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Kim A, Kim YE, Seo S, Kim S, Cho E, Kang YJ, Kim M, Lee E, Son MJ. Safety of herbal medicine in the postpartum period of a Korean Medicine hospital and postpartum care centre: protocol of a registry study (SAFEHERE-PC). BMJ Open 2024; 14:e086645. [PMID: 39181559 PMCID: PMC11344528 DOI: 10.1136/bmjopen-2024-086645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 08/09/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Herbal medicines (HMs) are commonly used during the postpartum period in South Korea. However, the safety concerns associated with these medicines remain unresolved. This study aims to establish a registry of patients receiving HM treatment during the postpartum period and collect clinical data on treatments and adverse reactions to build evidence evaluating the safety of HM use. METHODS AND ANALYSIS This study will use a prospective observational registry, including patients admitted to the obstetrics and gynaecology department of the Woosuk University Korean Medicine Hospital's postpartum care centre. A total of 1000 eligible patients visiting the Korean medicine hospital to recover from various postchildbirth symptoms and opting for HM treatment will be enrolled in the registry. For safety assessment, demographic information, medical history, adverse events (AEs) and treatment details, including HM prescription and concomitant medication usage, will be collected throughout the patient's hospitalisation period at the postpartum care centre for analysis. Adverse reactions will be monitored daily during hospitalisation, and collected AEs will be analysed for causality using the WHO Uppsala Monitoring Centre causality assessment and the Naranjo Algorithm Score. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board of Woosuk University Korean Medicine Medical Center (WSOH IRB H2311-03-01). The results will be published in peer-reviewed journals or disseminated through conference presentations. TRIAL REGISTRATION NUMBER KCT0009060.
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Affiliation(s)
- Anna Kim
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Young Eun Kim
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sumin Seo
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sungha Kim
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Eunbyul Cho
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Yu-Jeong Kang
- Obstetrics & Gynecology, Woosuk University, Jeonju, Republic of Korea
| | - Moonsun Kim
- Neuropsychiatry, Woosuk University, Jeonju, Republic of Korea
| | - Eunhee Lee
- Obstetrics & Gynecology, Woosuk University, Jeonju, Republic of Korea
| | - Mi Ju Son
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Mohammed A, Amsalu B, Hailu M, Sintayehu Y, Weldeamanuel T, Belay Y, Hassen Z, Dinkesa T, Dechasa N, Mengist B, Mengesha T, Nuri A, Getnet T, Manaye Y, Aliyi Usso A, Legesse H, Sertsu A. Indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care at public health facilities in Dire Dawa, Ethiopia: a cross-sectional study. BMJ Open 2024; 14:e079719. [PMID: 38830740 PMCID: PMC11149149 DOI: 10.1136/bmjopen-2023-079719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/29/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia. DESIGN A facility-based cross-sectional study design. SETTING The study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022. PARTICIPANTS 628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included. MAIN OUTCOME MEASURES Prevalence of indigenous herbal medicine (users vs non-users) and associated factors. RESULTS The study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress (Lepidium sativum) (32%), bitter leaf (Vernonia amygdalina) (25.2%), moringa (Moringa oleifera) (24.5%). Common indications were related to gastrointestinal problems, blood pressure and sugar. CONCLUSION The prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study's findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.
