It is recommended that more efforts be made by healthcare providers to target attitudes towards herbal treatments by providing accurate knowledge and reinforcing healthy practices among Saudi women.
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Affiliation(s)
- Fatmah Almoayad
- Departments of Health Sciences, College of Health and Rehabilitation Sciences
| | - Insherah A Assiri
- Departments of Health Sciences, College of Health and Rehabilitation Sciences
| | - Haifa F Almarshoud
- Departments of Health Sciences, College of Health and Rehabilitation Sciences
| | - Atheer M Safhi
- Departments of Health Sciences, College of Health and Rehabilitation Sciences
| | - Hend M Altahan
- Departments of Health Sciences, College of Health and Rehabilitation Sciences
| | - Nada Benajiba
- Basic Sciences, Deanship of Preparatory Year, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Schäfer W, Wentzell N, Schink T, Haug U. Characterization of pregnancies exposed to St. John's wort and their outcomes: A claims data analysis. Reprod Toxicol 2021; 102:90-97. [PMID: 33961968 DOI: 10.1016/j.reprotox.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/01/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
Little is known about the utilization of St. John's wort (Hypericum perforatum L.) during pregnancy. In Germany, certain preparations of St. John's wort can be reimbursed by statutory health insurances, facilitating to investigate exposure to St. John's wort based on claims data. We therefore aimed to characterize pregnancies exposed to St. John's wort and to explore potential malformations in the babies. Using claims data from the German Pharmacoepidemiological Research Database (GePaRD), pregnancies exposed to St. John's wort during at least one trimester between 2006 and 2016 and the corresponding babies were identified. Exposure was identified via outpatient dispensations. Pregnancies were characterized regarding timing of exposure, use of other antidepressants, pregnancy outcomes and the occurrence of major malformations in the babies (not considering codes for musculoskeletal and other malformations due to low data quality in this regard). Out of 496 pregnancies with a dispensation of St. John's wort during pregnancy, 420 (85 %) had a dispensation during the first trimester. There was a dispensation of other antidepressants before pregnancy in 21 % (during pregnancy: 12 %). Eleven percent of pregnancies ended in non-live births. In 312 babies linked to 305 pregnancies, major malformations were coded in 18 babies (5.8 %), of which 17 were exposed in the first trimester. The crude relative risk of major malformations for babies exposed during the first vs. the second or third trimester only was 3.56 (0.48-26.17). Our results suggest that only in a minority of pregnancies, St. John's wort is used as an alternative to other antidepressants. Even though the relatively high rates of non-live births and major malformations after exposure to St. John's wort during the first trimester need to be interpreted with caution, the findings are striking and generate hypotheses that merit further investigation.
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Affiliation(s)
- Wiebke Schäfer
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
| | - Nadine Wentzell
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tania Schink
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Ulrike Haug
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Human and Life Sciences, University of Bremen, Bremen, Germany
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Kretchy IA, Koduah A, Opuni KFM, Agyabeng K, Ohene‐Agyei T, Boafo EA, Ntow PO. Prevalence, patterns and beliefs about the use of herbal medicinal products in Ghana: a multi‐centre community‐based cross‐sectional study. Trop Med Int Health 2021; 26:410-420. [DOI: 10.1111/tmi.13541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
| | - Kwabena F. M. Opuni
- Department of Pharmaceutical Chemistry School of Pharmacy University of Ghana Legon Ghana
| | | | - Thelma Ohene‐Agyei
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
| | - Eugene A. Boafo
- Department of Pharmaceutical Chemistry School of Pharmacy University of Ghana Legon Ghana
| | - Prisca O. Ntow
- Department of Pharmacy Practice and Clinical Pharmacy School of Pharmacy University of Ghana Legon Ghana
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Bernstein N, Akram M, Yaniv-Bachrach Z, Daniyal M. Is it safe to consume traditional medicinal plants during pregnancy? Phytother Res 2020; 35:1908-1924. [PMID: 33164294 DOI: 10.1002/ptr.6935] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 10/04/2020] [Accepted: 10/18/2020] [Indexed: 12/24/2022]
Abstract
The popularity of natural medicine is growing worldwide. Unlike conventional licensed medicines, herbal medicine practices are usually not supported by effectiveness, efficacy, or safety studies, which raise concerns about potential risks involved in their usage, particularly in high-risk patients such as pregnant women where teratogenicity is a concern. Despite a lack of science-based evidence, the use of herbal products for the management of pregnancy-associated challenges is common, due to the common notion that they are free of toxic effects and adverse reactions because they are "natural." The lack of concern about utilizing herbal remedies during pregnancy is strengthened by the lack of regulation in most countries for their marketing. However, plant-based remedies are not free of adverse reactions. Medicinal plants and herbal remedies contain substances that can be toxic to the human body and the fetus. Potential effects of indiscriminate use of medicinal plants are embryotoxicity, teratogenic, and abortifacient effects. Some plant constituents can cross the placenta and reach the fetus. Phytochemicals and their metabolites are known to induce stimulation of uterine contraction and hormone imbalance that could result in abortion. The alterations to the hormonal profile can affect conception, induce teratogenic activity, and halt the pregnancy or produce a congenital malformation. Due to the wide range of modes of action of phytochemicals, some medicinal plants may be safe to use during certain trimesters of pregnancy and harmful at other stages. This manuscript reviews available scientific information concerning potential health hazards associated with the consumption of herbal medicines during pregnancy, highlighting those herbs that should be avoided due to their potential abortifacient and/or teratogenic activity. We focused on plants that were tested by preclinical studies, and studies of these plants are summarized. Common therapeutic use of these herbs, estimated effects, toxicological effects, and animal studies of these plants is summarized. The literature reviewed suggests that consumption of the following medicinal plants should be avoided during pregnancy: Abrus precatorius, Achyranthes aspera, Ailanthus excelsa, Aloe vera, Aristolochia indica, Areca catechu, Bambusa vulgaris, Cassia occidentalis, Cicer arietinum, Cimicifuga racemose, Dolichandrone falcate, Ginkgo biloba, Hydrastis canadensis, Indigofera trifoliate, Lavandula latifolia, Maytenus ilicifolia, Momordica cymbalaria, Moringa oleifera, Musa rosacea, Oxalis corniculate, Phytolacca dodecandra, Plumeria rubra, Ricinus communis, Ruta graveolens, Stachys lavandulifolia, Senna alata, Trigonella foenum-graecum, Vitus agnus-castus, and Valeriana officinalis.
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Affiliation(s)
- Nirit Bernstein
- Institute of Soil, Water and Environmental Sciences, Volcani Center, Rishon LeZion, Israel
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | | | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation & Development Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China.,College of Biology, Hunan Province Key Laboratory of Plant Functional Genomics and Developmental Regulation, Hunan University, Changsha, China
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Talebi F, Malchi F, Abedi P, Jahanfar S. Effect of dill (Anethum Graveolens Linn) seed on the duration of labor: A systematic review. Complement Ther Clin Pract 2020; 41:101251. [PMID: 33130423 DOI: 10.1016/j.ctcp.2020.101251] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/16/2020] [Accepted: 10/25/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND It is well documented that prolonged labor is associated with complications. This systematic review aimed to study the effect of Anethum Graveolens Linn (Dill) on the duration of labor. METHODS We conducted a search on PubMed, Scopus, Cochrane central, Web of Science, and MEDLINE. All randomized controlled trials and observational studies evaluating the effect of Dill seeds on labor were recruited. The mean differences (MD) with 95% CI were calculated. RESULTS Two RCTs showed that using Dill seeds could significantly reduce duration of the first stage (MD = -43.66, 95% CI [-52.99, - 34.33]), second stage (MD = -15.76, 95% CI [-20.06, -11.47]) and third stage of labor (MD = -1.79, 95% CI [-2.62, -0.95]). Two retrospective cohort studies showed a significant reduction in the first, and second stages of labor. CONCLUSION Using Dill seeds could reduce the duration of labor. Using this herb in low-risk pregnant women is recommended. Systematic review registration number: CRD42020145225.
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Affiliation(s)
- Forough Talebi
- Department of Midwifery, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Malchi
- Department of Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Parvin Abedi
- Department of Midwifery, Menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Shayesteh Jahanfar
- Reproductive Epidemiologist, School of Health Sciences, MPH Program Health Professions Building 2212, Central Michigan University, USA.