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Affiliation(s)
- Aminu Mohammed
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Bezabih Amsalu
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mickiale Hailu
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yitagesu Sintayehu
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tadesse Weldeamanuel
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yalelet Belay
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Zeyniya Hassen
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tesema Dinkesa
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Natnael Dechasa
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Betelhem Mengist
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Teshale Mengesha
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Aliya Nuri
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tewodros Getnet
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yibekal Manaye
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Ahmedin Aliyi Usso
- School of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Henok Legesse
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Im HB, Hwang JH, Choi D, Choi SJ, Han D. Patient-physician communication on herbal medicine use during pregnancy: a systematic review and meta-analysis. BMJ Glob Health 2024; 9:e013412. [PMID: 38448037 PMCID: PMC10916170 DOI: 10.1136/bmjgh-2023-013412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/01/2024] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION Lack of transparent communication between patients and physicians regarding the use of herbal medicine (HM) presents a major public health challenge, as inappropriate HM use poses health risks. Considering the widespread use of HM and the risk of adverse events, it is crucial for pregnant women to openly discuss their HM use with healthcare providers. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of pregnant women's HM use and disclosure to healthcare providers and to examine the relationship between HM disclosure and various maternal and child health (MCH) measures. METHODS A systematic search of five databases was conducted for cross-sectional studies on HM use during pregnancy published from 2000 to 2023. Data extraction followed a standardised approach, and Stata V.16.0 was used for data analysis. Also, Spearman's correlation coefficient was calculated to examine the association between use and disclosure of HM and various MCH indicators. RESULTS This review included 111 studies across 51 countries on the use of HM among pregnant women. Our findings showed that 34.4% of women used HM during pregnancy, driven by the perception that HM is presumably safer and more natural than conventional medical therapies. However, only 27.9% of the HM users disclosed their use to healthcare providers because they considered HM as harmless and were not prompted by the healthcare providers to discuss their self-care practices. Furthermore, a significant correlation was observed between HM disclosure and improved MCH outcomes. CONCLUSION Inadequate communication between pregnant women and physicians on HM use highlights a deficiency in the quality of care that may be associated with unfavourable maternal outcomes. Thus, physician engagement in effective and unbiased communication about HM during antenatal care, along with evidence-based guidance on HM use, can help mitigate the potential risks associated with inappropriate HM use.
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Affiliation(s)
- Hyea Bin Im
- Department of Global Health and Development, Hanyang University, Seoul, Korea
- Institute of Health Services Management, Hanyang University, Seoul, Korea
| | - Jung Hye Hwang
- Institute of Health Services Management, Hanyang University, Seoul, Korea
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Korea
| | - Dain Choi
- Department of Global Health and Development, Hanyang University, Seoul, Korea
- Institute of Health Services Management, Hanyang University, Seoul, Korea
| | - Soo Jeung Choi
- Department of Global Health and Development, Hanyang University, Seoul, Korea
- Institute of Health Services Management, Hanyang University, Seoul, Korea
| | - Dongwoon Han
- Department of Global Health and Development, Hanyang University, Seoul, Korea
- Department of Preventive Medicine, Hanyang University, Seoul, Korea
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Romero NG, Gutierrez G, Teixidó E, Li L, Klose J, Leung PC, Cañigueral S, Fritsche E, Barenys M. Developmental neurotoxicity evaluation of three Chinese herbal medicines in zebrafish larvae by means of two behavioral assays: Touch-evoked response and light/dark transition. Reprod Toxicol 2023; 121:108469. [PMID: 37673194 DOI: 10.1016/j.reprotox.2023.108469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/28/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023]
Abstract
Chinese herbal medicine (CHM) is used among pregnant women. However, the question of its safety during pregnancy remains unclear. The use of these products relies on history of use data but there are specific toxicities like developmental neurotoxicity that are clearly understudied. Here we use the zebfrafish embryo developmental toxicity assay (ZEDTA) in combination with two behavioral assays: touch-evoked response and Light/Dark (L/D) transition assay to evaluate the neuro/developmental toxicity of three herbal products commonly used in CHM [Chinese name (abbreviation; part of the plant and Scientific name]: tian ma (TM; tuber form Gastrodia elata Blume), lei gong teng (LGT; root and rhizome of Tripterygium wilfordii Hook.f) and cha ye (green tea, leaves from Camellia sinensis (L.) Kuntze). In case significant alterations were detected, single components with potential exposure during pregnancy were identified in the literature and further tested. TM had no neurodevelopmental toxic potential in zebrafish embryos, while LGT and its main compounds triptolide and celastrol induced significant alterations in behavior. Developmental exposure to EGCG, the main catechin of green tea, also produced significant alterations in zebrafish embryos behavior after developmental exposure. A combination of ZEDTA with L/D Transition assay is proposed as a useful combination of alternative methods for DNT assessment of CHM products together with other New Approach Methodologies (NAMs).
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Affiliation(s)
- Noelia G Romero
- GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; Institute of Nutrition and Food Safety of the University of Barcelona (INSA-UB), Spain
| | - Gerard Gutierrez
- GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Elisabet Teixidó
- GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; Institute of Nutrition and Food Safety of the University of Barcelona (INSA-UB), Spain
| | - Lu Li
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China; Department of Obstetrics & Gynaecology, Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong; National Key Laboratory of Chinese Medicine Modernization, Innovation Center of Yangtze River Delta, Zhejiang University, 314100, Jiaxing, China
| | - Jördis Klose
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Ping Chung Leung
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Salvador Cañigueral
- Unitat de Farmacologia, Farmacognòsia, i Terapèutica, Facultat de Farmàcia, i Ciències de l'Alimentació, Universitat de Barcelona, Av. Joan XXIII 27-31, 08028 Barcelona, Spain
| | - Ellen Fritsche
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; Medical Faculty, University of Düsseldorf, 40225 Düsseldorf, Germany; DNTOX GmbH, 40223 Düsseldorf, Germany
| | - Marta Barenys
- GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; Institute of Nutrition and Food Safety of the University of Barcelona (INSA-UB), Spain; German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany.
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Liu L, Birling Y, Zhao Y, Ma W, Tang Y, Sun Y, Wang X, Yu M, Bi H, Liu JP, Li L, Liu Z. Mechanism of Chinese botanical drug Dizhi pill for myopia: An integrated study based on bioinformatics and network analysis. Medicine (Baltimore) 2023; 102:e34753. [PMID: 37747014 PMCID: PMC10519534 DOI: 10.1097/md.0000000000034753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 09/26/2023] Open
Abstract
To identify the active constituents, core targets, immunomodulatory functions and potential mechanisms of Dizhi pill (DZP) in the treatment of myopia. The active constituents and drug targets of DZP were searched in the TCMSP, Herb databases and correlational studies. The targets of myopia were searched in the TTD, Genecards, OMIM and Drugbank databases. Gene expression profile data of GSE136701 were downloaded from the GEO database and subjected to WGCNA and DEG analysis to screen for significant modules and targets of myopia. Intersectional targets of myopia and DZP and core targets of myopia were analyzed through the String database. The GO and KEGG enrichment analyses of the interested targets were conducted. Cibersort algorithm was used for immune infiltration analysis to investigate the immunomodulatory functions of DZP on myopia. Autodock was used to dock the important targets and active constituents. Eight targets (STAT3, PIK3CA, PIK3R1, MAPK1, MAPK3, HSP90AA1, MIP, and LGSN) and 5 active constituents (Quercetin, Beta-sitosterol, Diincarvilone A, Ferulic acid methyl ester, and Naringenin) were identified from DZP. In pathways identified by the GO and KEGG enrichment analyses, "ATP metabolic process" and "AGE-RAGE diabetes complication signaling" pathways were closely related to the mechanisms of DZP in the treatment of myopia. Molecular docking showed that both the intersectional targets and core targets of myopia could bind stably and spontaneously with the active constituents of DZP. This study suggested that the mechanisms of DZP in the treatment of myopia were related to active constituents: Quercetin, Beta-sitosterol, Diincarvilone A, Ferulic acid methyl ester and Naringenin, intersectional targets: STAT3, PIK3CA, PIK3R1, MAPK1, MAPK3, and HSP90AA1, core targets of myopia: MIP and LGSN, AGE-RAGE signaling pathway, positive regulation of ATP metabolic process pathway and immunomodulatory functions.