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Fukunaga R, Morof D, Blanton C, Ruiz A, Maro G, Serbanescu F. Factors associated with local herb use during pregnancy and labor among women in Kigoma region, Tanzania, 2014-2016. BMC Pregnancy Childbirth 2020; 20:122. [PMID: 32085731 PMCID: PMC7035699 DOI: 10.1186/s12884-020-2735-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 01/09/2020] [Indexed: 11/11/2022] Open
Abstract
Background Despite research suggesting an association between certain herb use during pregnancy and delivery and postnatal complications, herbs are still commonly used among pregnant women in sub-Sahara Africa (SSA). This study examines the factors and characteristics of women using local herbs during pregnancy and/or labor, and the associations between local herb use and postnatal complications in Kigoma, Tanzania. Methods We analyzed data from the 2016 Kigoma Tanzania Reproductive Health Survey (RHS), a regionally representative, population-based survey of reproductive age women (15–49 years). We included information on each woman’s most recent pregnancy resulting in a live birth during January 2014–September 2016. We calculated weighted prevalence estimates and used multivariable logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for factors associated with use of local herbs during pregnancy and/or labor, as well as factors associated with postnatal complications. Results Of 3530 women, 10.9% (CI: 9.0–13.1) used local herbs during their last pregnancy and/or labor resulting in live birth. The most common reasons for taking local herbs included stomach pain (42.9%) and for the health of the child (25.5%). Adjusted odds of local herb use was higher for women reporting a home versus facility-based delivery (aOR: 1.6, CI: 1.1–2.2), having one versus three or more prior live births (aOR: 1.8, CI: 1.4–2.4), and having a household income in the lowest versus the highest wealth tercile (aOR: 1.4, CI: 1.1–1.9). Adjusted odds of postnatal complications were higher among women who used local herbs versus those who did not (aOR: 1.5, CI: 1.2–1.9), had four or more antenatal care visits versus fewer (aOR: 1.4, CI: 1.2–1.2), and were aged 25–34 (aOR: 1.1, CI: 1.0–1.3) and 35–49 (aOR: 1.3, CI: 1.0–1.6) versus < 25 years. Conclusions About one in ten women in Kigoma used local herbs during their most recent pregnancy and/or labor and had a high risk of postnatal complications. Health providers may consider screening pregnant women for herb use during antenatal and delivery care as well as provide information about any known risks of complications from herb use.
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Affiliation(s)
- R Fukunaga
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. .,Epidemic Intelligence Service, Atlanta, Georgia, USA.
| | - D Morof
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,United States Public Health Service, Atlanta, USA
| | - C Blanton
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A Ruiz
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - G Maro
- Bloomberg Philanthropies, New York, New York, United States
| | - F Serbanescu
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Sumankuuro J, Soyen C, Crockett J, Ibrahim M, Ngmenkpieo F, Wulifan JK. Women’s Motivation and Associated Factors for Herbal Medicine Use during Pregnancy and Childbirth: A Systematic Review. Health (London) 2020. [DOI: 10.4236/health.2020.126044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Use of complementary and alternative medicine in pregnant women: A cross-sectional survey in the south of Iran. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:392-395. [DOI: 10.1016/j.joim.2019.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/05/2019] [Indexed: 12/28/2022]
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Exploring the effects of peri-partum ingestion of traditional medicine on maternal and foetal outcomes: a prospective cohort study. BMC Res Notes 2019; 12:166. [PMID: 30909953 PMCID: PMC6434835 DOI: 10.1186/s13104-019-4199-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 03/16/2019] [Indexed: 11/21/2022] Open
Abstract
Objective In Africa, 80% of women ingest traditional medicine (TM) during pregnancy. Although widely used in Cameroon, no study in has either demonstrated its safety or effectiveness. Hence, we sought to determine the effects of TM ingestions during the peri-partum period on maternal and foetal outcomes. A cohort study was conducted from January to April 2016 in two referral maternity departments of Cameroon. We consecutively enrolled all consenting parturients with gestational age above 28 weeks. We divided them into two groups; exposed and unexposed. The exposure studied was ingestion of TM within 72 h prior to delivery. Variables studied were socio-demographic characteristics, type and frequency of TM ingested and details of labour. Results We enrolled a total of 603 parturients of whom 147 in the exposed group and 456 in the non-exposed group. The most frequently used TM were honey and Triumfetta pentandra A. Ingestion of TM in the peri-paritum period was associated with intra-partum vaginal bleeding, dystocic labour, tachysystole and uterine atony. No adverse neonatal outcome was observed. Overall, these findings could help guide the direction of future research into the safety and potential benefits of peri-partum TM use, as well as serving as a preliminary reference for counselling.
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Al Essa M, Alissa A, Alanizi A, Bustami R, Almogbel F, Alzuwayed O, Abo Moti M, Alsadoun N, Alshammari W, Albekairy A, Al Harbi S, Alhokail M, Gramish J. Pregnant women's use and attitude toward herbal, vitamin, and mineral supplements in an academic tertiary care center, Riyadh, Saudi Arabia. Saudi Pharm J 2019; 27:138-144. [PMID: 30662317 PMCID: PMC6323193 DOI: 10.1016/j.jsps.2018.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 09/10/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Herbal medicine has been widely utilized by pregnant women despite the limited available evidence regarding the safety and efficacy of that practice. The current available studies, from different countries, estimated that the use of herbal medicine during pregnancy range from 7% up to 96%. The aim of this study is to determine the prevalence, attitude, source of information, and reasoning behind the use of herbal medicine among pregnant women in Saudia Arabia. METHODS A cross-sectional study conducted using a convenience sample including pregnant women who visited the obstetric clinics at King Abdulaziz Medical City in Riyadh, Saudi Arabia. A survey was administered in order to evaluate the prevalence and perception toward herbal medicine use among pregnant women in Saudi Arabia. RESULTS A total of 297 pregnant women completed the survey. The results showed that 56% of the respondents have used some type of herbal medicine during their pregnancy. Olive oil was utilized in 26% of the respondents followed by cumin 20% and garlic 15%. In addition, 37% of the respondents used herbal medicine by their own initiative, while 33% and 12% used herbal medicine based on recommendations from their families and friends, respectively. Furthermore, 19% of the respondents reported a positive attitude toward herbal medicine use during pregnancy. In addition, the percentage of women with positive attitude was marginally higher among respondents with lower educational level. CONCLUSION The prevalence of using herbal medicine is considerably high among pregnant women in Saudi Arabia. Unfortunately, the majority of the users relied on informal sources to use herbal medicine during pregnancy.
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Affiliation(s)
- Mohammed Al Essa
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 14611, Saudi Arabia
| | - Abdulrahman Alissa
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
| | - Abdalrhman Alanizi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
| | - Rami Bustami
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
| | - Feras Almogbel
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
| | - Omar Alzuwayed
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
| | - Meshari Abo Moti
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
| | - Nouf Alsadoun
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 22490, Riyadh 11426, Saudi Arabia
| | - Wasmiyah Alshammari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 22490, Riyadh 11426, Saudi Arabia
| | - Abdulkareem Albekairy
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
| | - Shmeylan Al Harbi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
| | - Mohammed Alhokail
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
| | - Jawaher Gramish
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. BOX 3660, Riyadh 11426, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
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Ahmed M, Hwang JH, Hasan MA, Han D. Herbal medicine use by pregnant women in Bangladesh: a cross-sectional study. Altern Ther Health Med 2018; 18:333. [PMID: 30545348 PMCID: PMC6293557 DOI: 10.1186/s12906-018-2399-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/04/2018] [Indexed: 12/14/2022]
Abstract
Background Herbal medicines in pregnancy are increasingly used worldwide with prevalence of up to 67%. Although this popularity is mainly because of the common belief that these medicines are safe, recent reports suggest that several herbal medicines are potentially harmful to mother and fetus if used in pregnancy. Methods This cross-sectional study was conducted in July and August of year 2017, at maternity wards of two public hospitals in Dhaka, Bangladesh. Postpartum women were interviewed via the structured questionnaire to collect information regarding socio-demographic and health characteristics, patterns of herbal medicines used in the previous pregnancy, and outcome of pregnancy. Results Two hundred forty-three postpartum women participated in the study, with 70% of them using at least one modality of herbal medicines in previous pregnancy. Ginger, black seed, lemon tea, prune, and mustard oil were most commonly used herbal medicines. Herbal medicines were mostly used for pregnancy-related symptoms such as nausea, vomiting, and cold. Fifteen (8.8%) herbal medicine users reported side effects. Conclusions This study highlights popularity of herbal medicines during pregnancy in Bangladesh. Previous herbal medicine users and unemployed women turned significantly more to herbal medicines during pregnancy. Reports of side effects and use of some potentially harmful modalities warrant awareness regarding proper use of herbal medicines in pregnancy and its pharmacovigilance. Electronic supplementary material The online version of this article (10.1186/s12906-018-2399-y) contains supplementary material, which is available to authorized users.