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Affiliation(s)
- Longkun Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yoann Birling
- NICM Health Research Institute, Western Sydney University, Penrith, NSW
| | - Yan Zhao
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wenxin Ma
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yang Tang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuxin Sun
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xuehui Wang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Mingkun Yu
- Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Hongsheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Jian-ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Li Li
- Beijing Institute for Drug Control, NMPA Key Laboratory for Safety Research and Evaluation of Innovative Drugs, Beijing Key Laboratory of Analysis and Evaluation on Chinese Medicine, Beijing, China
| | - Zhaolan Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Xiong Y, Liu C, Li M, Qin X, Guo J, Wei W, Yao G, Qian Y, Ye L, Liu H, Xu Q, Zou K, Sun X, Tan J. The use of Chinese herbal medicines throughout the pregnancy life course and their safety profiles: a population-based cohort study. Am J Obstet Gynecol MFM 2023; 5:100907. [PMID: 36813231 DOI: 10.1016/j.ajogmf.2023.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Chinese herbal medicines have been long used among pregnant populations in China. However, despite the high susceptibility of this population to drug exposure, it continued to remain unclear about how often they were used, to what extent they were used at different pregnancy stages, and whether their use was based on sound safety profiles, particularly when used in combination with pharmaceutical drugs. OBJECTIVE This descriptive cohort study aimed to systematically investigate the use of Chinese herbal medicines throughout pregnancy and their safety profiles. STUDY DESIGN A large medication use cohort was developed by linking a population-based pregnancy registry and a population-based pharmacy database, which documented all prescriptions at both outpatients and inpatients from conception to 7 days after delivery, including pharmaceutical drugs and processed Chinese herbal medicine formulas that were approved by the regulatory authority and prepared under the guidance of national quality standards. The prevalence of the use of Chinese herbal medicine formulas, prescription pattern, and combination use of pharmaceutical drugs throughout pregnancy were investigated. Multivariable log-binomial regression was performed to assess temporal trends and further explore the potential characteristics associated with the use of Chinese herbal medicines. Of note, 2 authors independently conducted a qualitative systematic review of patient package inserts of the top 100 Chinese herbal medicine formulas used to identify their safety profiles. RESULTS This study included 199,710 pregnancies; of those pregnancies, 131,235 (65.71%) used Chinese herbal medicine formulas, including 26.13% during pregnancy (corresponding to 14.00%, 8.91%, and 8.26% in the first, second, and third trimesters of pregnancy) and 55.63% after delivery. The peak uses of Chinese herbal medicines occurred between 5 and 10 weeks of gestation. The use of Chinese herbal medicines significantly increased over the years (from 63.28% in 2014 to 69.59% in 2018; adjusted relative risk, 1.11; 95% confidence interval, 1.10-1.13), which was particularly great during pregnancy (from 18.47% in 2014 to 32.46% in 2018; adjusted relative risk, 1.84; 95% confidence interval, 1.77-1.90). Our study observed 291,836 prescriptions involving 469 Chinese herbal medicine formulas, and the top 100 most used Chinese herbal medicines accounted for 98.28% of the total prescriptions. Of those, a third (33.39%) were dispensed at outpatient visits; 6.79% were external use, and 0.29% were administered intravenously. However, Chinese herbal medicines were very often prescribed in combination with pharmaceutical drugs (94.96% overall), involving 1175 pharmaceutical drugs with 1,667,459 prescriptions. The median of pharmaceutical drugs prescribed in combination with Chinese herbal medicines per pregnancy was 10 (interquartile range, 5-18). The systematic review of drug patient package inserts found that the 100 most frequently prescribed Chinese herbal medicines contained a total of 240 herb constituents (median, 4.5); 7.00% were explicitly indicated for pregnancy or postpartum conditions; 43.00% were reported with efficacy or safety data from randomized controlled trials. Information was lacking about whether the medications had any reproductive toxicity, were excreted in human milk, or crossed the placenta. CONCLUSION The use of Chinese herbal medicines was prevalent throughout pregnancy and increased over the years. The use of Chinese herbal medicines peaked in the first trimester of pregnancy and was very often used in combination with pharmaceutical drugs. However, their safety profiles were mostly unclear or incomplete, suggesting a strong need for postapproval surveillance for the use of Chinese herbal medicines during pregnancy.
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Affiliation(s)
- Yiquan Xiong
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Chunrong Liu
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Mingxi Li
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Xuan Qin
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Jin Guo
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Wanqiang Wei
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Guanhua Yao
- Xiamen Health Commission, Xiamen, China (Dr Yao and Dr Qian)
| | - Yongyao Qian
- Xiamen Health Commission, Xiamen, China (Dr Yao and Dr Qian)
| | - Lishan Ye
- Xiamen Health and Medical Big Data Center, Xiamen, China (Ms Ye, Mr Liu, and Mr Xu)
| | - Hui Liu
- Xiamen Health and Medical Big Data Center, Xiamen, China (Ms Ye, Mr Liu, and Mr Xu)
| | - Qiushi Xu
- Xiamen Health and Medical Big Data Center, Xiamen, China (Ms Ye, Mr Liu, and Mr Xu)
| | - Kang Zou
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan)
| | - Xin Sun
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan).
| | - Jing Tan
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan); Sichuan Center of Technology Innovation for Real World Data, Chengdu, China (Dr Xiong, Ms Liu, Ms Li, Ms Qin, Ms Guo, Mr Wei, Mr Zou, Dr Sun, and Dr Tan).
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Pasalar M, Vardanjani H, Steel A, Mofarrahi D, Jaladat A, Amini F, Zeraatpishe M. Use of complementary and alternative medicine and its related factors among pregnant women in Shiraz, South of Iran: A cross-sectional study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:53-59. [DOI: 10.4103/ijnmr.ijnmr_301_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/11/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
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Öztürk R, Emi̇nov A, Ertem G. Use of complementary and alternative medicine in pregnancy and labour pain: a cross-sectional study from turkey. BMC Complement Med Ther 2022; 22:332. [PMCID: PMC9749170 DOI: 10.1186/s12906-022-03804-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
This study aimed to determine the prevalence and pattern of complementary and alternative medicine (CAM) use by and attitudes towards CAM of Turkish women during pregnancy and birth.
Methods
This was a descriptive, cross-sectional study that included 260 women who gave birth in a university hospital. The Personal Information Form and Complementary, Alternative and Conventional Medicine Attitudes Scale (CACMAS) were used as data collection tools.
Results
A total of 71.5% of the pregnant women received CAM. Phytotherapy, spiritual meditation and therapeutic touch techniques were the most frequently used techniques. A total of 42.7% women used herbal products. The mean score of the women on the CACMAS scale was 108.37 ± 7.71; this result indicates that pregnant women had a positive attitude. There were significant differences in attitudes according to marital status, education level and place of residence. It was determined that there was a significant difference in the CACMAS scores of the women according to the symptoms experienced during pregnancy, CAM use during pregnancy and the concerns about triggering preterm birth by using CAM methods (p < 0.05).
Conclusion
Although the women commonly used CAM methods during pregnancy, the rate of using these methods during birth considerably decreased. Despite such widespread use, pregnant women have concerns about CAM methods. Therefore, health professionals must actively provide counselling on CAM methods for the protection of maternal and infant health.
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Deligiannidou GE, Kyrgou C, Nena E, Manolopoulos VG, Bezirtzoglou E, Kontogiorgis CA, Constantinidis TC. Use of Edible, Medicinal, and Aromatic Plants in Various Health Disorders: A Cross-Sectional Evaluation among Inhabitants in the Area of Thrace, North-Eastern Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12576. [PMID: 36231876 PMCID: PMC9566107 DOI: 10.3390/ijerph191912576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Medicinal and aromatical plants (MAPs) have been historically used as traditional remedies in many cultures in Europe and globally. The aim of this study was to evaluate the use of MAPs in various health disorders in association to dietary habits and other lifestyle factors among residents in Thrace, NE Greece. METHODS Data were collected through anonymous and voluntary responses to a structured online questionnaire, via convenience (snowball) sampling. RESULTS The 561 responders (age: 39.7 ± 11.6 y) were mostly female (59.7%), with higher education (69.8%), working as state or private employees (55.4%), and having low/medium income (77.1%). Overall, more than 70% were using MAPs in various symptoms and common health disorders, such as chamomile against common cold and the flu. More than 20 different MAPs were being used in smaller frequencies against various conditions. Key contributing factors to the consumption of MAPs were sex (female over male), employment (employed vs. unemployed), education (higher education vs. lower) and higher Body Mass Index (overweight and obese vs. normal), while consumption of fruit, fish, and vegetables was mainly associated with the use of MAPs as common items of diet and in health disorders. CONCLUSIONS The use of MAPs as part of the diet and as traditional remedy is present in the examined population, while particular choices seem to be affected by sociodemographic and lifestyle factors.