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Pour ZS, Hosseinkhani A, Asadi N, Shahraki HR, Vafaei H, Kasraeian M, Bazrafshan K, Faraji A. Double-blind randomized placebo-controlled trial on efficacy and safety of Lactuca sativa L. seeds on pregnancy-related insomnia. JOURNAL OF ETHNOPHARMACOLOGY 2018; 227:176-180. [PMID: 30172900 DOI: 10.1016/j.jep.2018.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 07/20/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE There is limited evidence about the role of herbal and traditional medicine in pregnancy-related insomnia. Extant documents on traditional Persian medicine refer to many plants which could induce sleep and which were used by pregnant women. In Iran, local herbal shops continue to provide these herbs to pregnant women to treat insomnia. One such herb is Lactuca sativa L. The aim of this study was to evaluate the effects of lettuce seed on pregnant women for the treatment of insomnia. METHODS AND MATERIALS In a prospective randomized clinical trial, 100 pregnant women with insomnia aged 20-45 years were assigned to receive capsules containing 1000 mg of lettuce seed or a placebo daily for two weeks. The main outcome was the quality of sleep, which was measured using the Pittsburgh Sleep Quality Index (PSQI). RESULTS Each group contained 50 participants. An improvement in the PSQI score was significantly greater in patients receiving lettuce seed than those receiving the placebo. Linear regression analysis showed that, after controlling for the other variables, the average sleep score of the experimental group was significantly lower than for the placebo group (p = 0.03). CONCLUSIONS The findings of this study suggest that lettuce seed decreased insomnia during pregnancy and could be recommended as a safe natural remedy for treatment of pregnancy-related insomnia.
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Affiliation(s)
- Zohreh Safari Pour
- Dept of Obstetrics &Gynecology, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ayda Hosseinkhani
- Research center for traditional medicine and history of medicine, Shiraz University of medical sciences, Shiraz, Iran.
| | - Nasrin Asadi
- Maternal-Fetal Medicine Research Center, Perinatology Ward, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hadi Raeisi Shahraki
- Department of biostatistics school of medicine Shiraz University of Medical Science, Shiraz, Iran.
| | - Homeira Vafaei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Kasraeian
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Khadije Bazrafshan
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Azam Faraji
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Prevalence and Related Factors to Herbal Medicines Use among Pregnant Females. Jundishapur J Nat Pharm Prod 2018. [DOI: 10.5812/jjnpp.13785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abdollahi F, Yazdani Chareti J. The relationship between women's characteristics and herbal medicines use during pregnancy. Women Health 2018; 59:579-590. [PMID: 29336734 DOI: 10.1080/03630242.2017.1421285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The use of herbal medicines (HM) has been increasing worldwide. This cross-sectional study investigated the prevalence of and characteristics related to use of HM among 320 pregnant women. Participants were admitted to Mazandaran-based hospitals' postnatal wards from March to June 2015. Data were collected via a self-report questionnaire, including herbs used during pregnancy and demographic, socioeconomic, and pregnancy-related factors. Nearly half (48.4%) of the women reported taking one or more HM during pregnancy. The most frequently used herbs were sour orange (30.97%), peppermint (19.81%), and Borage (19.46%). Most women (29.20%) were advised by their relatives to take these and did not disclose this use to their health care providers (50%) because they perceived their use as safe (39.7%). The use of herbs was greater among pregnant women with upper secondary level education, living in their own house and from higher socioeconomic classes. Most of the information sources for women were informal, indicating they were not knowledgeable about the herbs' safety and efficacy during pregnancy. Health care providers should be informed about HM and question pregnant women about their use of HM during pregnancy so that they can advise them about potential side effects and drug interactions.
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Affiliation(s)
- Fatemeh Abdollahi
- a Department of Public Health, Faculty of Health, Traditional and Complementary Medicine Research Center , Addiction Institute, Mazandaran University of Medical Sciences , Sari , Iran
| | - Jamshid Yazdani Chareti
- b Department of Biostatistics, Faculty of Health, Traditional and Complementary Medicine Research Center , Addiction Institute, Mazandaran University of Medical Science , Sari , Iran
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Marwa KJ, Njalika A, Ruganuza D, Katabalo D, Kamugisha E. Self-medication among pregnant women attending antenatal clinic at Makongoro health centre in Mwanza, Tanzania: a challenge to health systems. BMC Pregnancy Childbirth 2018; 18:16. [PMID: 29310609 PMCID: PMC5759229 DOI: 10.1186/s12884-017-1642-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-medication is a universal challenge that requires attention because of the potential threat not only to the pregnant women but also to unborn child. Data on self-medication practice and predictors among pregnant women is lacking in Tanzania. Information on the effects of this practice to the pregnant woman and the foetus globally is also scanty. METHODS This was a cross sectional study which was conducted using face to face interview with 372 pregnant women at Makongoro health centre. Semi-structured questionnaires were used. Data were analysed using STATA 13 (Statistical Corporation, College Station, Texas, US). RESULTS A total of 372 pregnant women participated in the study. The prevalence of self-medication among pregnant women was 172 (46.24%). There was a significant statistical association between self-medication and occupation (P value =0.01), gestation age (P < 0.01) and education (P < 0.01). Age, marital status and gravidity were not associated with self-medication (P = 0.809, P = 0.243 and P = 0.922) respectively. When bivariate logistic regression was performed, occupation and education were the only determining factors for self-medication. Pregnant women who were unemployed, doing business and house wife were most likely to practice self-medication than employed pregnant women (P = 0.03; OR = 2.33; 95% CI, 1.06-5.31, P = 0.01; OR = 2.31; CI 1.21-4.41, P = <0.01, OR = 2.73, 95% CI 0.52-2.43) respectively. Pregnant women with no formal education, incomplete primary education, primary education and secondary education were most likely to practice self-medication than pregnant women with college or university education (P < 0.01, OR = 6.37 95% CI 2.37-19.03, P < 0.01, OR = 6.58, 95% CI 2.36-18.25, P < 0.01, OR = 3.78, 95% CI 1.89-7.56, P < 0.01, OR = 2.59 95% CI = 1.30-5.17). The leading illness/symptoms which led to self-medication among pregnant women attending clinic were malaria 56 (32.56%, morning sickness 44 (25.55%) and headache 33(19.19%). Drugs commonly used in self-medication among pregnant women were ant malarial 42 (24.42%), antiemetics 59 (34.30%) and analgesics 33 (19.19%). CONCLUSION Prevalence of self-medication among pregnant women is high in Tanzania. This is a threat to the safety of the developing foetus and the pregnant woman. Therefore there is a need of interventions to minimize the practice among pregnant women.
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Affiliation(s)
- Karol J. Marwa
- Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Agnes Njalika
- School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Deodatus Ruganuza
- Department of Parasitology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Deogratias Katabalo
- School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Erasmus Kamugisha
- Department of Biochemistry, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Women's perspectives towards traditional and complementary medicine used to conceive, during pregnancy and the postpartum period. Complement Ther Clin Pract 2017; 30:109-115. [PMID: 29389469 DOI: 10.1016/j.ctcp.2017.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/11/2017] [Accepted: 12/09/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aims to explore pregnant and postpartum women's understanding of the meaning of traditional and complementary medicine (T&CM) and how that may affect their T&CM use. METHODS A cross-sectional study was conducted using self-administered questionnaires. Data collected from 374 women were analysed and represented via descriptive statistics. RESULTS Out of the 374 participants, 285 (76.2%) reported using at least one type of T&CM to conceive, during pregnancy or in the postpartum period. The majority of the participants identified that T&CM is all about plants or natural products without chemicals or drugs (n = 267, 71.4%, p < .001). The category of T&CM with the highest usage was biological based therapies (n = 272, 95.4%), while the lowest was energy therapies (n = 8, 2.8%). The most commonly used T&CM was the traditional Malay massage (n = 170, 59.6%). The main sources of information and recommendations for using T&CM came from their family members or friends (n = 199, 69.8%). Almost half of the participants incurred minimum expenditures of MYR100 and below on the T&CM used (n = 137, 48.1%) and there was no significant difference between pregnant and postpartum women (p = .056). CONCLUSION This study reveals that many women are practising T&CM when trying to conceive and during pregnancy and the postpartum period even though they are aware that there is insufficient evidence on its safety and efficacy. Therefore, further studies are needed in order to gain sufficient clinical evidence that could be used to structure better guidelines for T&CM practices and services in Malaysia.
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Ahmed M, Hwang JH, Choi S, Han D. Safety classification of herbal medicines used among pregnant women in Asian countries: a systematic review. Altern Ther Health Med 2017; 17:489. [PMID: 29137614 PMCID: PMC5686907 DOI: 10.1186/s12906-017-1995-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/07/2017] [Indexed: 11/30/2022]
Abstract
Background High prevalence of herbal medicines used in pregnancy and the lack of information on their safety is a public concern. Despite this, no significant research has been done regarding potential adverse effects of using herbal medicines during pregnancy, especially among developing Asian countries. Methods Cross-sectional studies were searched up to year 2016 on PubMed/Medline and EMBASE, the data were extracted and quality of studies was assessed using the quality appraisal tool. The findings are reported in accordance to the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Classification on safety of identified herbal medicines was done based on current scientific literature. Results This study included eight cross-sectional studies (2729 participants) from seven different Asian countries, of which 1283 (47.01%) women used one or more herbal medicines during pregnancy. Peppermint (22.8%), aniseed (14.7%), olibanum (12.9%), flixweed seed (12.2%) and ginger (11.5%) were the most frequently used herbal medicines. Out of the 33 identified herbal medicines, 13 were classified as safe to use, five as use with caution, eight were potentially harmful to use in pregnancy and information on seven herbal medicines was not available in the current literature. Conclusions Several herbal medicines identified in this review were classified to be potentially harmful or the information regarding safety in pregnancy was missing. It is recommended that contraindicated herbal medicines should be avoided and other herbals should be taken under supervision of a qualified health care practitioner. The classification regarding safety of herbal medicines in pregnancy can be utilized to create awareness on prevention of adverse effects. Electronic supplementary material The online version of this article (10.1186/s12906-017-1995-6) contains supplementary material, which is available to authorized users.
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Khowaja AR, Qureshi RN, Sawchuck D, Oladapo OT, Adetoro OO, Orenuga EA, Bellad M, Mallapur A, Charantimath U, Sevene E, Munguambe K, Boene HE, Vidler M, Bhutta ZA, von Dadelszen P. The feasibility of community level interventions for pre-eclampsia in South Asia and Sub-Saharan Africa: a mixed-methods design. Reprod Health 2016; 13 Suppl 1:56. [PMID: 27357579 PMCID: PMC4943500 DOI: 10.1186/s12978-016-0133-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, pre-eclampsia and eclampsia are major contributors to maternal and perinatal mortality; of which the vast majority of deaths occur in less developed countries. In addition, a disproportionate number of morbidities and mortalities occur due to delayed access to health services. The Community Level Interventions for Pre-eclampsia (CLIP) Trial aims to task-shift to community health workers the identification and emergency management of pre-eclampsia and eclampsia to improve access and timely care. Literature revealed paucity of published feasibility assessments prior to initiating large-scale community-based interventions. Arguably, well-conducted feasibility studies can provide valuable information about the potential success of clinical trials prior to implementation. Failure to fully understand the study context risks the effective implementation of the intervention and limits the likelihood of post-trial scale-up. Therefore, it was imperative to conduct community-level feasibility assessments for a trial of this magnitude. METHODS A mixed methods design guided by normalization process theory was used for this study in Nigeria, Mozambique, Pakistan, and India to explore enabling and impeding factors for the CLIP Trial implementation. Qualitative data were collected through participant observation, document review, focus group discussion and in-depth interviews with diverse groups of community members, key informants at community level, healthcare providers, and policy makers. Quantitative data were collected through health facility assessments, self-administered community health worker surveys, and household demographic and health surveillance. RESULTS Refer to CLIP Trial feasibility publications in the current and/or forthcoming supplement. CONCLUSIONS Feasibility assessments for community level interventions, particularly those involving task-shifting across diverse regions, require an appropriate theoretical framework and careful selection of research methods. The use of qualitative and quantitative methods increased the data richness to better understand the community contexts. TRIAL REGISTRATION NCT01911494.
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Affiliation(s)
- Asif Raza Khowaja
- />Division of Women & Child Health, Aga Khan University, Karachi, Pakistan
- />Department of Obstetrics and Gynaecology, and the Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | | | - Diane Sawchuck
- />Department of Obstetrics and Gynaecology, and the Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Olufemi T. Oladapo
- />Centre for Research in Reproductive Health (CRRH), Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State Nigeria
| | - Olalekan O. Adetoro
- />Centre for Research in Reproductive Health (CRRH), Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State Nigeria
| | - Elizabeth A. Orenuga
- />Centre for Research in Reproductive Health (CRRH), Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State Nigeria
| | - Mrutyunjaya Bellad
- />KLE University’s JN Medical College, Belgaum & SN Medical College, Bagalkot, India
| | - Ashalata Mallapur
- />KLE University’s JN Medical College, Belgaum & SN Medical College, Bagalkot, India
| | - Umesh Charantimath
- />KLE University’s JN Medical College, Belgaum & SN Medical College, Bagalkot, India
| | - Esperança Sevene
- />Manhiça Health Research Centre (CISM), Mozambique and Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Khátia Munguambe
- />Manhiça Health Research Centre (CISM), Mozambique and Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Helena Edith Boene
- />Manhiça Health Research Centre (CISM), Mozambique and Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Marianne Vidler
- />Department of Obstetrics and Gynaecology, and the Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Zulfiqar A. Bhutta
- />Division of Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Peter von Dadelszen
- />Department of Obstetrics and Gynaecology, and the Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - CLIP Working Group
- />Division of Women & Child Health, Aga Khan University, Karachi, Pakistan
- />Department of Obstetrics and Gynaecology, and the Child and Family Research Institute, University of British Columbia, Vancouver, Canada
- />Centre for Research in Reproductive Health (CRRH), Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State Nigeria
- />KLE University’s JN Medical College, Belgaum & SN Medical College, Bagalkot, India
- />Manhiça Health Research Centre (CISM), Mozambique and Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique
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Kristanc L, Kreft S. European medicinal and edible plants associated with subacute and chronic toxicity part I: Plants with carcinogenic, teratogenic and endocrine-disrupting effects. Food Chem Toxicol 2016; 92:150-64. [PMID: 27090581 DOI: 10.1016/j.fct.2016.04.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/08/2016] [Accepted: 04/10/2016] [Indexed: 12/14/2022]
Abstract
In recent decades, the use of herbal medicines and food products has been widely embraced in many developed countries. These products are generally highly accepted by consumers who often believe that "natural" equals "safe". This is, however, an oversimplification because several botanicals have been found to contain toxic compounds in concentrations harmful to human health. Acutely toxic plants are in most cases already recognised as dangerous as a result of their traditional use, but plants with subacute and chronic toxicity are difficult or even impossible to detect by traditional use or by clinical research studies. In this review, we systematically address major issues including the carcinogenicity, teratogenicity and endocrine-disrupting effects associated with the use of herbal preparations with a strong focus on plant species that either grow natively or are cultivated in Europe. The basic information regarding the molecular mechanisms of the individual subtypes of plant-induced non-acute toxicity is given, which is followed by a discussion of the pathophysiological and clinical characteristics. We describe the genotoxic and carcinogenic effects of alkenylbenzenes, pyrrolizidine alkaloids and bracken fern ptaquiloside, the teratogenicity issues regarding anthraquinone glycosides and specific alkaloids, and discuss the human health concerns regarding the phytoestrogens and licorice consumption in detail.
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Affiliation(s)
- Luka Kristanc
- Institute of Biophysics, Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia; Primary Healthcare of Gorenjska, ZD Kranj, Gosposvetska Ulica 10, 4000 Kranj, Slovenia.
| | - Samo Kreft
- Faculty of Pharmacy, University of Ljubljana, Tržaška Cesta 32, 1000 Ljubljana, Slovenia
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Safety classification of herbal medicines used in pregnancy in a multinational study. Altern Ther Health Med 2016; 16:102. [PMID: 26980526 PMCID: PMC4793610 DOI: 10.1186/s12906-016-1079-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 03/09/2016] [Indexed: 01/25/2023]
Abstract
Background The use of herbal medicines for health prevention and ailments is an increasing trend worldwide. Women in pregnancy are no exception; the reported prevalence of herbal medicine use in pregnancy ranges from 1 to 60 %. Despite a common perception of safety, herbal medicines may have potent pharmacological actions, and historically, have been used for this reason. Methods A multinational, cross-sectional study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North America, and Australia. This study’s primary aim was to evaluate and classify the herbal medicines used according to their safety in pregnancy and, secondly, to investigate risk factors associated with the use of contraindicated herbal medicines during pregnancy. Results In total, 29.3 % of the women (n = 2673) reported the use of herbal medicines in pregnancy; of which we were able to identify 126 specific herbal medicines used by 2379 women (89.0 %). Twenty seven out of 126 herbal medicines were classified as contraindicated in pregnancy, and were used by 476 women (20.0 %). Twenty-eight were classified as safe for use in pregnancy and used by the largest number of women (n = 1128, 47.4 %). The greatest number was classified as requiring caution in pregnancy; these sixty herbal medicines were used by 751 women (31.6 %). Maternal factors associated with the use of contraindicated herbal medicines in pregnancy were found to be working in the home, having a university education, not using folic acid, and consuming alcohol. Interestingly, the recommendation to take a contraindicated herbal medicine was three times more likely to be from a healthcare practitioner (HCP) than an informal source. Conclusion Based on the current literature the majority of women in this study used an herbal medicine that was classified as safe for use in pregnancy. Women who reported taking a contraindicated herb were more likely to have been recommended it use by an HCP rather than informal source(s), indicating an urgent need for more education among HCPs. The paucity of human studies on herbal medicines safety in pregnancy stands in stark contrast to the widespread use of these products among pregnant women. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1079-z) contains supplementary material, which is available to authorized users.