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Affiliation(s)
- Georgia-Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Chrysoula Kyrgou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Vangelis G. Manolopoulos
- Laboratory of Pharmacology, Democritus University of Thrace-School of Medicine, 68100 Alexandroupolis, Greece
| | - Eugenia Bezirtzoglou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Theodoros C. Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Lee DE, Suh HW, Park HS, Youn I, Park M, Seo J. Mothers' Experiences of Childbirth and Perspectives on Korean Medicine-Based Postpartum Care in Korea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095332. [PMID: 35564730 PMCID: PMC9105879 DOI: 10.3390/ijerph19095332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Abstract
This study aimed to record the experiences of childbirth and postpartum care of postpartum women and gain an in-depth understanding of their experiences of Korean medicine-based postpartum healthcare. The investigator conducted a 60–90-min interview with the 8 participants (mean age 34 years), and the comments were analyzed using the thematic analysis method. The two major themes emerging from the participants’ comments were: “experience and awareness of childbirth and postpartum care” and “experiences of the Korean medicine-based postpartum program”. The first theme was analyzed in four primary categories: (1) experiences of breakdown of the body and mind; (2) impossibility of postpartum care without help; (3) experiences of relentless effort for recovery; and (4) experiences of body and mind recovery. The second theme was analyzed in four primary categories: (1) participation with vague expectations; (2) experiences of the effects of managing postpartum symptoms; (3) the need for a comprehensive Korean medicine management for postpartum women; and (4) suggested improvements for the Korean medicine-based postpartum program. Mothers recognized the importance of Korean medicine treatment during the postpartum period for the management of Sanhupung symptoms and postpartum care and reported the benefits of body warming, Sanhupung prevention, pain reduction, and sense of psychological stability.
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Affiliation(s)
- Do-Eun Lee
- Department of Neuropsychiatry, College of Korean Medicine, Won Kwang University, Iksan 54538, Korea;
| | - Hyo-Weon Suh
- Department of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02453, Korea;
| | - Han-Song Park
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea; (H.-S.P.); (I.Y.)
| | - Inae Youn
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea; (H.-S.P.); (I.Y.)
| | - Minjung Park
- National Agency for Development of Innovative Technologies in Korean Medicine, National Institute of Korean Medicine Development, 12F Namsan Square Building, 173 Toegyero, Jung-gu, Seoul 04553, Korea; or
| | - Joohee Seo
- Department of Korean Neuropsychiatry, National Medical Center, 245 Euljiro, Jung-gu, Seoul 04564, Korea
- Correspondence: ; Tel.: +82-2-2260-7466
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11
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Molavi Vardanjani H, Salehi Z, Alembizar F, Cramer H, Pasalar M. Prevalence and the Determinants of Traditional, Complementary, and Integrative Medicine Use Among Breastfeeding Mothers: A Cross-Sectional Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:67-76. [PMID: 35085020 DOI: 10.1089/jicm.2021.0270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: Breastfeeding is highly important for a child's health, and the widespread use of herbal medicines as galactagogues has been reported. The present study was conducted to evaluate the use of traditional, complementary, and integrative medicine (TCIM) and its determinants among breastfeeding mothers in Shiraz, Iran. Design: Cross-sectional study. Setting/Location: Neonatal clinics affiliated to Shiraz University of Medical Sciences. Subjects: Mothers elder than 18 years old. Interventions: Nothing. Outcome Measures: Prevalence and of the use of TCIM products and its associated factors. Methods: In this cross-sectional study, mothers older than 18 years who referred to neonatal clinics affiliated to Shiraz University of Medical Sciences were enrolled. Using a structured interview, the authors explored the prevalence and of the use of TCIM products and its associated factors. Results: Of 625 mothers who were approached, 483 agreed to participate (response rate: 77.3%). The average age was 27.3 ± 5.9 years. The prevalence of using TCIM products