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Heitmann K, Havnen GC, Holst L, Nordeng H. Pregnancy outcomes after prenatal exposure to echinacea: the Norwegian Mother and Child Cohort Study. Eur J Clin Pharmacol 2016; 72:623-30. [PMID: 26895223 DOI: 10.1007/s00228-016-2021-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/05/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Previous studies have shown that echinacea is among the most widely used herbal medicines during pregnancy in Western countries. Despite its frequent use, we know little about the safety of this herbal medicine during pregnancy. The primary aim of this study was to study the consequences of the use of echinacea on malformations and common adverse pregnancy outcomes. Secondly, we aimed to characterize women using this herb in pregnancy. METHOD This study is based on the Norwegian Mother and Child Cohort Study (MoBa) and included 68,522 women and their children. Information was retrieved from three self-administered questionnaires completed by the women in pregnancy weeks 17 and 30 and 6 months after birth. Information on pregnancy outcomes was retrieved from the Medical Birth Registry of Norway. Generalized estimating equations analyses were performed to assess the association between exposure to echinacea and pregnancy outcomes. Pearson's chi-square test was used to assess factors related to use of echinacea in pregnancy. RESULTS Among 68,522 women, 363 (0.5 %) reported the use of echinacea during pregnancy. These women were characterized by high age and delivery before 2002 and were to a less extent smoking in pregnancy. The use of echinacea was not associated with an increased risk of malformations or adverse pregnancy outcomes. CONCLUSION This study revealed no increased risk of malformations or adverse pregnancy outcomes after the use of echinacea in pregnancy. Studies on the safety of commonly used herbal medications are important to identify herbals that should be avoided in pregnancy.
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Affiliation(s)
- K Heitmann
- Department of Global Public Health and Primary Care and Centre for Pharmacy, Faculty of Medicine and Dentistry, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.
| | - G C Havnen
- Regional Medicines Information and Pharmacovigilance Centre (RELIS), Oslo University Hospital, Oslo, Norway
| | - L Holst
- Department of Global Public Health and Primary Care and Centre for Pharmacy, Faculty of Medicine and Dentistry, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway
| | - H Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway.,Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
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Haseeb A, Bilal M. Prevalence of using non prescribed medications in economically deprived rural population of Pakistan. ACTA ACUST UNITED AC 2016; 74:1. [PMID: 26807216 PMCID: PMC4722669 DOI: 10.1186/s13690-015-0113-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/31/2015] [Indexed: 11/28/2022]
Abstract
Background Self medication is described as an act of procurement and consumption of medical drugs without the advice of medical physician for diagnosis, prescription and surveillance of treatment. There is a paucity of literature with regards to self medication among rural dwellers of Pakistan and no initiatives have been taken to resolve this issue. Therefore, the study aimed to evaluate frequency, practice and prevalence of self medication among economically deprived rural population of Karachi (South Pakistan). Methods This was the descriptive, epidemiological cross sectional survey which was conducted at the two largest tertiary care government based teaching hospitals of Karachi, Civil hospital and Jinnah Postgraduate Medical Centre, from January 2015 until March 2015. Seven hundred rural dwellers were recruited; who were the residents of outskirts of Karachi city were enrolled in the above mentioned period through the outpatient department (OPD) of the respective hospitals. Results According to the survey, 595 (85 %) subjects practiced self medication. The most common reasons evaluated for self medication were cost of consultation (90.3 %) and availability of transport (81.0 %) from rural area to health care facility. The paracetamol as a painkiller (93.0 %), acetylsalicylic acid as an anti pyretic (69.0 %), anti biotic (52.0 %) and anti allergic (51.0 %) were the commonest drug used without prescription of a health care physician. A significant difference was obtained in carrying out self medication between participants earning less than 50,000 PKR and greater than this amount (p = 0.029; 61 % vs. 24 %) and for the self medicated patients having education less than graduation with the participants having education of graduation or above it (p = 0.03; 63 % vs. 22 %). Conclusion The self medication among rural dwellers of Karachi is high . As a result, urgent steps must be taken to initiate the awareness and educational programs regarding potential risks of self medication. Secondly, strict measures must be introduced to stop supply of prescription drugs from pharmacies without prescription. Thirdly, provision of cost effective treatment from public sector hospitals to rural population can help to reduce self medication among rural population of Pakistan.
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Affiliation(s)
- Abdul Haseeb
- Dow University of Health Sciences, Karachi, Pakistan
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Nergard CS, Ho TPT, Diallo D, Ballo N, Paulsen BS, Nordeng H. Attitudes and use of medicinal plants during pregnancy among women at health care centers in three regions of Mali, West-Africa. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2015; 11:73. [PMID: 26453339 PMCID: PMC4600315 DOI: 10.1186/s13002-015-0057-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 09/18/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND Although, medicinal plants have been important for women's health historically, the knowledge about such use during pregnancy in developing countries is limited. This is the first quantitative, ethnobotanical study on Malian women's use of and attitudes towards the use of medicinal plants during pregnancy. The aim of the study was to describe Malian women's use of medicinal plants during pregnancy according to indications and to evaluate the potentially safety of such use. The overall aim was to preserve valuable information about medicinal plants for women's reproductive health for the future. METHODS Data was collected through structured interviews of 209 pregnant women or mothers in three health care centers in Mali. The women were interviewed about their uses of medicinal plants during pregnancy and their attitudes to such use. Nine specific medicinal plants commonly used in Mali and treatment of eleven common ailments in pregnancy were specifically queried about. RESULTS In total, 79.9 % had used medicinal plants during pregnancy. Only 17 women (8.5 %) had received a recommendation from a traditional practitioner (TP). The most commonly used medicinal plants were Lippia chevalieri (55.5 %), Combretum micranthum (39.7 %), Parkia biglobosa (12.0 %) and Vepris heterophylla (8.1 %). The most common reasons for use were for well-being (37.7 %), symptoms of malaria (37.1 %) and "increased salt-elimination" (to reduce edema) (19.2 %). For treatment of symptoms of malaria and urinary tract infections during pregnancy, the women's choices of medicinal plants agreed with those previously reported from interviews with TPs. Almost 30 % believed that medicinal plants had no adverse effects for the mother. CONCLUSION This study showed an extensive use and knowledge of medicinal plants during pregnancy in three regions in Mali. However, exclusive use of medicinal plants as treatment of malaria and urinary tract infections during pregnancy may pose a health risk for the mother and her unborn child. A wider collaboration with TPs, with local communities and conventional health workers of the health care centers, on the safe use of medicinal plants, is important to promote safer pregnancies and better health care for pregnant women and their unborn infants in Mali.
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Affiliation(s)
- Cecilie Sogn Nergard
- Department of Pharmacy, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1065 Blindern, Oslo, N-0316, Norway.
| | - Thi Phung Than Ho
- Department of Pharmacy, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1065 Blindern, Oslo, N-0316, Norway.
| | - Drissa Diallo
- Department of Traditional Medicine, National Institute of Research in Public Health, Bamako, Mali.
| | - Ngolo Ballo
- Department of Traditional Medicine, National Institute of Research in Public Health, Bamako, Mali.
| | - Berit Smestad Paulsen
- Department of Pharmacy, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1065 Blindern, Oslo, N-0316, Norway.
| | - Hedvig Nordeng
- Department of Pharmacy, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1065 Blindern, Oslo, N-0316, Norway.
- Division of Mental Health, National Institute of Public Health, Oslo, Norway.
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Ly C, Yockell-Lelièvre J, Ferraro ZM, Arnason JT, Ferrier J, Gruslin A. The effects of dietary polyphenols on reproductive health and early development†. Hum Reprod Update 2014; 21:228-48. [DOI: 10.1093/humupd/dmu058] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Abstract
PURPOSE OF REVIEW The aim of this article is two-fold: to report the prevalence of herbal products used by pregnant women and to evaluate the evidence of efficacy and safety of the most popular remedies. RECENT FINDINGS Of the 671 articles identified, 15 randomized controlled trials (RCTs) and 16 non-RCTs were eligible. Ginger was the most investigated remedy and it was consistently reported to ameliorate nausea and vomiting in pregnancy. Although raspberry, blue cohosh, castor oil, and evening primrose oil are believed to facilitate labor in traditional medicine, very few scientific data support such indication. Moreover, they have been associated with severe adverse events. Data on the safety of Hypericum perforatum in pregnancy or lactation are reassuring, whereas efficacy was demonstrated only in nonpregnant individuals. There is still insufficient evidence regarding the efficacy and safety of Echinacea, garlic, and cranberry in pregnancy. SUMMARY Epidemiological studies reported a wide range of use of herbal remedies in pregnancy. Too few studies have been devoted to the safety and efficacy of singular herbs. With the exception of ginger, there are no consistent data to support the use of any other herbal supplement during pregnancy. Severe adverse events have been reported using blue cohosh and evening primrose oil.
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Affiliation(s)
- Giulia Dante
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
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Kureshee NI, Dhande PP. Awareness of Mothers and Doctors about Drug Utilization Pattern for Illnesses Encountered during Pregnancy. J Clin Diagn Res 2013; 7:2470-4. [PMID: 24392375 DOI: 10.7860/jcdr/2013/6329.3582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/05/2013] [Indexed: 01/21/2023]
Abstract
BACKGROUND Careful consideration of the benefit to the mother and risk to the foetus, is required, while prescribing drugs during pregnancy. OBJECTIVES To assess the pattern of drug utilization during pregnancy and to explore the knowledge, attitude and awareness on drug use by the antenatal mother in a tertiary care hospital setup in western India. MATERIAL AND METHODS Observational, cross-sectional study involved holding interviews on 501 pregnant women, in OPD and IPD of Obstetrics-Gynaecology Department using a pilot-based questionnaire, was done. Data from prescriptions and case-files were also collected. Drugs were classified pharmacologically and according to teratogenic potential using U.S.FDA classification. Study population was classified according to the trimester of pregnancy and educational and socioeconomic status. Intergroup comparison was done using Chi-square test. RESULTS Majority of the drugs were from Category A(71.2%) and Category B (16.5%), followed by those from Categories C(9.09%), D(1.12%) and X(0.7%). Category A drugs were significantly used more in first trimester, while Category C and D drugs were used in the last two trimesters (p<0.0001) for pregnancy associated complications. Only 24.55% of the women believed that drug use in pregnancy could be harmful to both mother and baby, while 35.52% believed that drug use could be dangerous throughout pregnancy. Patients' educational and socio-economic statuses influenced their compliance for nutritional supplements prescribed during pregnancy and their awareness on common contraceptive methods. Higher education and socioeconomic class provided information on safety of barrier contraception during pregnancy. CONCLUSION Study revealed careful prescribing behaviour of physicians. Lack of awareness on safety of drugs in pregnancy and contraceptive use advocates a need for educating and counselling women of child bearing ages.
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Al-Ramahi R, Jaradat N, Adawi D. Use of herbal medicines during pregnancy in a group of Palestinian women. JOURNAL OF ETHNOPHARMACOLOGY 2013; 150:79-84. [PMID: 23933314 DOI: 10.1016/j.jep.2013.07.041] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 07/28/2013] [Accepted: 07/29/2013] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The use of herbal medicines during pregnancy is common worldwide due to physiological changes that lead to pregnancy related problems. OBJECTIVES The aims of this study were to measure the prevalence and predictors of herb use among a group of Palestinian pregnant women and the possible influence of herbal consumption on pregnancy outcomes. METHODS This study was a questionnaire-based cross sectional descriptive study. It was conducted in the maternity ward of a governmental hospital between March and May 2012, a random sample of women who gave birth during the study period were met and asked to answer a face to face questionnaire. RESULTS Out of 300 women, 120 women (40.0%) used herbs during pregnancy; most women preferred to use herbs because they thought herbs are safer than medications (82.5%), women based in their choices mainly on advice from family or doctors (36.7%, 33.0%, respectively), 65.8% of them told their doctors that they used herbs, 91.7% considered these therapies beneficial, and 99.2% reported no side effects. The most commonly used herbs were anise (Pimpinella anisum) (61.7%), chamomile (Matricaria recutita) (53.3%), sage (Salvia officinalis) (55%), mixture of herbs (33.3%), and thyme (Thymus vulgaris) (29.2%). Most women were using herbs on as needed bases. There were no statistically significant differences between users and non-users of herbs in all socio-demographic variables and pregnancy outcomes. CONCLUSIONS This study found that the use of herbs during pregnancy is very common among Palestinian women. Infrequent use of herbs during pregnancy seems to be safe and beneficial. To provide the best care to pregnant women who use herbal products, clinicians and pharmacist are recommended to stay up to date with herb use and their safety in pregnancy. Not all women tell their doctors about herbal products use, so the physicians are recommended to ask pregnant women about this to avoid any possible negative outcomes on the mother or the fetus.
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Affiliation(s)
- Rowa Al-Ramahi
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, PO Box: 7, Nablus, Palestine.
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Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2013; 69:269-77. [PMID: 22706624 DOI: 10.1007/s00228-012-1331-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 05/30/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The objective of the study was to examine the safety of ginger use during pregnancy on congenital malformations and selected pregnancy outcomes. METHODS The Norwegian Mother and Child Cohort study, a large population-based cohort, provided the data used in this study. Our study population consisted of 68,522 women. Data on ginger use and socio-demographic factors were retrieved from three self-administered questionnaires completed by the women during weeks 17 and 30 of the pregnancy and when their child was 6 months old. Data on pregnancy outcomes were provided by the Medical Birth Registry of Norway. RESULTS Among the 68,522 women in the study, 1,020 (1.5 %) women reported using ginger during pregnancy. The use of ginger during pregnancy was not associated with any increased risk of congenital malformations. No increased risk for stillbirth/perinatal death, preterm birth, low birth weight, or low Apgar score was detected for the women exposed to ginger during pregnancy compared to women who had not been exposed. CONCLUSION Use of ginger during pregnancy does not seem to increase the risk of congenital malformations, stillbirth/perinatal death, preterm birth, low birth weight, or low Apgar score. This finding is clinically important for health care professionals giving advice to pregnant women with NPV.
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Affiliation(s)
- Kristine Heitmann
- Department of Public Health and Primary Health Care and Centre of Pharmacy, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway.
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Dante G, Pedrielli G, Annessi E, Facchinetti F. Herb remedies during pregnancy: a systematic review of controlled clinical trials. J Matern Fetal Neonatal Med 2012; 26:306-12. [PMID: 22928540 DOI: 10.3109/14767058.2012.722732] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The use of herbal remedies has been documented both among various patient groups and in the general population to promote health. The aim of this systematic review is to analyze the benefits of herb use during pregnancy. METHODS A systematic literature search covering the period from January 1990 to September 2010 was performed using various electronic databases. Randomized controlled clinical trials (RCTs) were included. Paper quality was evaluated using the Jadad scale. RESULTS Of the 511 articles identified, 14 RCTs were eligible. Ginger was the most investigated remedy and was consistently reported to ameliorate nausea and vomiting during pregnancy better than placebo; its efficacy in doing so was noted to be equal to that of vitamin B6 and dimenhydrinate. A single trial also supported the use of Hypericum perforatum for wound healing. Cranberry, however, was not efficacious in the treatment of urinary tract infections; finally, raspberry leaf did not shorten the first stage of labor, and garlic did not prevent pre-eclampsia. CONCLUSIONS Despite the widespread, popular use of herbal remedies during pregnancy, too few studies have been devoted to specific clinical investigations. With the exception of ginger, there is no data to support the use of any other herbal supplement during pregnancy.
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Affiliation(s)
- G Dante
- Mother-Infant Department, University of Modena and Reggio Emilia, Italy
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Soligard HT, Bratlid D, Cao C, Liang A, Nilsen OG. Displacement of bilirubin from albumin in plasma from jaundiced newborns. An in vitro study of purified Chinese herbal constituents and sulfisoxazole. Phytother Res 2012; 25:1068-72. [PMID: 21280114 DOI: 10.1002/ptr.3402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of the present study was to clarify the in vitro potential of the purified Chinese herbal constituents LZX-A (neferine), QTJ (sinomenine), YHS (tetrahydropalmitine) and SQZG (notoginsenoside R1) to displace the highly bound bilirubin from albumin binding sites in plasma from jaundiced newborn infants. Sulfisoxazole (1.32 mM) was used as a positive control for bilirubin displacement. The displacing potential of the herbal constituents was investigated at assumed therapeutic concentrations and up to 100 times higher. Total (TB) and unbound (UB) bilirubin in plasma were measured by the peroxidase method. Sulfisoxazole increased the UB concentration in plasma by more than 60%. An increased % displacement of bilirubin was found at higher TB levels confirming the presence also of lower affinity binding sites for bilirubin in plasma. None of the purified herbal constituents showed any bilirubin displacing properties and were unaffected by the level of TB in plasma. The combination of sulfisoxazole and the herbal constituents showed no synergistic effect. It is concluded that none of the investigated purified herbal constituents possess any significant potential in vitro to increase the UB concentration in plasma from jaundiced newborn infants.
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Affiliation(s)
- Hanne Tegnander Soligard
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
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Costa KCDS, Bezerra SB, Norte CM, Nunes LMN, Olinda TMD. Medicinal plants with teratogenic potential: current considerations. BRAZ J PHARM SCI 2012. [DOI: 10.1590/s1984-82502012000300009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to present the implications of the use of herbs during pregnancy, pointing out those that should be avoided during this condition because of their abortifacient and/or teratogenic potential. We carried out searches in the databases ScienceDirect, Scielo and Google Scholar, adopting as criteria for inclusion: book chapters and/or complete articles (with abstract), available in English, Portuguese or Spanish, published from 1996 to in 2011. After a pre-selection of 83 articles, 49 bibliographies were used in the manufacturing end of the article, where 25 were from the Scielo database, 18 from ScienceDirect and 6 from Google Scholar. From the articles studied, we identified the four most commonly used plants as emmenagogue/abortifacient agents by patients of the Department of Prenatal SUS: senne, arruda, boldo and buchinha-do-norte or cabacinha. Thus, we conclude that people often adhere to the maxim "if it's natural, it does no harm" in their rational use of natural products, without the right guidance, believing that these products are safe to use. This usage is even more worrisome among the elderly, pregnant women and children. Regarding the safety of these products, some information and reliable data are scarce or contradictory.
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Sattari M, Dilmaghanizadeh M, Hamishehkar H, Mashayekhi SO. Self-reported Use and Attitudes Regarding Herbal Medicine Safety During Pregnancy in Iran. Jundishapur J Nat Pharm Prod 2012. [DOI: 10.17795/jjnpp-3416] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Self-reported Use and Attitudes Regarding Herbal Medicine Safety During Pregnancy in Iran. Jundishapur J Nat Pharm Prod 2012. [DOI: 10.5812/jjnpp.3416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sattari M, Dilmaghanizadeh M, Hamishehkar H, Mashayekhi SO. Self-reported Use and Attitudes Regarding Herbal Medicine Safety During Pregnancy in Iran. Jundishapur J Nat Pharm Prod 2012; 7:45-9. [PMID: 24624153 PMCID: PMC3941856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Revised: 02/20/2012] [Accepted: 02/22/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Despite the vast use of herbal medicines in the world, little is known about their use in pregnancy and the attitudes of pregnant women regarding their safety during pregnancy. OBJECTIVES The aim of this study was to evaluate the use and attitudes of pregnant women toward herbal medicine use in pregnancy in Iran. MATERIALS AND METHODS A questionnaire was completed by 400 women selected by convenience sampling from postnatal and prenatal wards of two hospitals. Data were analyzed using the SPSS software version 13.5. Chi2 test was used to analyze the data. RESULTS The median age was 26.4 (± 5.2) years and the mean number of pregnancies was 1.9 (± 0.98). The use of herbal remedies during pregnancy was positive in 22.3% of patients. They took herbal medicines recommended by their physician (46.1%), through self-medication (44.9%), or with the advice of family members or friends (9%). Additionally, 39.8% believed that it was safe to use herbal remedies during pregnancy, 32.3% believed that it was harmful for both mother and fetus, and 22% did not know whether it was safe or not. CONCLUSIONS Herbal medicine use was not high among our subjects but was significantly affected by age. The level of education, place of living, and number of pregnancies significantly affected the attitudes of the subjects. Women with higher education mostly relied on their own information, whereas those with lower education relied on physician advice. Further educational programs are required to increase the information for this group of susceptible individuals.
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Affiliation(s)
- Mohammadreza Sattari
- Infectious Disease Research Center, Tabriz University of Medical Sciences, IR Iran
| | - Maryam Dilmaghanizadeh
- Student Research Center, Faculty of Pharmacy, Tabriz University of Medical Sciences, IR Iran
| | - Hadi Hamishehkar
- Drug applied research center, Faculty of Pharmacy, Tabriz University of Medical Sciences, IR Iran
| | - Simin Ozar Mashayekhi
- Health Services Management Research Center, Faculty of Pharmacy, Tabriz University of Medical Sciences, IR Iran,Corresponding author: Simin Ozar Mashayekhi, School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, IR Iran, P.O. Box: 54664-14766. Tel: +98-4113341315, Fax: +98-4113344798, E-mail:
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Rayner JA, Willis K, Burgess R. Women's Use of Complementary and Alternative Medicine for Fertility Enhancement: A Review of the Literature. J Altern Complement Med 2011; 17:685-90. [DOI: 10.1089/acm.2010.0435] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jo-Anne Rayner
- Mother and Child Health Research, La Trobe University, Melbourne, Victoria, Australia
| | - Karen Willis
- School of Sociology and Social Work, University of Tasmania, Launceston, Tasmania, Australia
| | - Rebekah Burgess
- School of Sociology and Social Work, University of Tasmania, Launceston, Tasmania, Australia
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Cuzzolin L, Francini-Pesenti F, Verlato G, Joppi M, Baldelli P, Benoni G. Use of herbal products among 392 Italian pregnant women: focus on pregnancy outcome. Pharmacoepidemiol Drug Saf 2011; 19:1151-8. [PMID: 20872924 DOI: 10.1002/pds.2040] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The present study aimed to explore the use of herbal products among a sample of Italian pregnant women and the possible influence of herbal consumption on pregnancy outcome. METHODS The study was conducted over a 10-month period (2 days a week, from January to October 2009) at the Maternity wards of Padua and Rovereto Hospital. Data were collected through a face-to-face interview on the basis of a prestructured questionnaire including socio-demographic characteristics of the enrolled subjects, specific questions on herbal use, information about pregnancy and newborn. RESULTS In total, 392 interviews were considered. One hundred and nine out of 392 women (27.8%) reported to have been taking one or more herbal products during pregnancy, in the 36.7% of cases throughout all pregnancy. The most frequently herbs taken by interviewees were chamomile, licorice, fennel, aloe, valerian, echinacea, almond oil, propolis, and cranberry. Four out of 109 women (3.7%) reported side-effects: constipation after a tisane containing a mix of herbs, rash and itching after local application of aloe or almond oil. The decision to use herbal products was mainly based on personal judgement and on the conviction that these natural substances would be safer than traditional medicines. Users were more often affected by morbidities pregnancy-related and their neonates were more frequently small for their gestational age. An higher incidence of threatening miscarriages and preterm labours was observed among regular users of chamomile and licorice. CONCLUSIONS This research underlines that the use of herbal products during pregnancy is common among Italian women, not always appropriate and in some cases potentially harmful.
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Affiliation(s)
- Laura Cuzzolin
- Department of Public Health & Community Medicine, Section of Pharmacology, University of Verona, Verona, Italy.
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Lapi F, Vannacci A, Moschini M, Cipollini F, Morsuillo M, Gallo E, Banchelli G, Cecchi E, Di Pirro M, Giovannini MG, Cariglia MT, Gori L, Firenzuoli F, Mugelli A. Use, Attitudes and Knowledge of Complementary and Alternative Drugs (CADs) Among Pregnant Women: a Preliminary Survey in Tuscany. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2010; 7:477-86. [PMID: 18955336 PMCID: PMC2892351 DOI: 10.1093/ecam/nen031] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Accepted: 04/04/2008] [Indexed: 11/24/2022]
Abstract
To explore pregnant women's use, attitudes, knowledge and beliefs of complementary and alternative drugs (CADs) defined as products manufactured from herbs or with a natural origin. A preliminary survey was conducted among 172 pregnant women in their third trimester of pregnancy, consecutively recruited in two obstetrical settings; 15 women were randomly selected to compute a test-to-retest analysis. Response rate was 87.2%. Test-to-retest analysis showed a questionnaire's reproducibility exceeding a K-value of 0.7 for all items. Mean age was 32.4 ± 0.4 years; most women were nulliparae (62.7%). The majority of subjects (68%) declared to have used one or more CADs during their lifetime; 48% of pregnant women reported taking at least one CAD previously and during the current pregnancy. Women's habitual use of CADs meant they were at higher risk of taking CADs also during pregnancy (adjusted odds ratio = 10.8; 95% confidence interval: 4.7-25.0). Moreover, 59.1% of the subjects were unable to correctly identify the type of CADs they were using. The majority of women resorted to gynecologists as the primary information source for CADs during pregnancy, while they mainly referred to herbalists when not pregnant. Habitual use of CADs seems to be a strong predictor for their ingestion also during pregnancy; in addition most subjects were unable to correctly identify the products they were taking. In the light of the scanty data concerning the safety of CADs during pregnancy, these preliminary results confirm the need to investigate thoroughly the situation of pregnant women and CADs consumption.
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Affiliation(s)
- Francesco Lapi
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Alfredo Vannacci
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Martina Moschini
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Fabrizio Cipollini
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Maria Morsuillo
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Eugenia Gallo
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Grazia Banchelli
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Enrica Cecchi
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Marina Di Pirro
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Maria Grazia Giovannini
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Maria Teresa Cariglia
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Luigi Gori
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Fabio Firenzuoli
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
| | - Alessandro Mugelli
- Tuscan Regional Centre of Pharmacovigilance, Department of Preclinical and Clinical Pharmacology, Florence, Department of Statistical Science, University of Florence, Department of Emergency Medicine, ASL 4 Hospital, Prato and Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy
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Makaji E, Ho SHY, Holloway AC, Crankshaw DJ. Effects in Rats of Maternal Exposure to Raspberry Leaf and Its Constituents on the Activity of Cytochrome P450 Enzymes in the Offspring. Int J Toxicol 2010; 30:216-24. [DOI: 10.1177/1091581810388307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The goal of our study was to determine whether maternal exposure to red raspberry leaf (RRL) and its constituents can permanently alter biotransformation of fluorogenic substrates by cytochrome P450 (CYP) in the livers of male and female offspring. Nulliparous female rats received vehicle, raspberry leaf, kaempferol, quercetin, or ellagic acid orally once breeding had been confirmed until parturition. Hepatic microsomes were prepared from animals at birth (postnatal day 1 [PND1]), weaning (PND21), PND65, and PND120 to determine the biotransformation of 8 fluorogenic substrates. The pattern of biotransformation of all but 2 of the substrates was gender specific. Maternal consumption of RRL increased biotransformation of 3 substrates by female offspring at PND120 resulting in a more masculine profile. Kaempferol and quercetin had a similar effect to RRL. These results suggest that maternal consumption of either RRL or some of its constituents leads to long-term alterations of CYP activity in female offspring.
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Affiliation(s)
- Emilija Makaji
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Shirley H. Y. Ho
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
- Honours Biology & Pharmacology Program McMaster University, Hamilton, Ontario, Canada
| | - Alison C. Holloway
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Denis J. Crankshaw
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
- Honours Biology & Pharmacology Program McMaster University, Hamilton, Ontario, Canada
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Abstract
Depressive disorders are highly prevalent and are a leading cause of disability, morbidity, and mortality worldwide; however, they often remain undertreated or untreated. This article provides a broad overview of the many strategies for treating depression. More than 24 antidepressant medications and depression-focused psychotherapies are available as first-choice options for treating depression. When patients have not had a satisfactory treatment response, the 2 main strategies are switching to an alternative antidepressant therapy or adding a second antidepressant therapy. A large number of medication combinations have been reported in the literature, and some have been shown to be effective in controlled studies. Nonstandard alternatives to conventional antidepressant treatments include exercise, light therapy, sleep deprivation, and various complementary and alternative therapies. For more chronic and refractory forms of depression, various neuromodulation therapies are available or are being investigated. Because depressive disorders are common in primary care and other medical settings, medical practitioners should be aware of the therapeutic armamentarium available for treating depression.
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Affiliation(s)
- Robert H Howland
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
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Soares Neto JAR, Galduróz JCF, Rodrigues E. A rede de comércio popular de drogas psicoativas na cidade de Diadema e o seu interesse para a Saúde Pública. SAUDE E SOCIEDADE 2010. [DOI: 10.1590/s0104-12902010000200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O comércio popular de drogas vegetais sem garantia de qualidade implica risco sanitário. O presente estudo faz uma análise da rede de comércio popular de drogas vegetais psicoativas (DVPs) na cidade de Diadema e os riscos associados ao seu consumo. São apresentados dados parciais de um projeto realizado em colaboração com outras áreas de investigação. Métodos da etnofarmacologia, tais como entrevistas informais, semiestruturadas e observação participante foram utilizados para a realização do trabalho de campo, durante o qual selecionaram-se quatro comerciantes, a fim de registrar a obtenção, manipulação, acondicionamento e uso das DVPs comercializadas (nomes populares, receitas, partes utilizadas, contraindicações e doses). Foram registradas 63 DVPs distintas, e posteriormente categorizadas de acordo com suas possíveis ações psicoativas, predominando as estimulantes (67%) e depressoras (27%). Observaram-se deficiências na manipulação e acondicionamento das drogas por parte dos comerciantes, expondo seus clientes a possíveis riscos à saúde. Os resultados obtidos nesse estudo possibilitaram observar prioridades de adequação na comercialização de drogas vegetais no comércio popular a fim de resguardar a saúde de seus usuários, bem como a necessidade de promover um diálogo entre este e o sistema formal de saúde.
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Jing Zheng, Pistilli MJ, Holloway AC, Crankshaw DJ. The effects of commercial preparations of red raspberry leaf on the contractility of the rat's uterus in vitro. Reprod Sci 2010; 17:494-501. [PMID: 20220111 DOI: 10.1177/1933719109359703] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We investigated the direct effects of various commercially available preparations of red raspberry leaf (RRL) on the in vitro contractility of uteri collected from diethylstilbestrol (DES)-treated nonpregnant (NP) and late pregnant rats. In DES-treated NP rats, RRL tea and capsule caused weak contractions. Neither preparation affected the ability of oxytocin to initiate contractions; however, both partially inhibited preexisting oxytocin-driven contractions at the highest concentration tested. Red raspberry leaf ethanol extract had little effect on contractility. Pretreatment with tea did not alter the ability of oxytocin to initiate contractions. In pregnant animals red raspberry leaf tea had variable effects on preexisting oxytocin-induced contractions, sometimes augmenting oxytocin's effect and sometimes causing augmentation followed by inhibition. We conclude that the biological activity of RRL varies depending on the herbal preparation used and pregnancy status. These results do not support the hypothesis that RRL augments labor by a direct effect on uterine contractility.
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Affiliation(s)
- Jing Zheng
- Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Holst L, Wright D, Haavik S, Nordeng H. The use and the user of herbal remedies during pregnancy. J Altern Complement Med 2009; 15:787-92. [PMID: 19538045 DOI: 10.1089/acm.2008.0467] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The physiologic changes that occur during pregnancy can lead to a variety of conditions that can usually be self-treated. There are no licensed medicines for conditions such as morning sickness or insomnia in pregnancy, and evidence from Western countries suggests that patients often resort to using herbal medicines. Research on the health behaviors of pregnant women in the United Kingdom with respect to herbal remedies has not been undertaken. OBJECTIVE The objective of this study is to describe the use and the user of herbal remedies during pregnancy and to study the sources of information about herbs used. DESIGN The study design was a survey among expectant mothers more than 20 weeks pregnant presenting at an antenatal clinic. SETTING The setting was an antenatal clinic and antenatal ultrasound department at Norfolk and Norwich University Hospital. One thousand and thirty-seven (1037) questionnaires were handed out between November 2007 and February 2008. RESULTS Five hundred and seventy-eight (578) questionnaires were returned (55.7%). Three hundred and thirty-four (334) of the 578 respondents (57.8%) reported using herbal remedies during pregnancy with a mean of 1.2 remedies per woman (median: 1, range: 0-10). The most commonly used remedies were ginger, cranberry, and raspberry leaf. The most probable user had been pregnant before and had a university degree. "Family and friends" were the most frequently cited source of information about herbal remedies during pregnancy, and more than 75% of the users reportedly did not tell their doctor or midwife about the use. CONCLUSIONS A large percentage of the women in the study used herbal remedies during pregnancy--many of them without informing their doctor or midwife. Doctors or midwives should ask pregnant women if they use herbal remedies during pregnancy. Health care personnel should be open to discuss the use of herbal remedies during pregnancy and be able to give balanced information as the use is so widespread.
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Affiliation(s)
- Lone Holst
- Department of Chemistry/Centre for Pharmacy, University of Bergen, Allégaten 41, Bergen, Norway.
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