during current breastfeeding was 97.1%. There were 168 working mothers (44.9%); 163 mothers (34.1%) complaining of postpartum breastfeeding problems, and 327 mothers (68%) had no history of breastfeeding. Recommendations of medical staff or relatives were the most frequent reasons for the consumption of TCIM products (64.9%). Only 27% of mothers disclosed the use of TCIM products to their doctor or health care provider, although 62% of mothers were asked about the use of such products. Notably, 438 mothers (95.8%) considered TCIM to increase their milk. Based on multivariable logistic regression, literacy and past use of TCIM galactagogues were independently associated with TCIM products use. Conclusions: The use of TCIM galactagogues is highly common among breastfeeding mothers in south of Iran, showing a diverse range of determinants. It is necessary to evaluate the safety and efficacy of common herbal galactagogues, and evidence-based studies must be designed to achieve standardized complementary medicine approaches in this regard.
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Affiliation(s)
- Hossein Molavi Vardanjani
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Salehi
- Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faranak Alembizar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Sibeko L, Johns T, Cordeiro LS. Traditional plant use during lactation and postpartum recovery: Infant development and maternal health roles. JOURNAL OF ETHNOPHARMACOLOGY 2021; 279:114377. [PMID: 34192598 DOI: 10.1016/j.jep.2021.114377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/11/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Evidence of phytochemical roles in infant development and maternal recovery offers insights into beneficial functions of traditional plant use during lactation and the postpartum period. Ethnopharmacological research has relevance to global priorities on maternal and child health, to understanding origins and determinants of human self-medication, and for reconciling traditional postpartum practices and mainstream healthcare. AIM OF THE STUDY Present emerging evidence, within evolutionary and socio-cultural contexts, on the role of maternal consumption on transfer of phytochemicals into breast milk with impacts on maternal and child health, and on infant development. Establish current state of knowledge and an ethnopharmacological research agenda that is attentive to cross-cultural and regional differences in postpartum plant use. MATERIALS AND METHODS An extensive literature review using Medline, Scopus, and Web of Science focused on traditional and contemporary use and socio-cultural context, as well as physiological, pharmacological, toxicological, and behavioral activities of plants used medicinally by women during postpartum recovery and lactation. RESULTS The most widely reported postpartum plants show antimicrobial, anti-inflammatory, immunological, and neurophysiological activities, with low toxicity. Phytochemicals transfer from maternal consumption into breast milk in physiological concentrations, while animal studies demonstrate immunomodulation and other actions of medicinal plants during lactation. Reporting on the use and diverse traditional knowledge of women about plants during the postpartum period is obscured by the marginal place of obstetric issues and by gender biases in ethnobotanical research. In many contemporary contexts use is prejudiced by precautionary risk warnings in health literature and practice that confound lactation with pregnancy. CONCLUSIONS Although systematic investigation of postpartum plant use is lacking, known pharmacological activities support potential benefits on infant development and maternal health with immediate and long-term consequences in relation to allergic, inflammatory, autoimmune, and other diseases. An ethnopharmacological agenda focused on the perinatal period requires directed methodologies and a regional approach in relation to culturally-specific knowledge and practices, traditional plant use, and local health needs. Testing the hypothesis that phytochemicals transferred from medicinal plants into breast milk impact the human immune system and other aspects of infant development requires extended analysis of phytochemicals in human milk and infant lumen and plasma, as well as effects on gastrointestinal and milk microbiome.
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Affiliation(s)
- Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Timothy Johns
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, H9X 3V9, Canada.
| | - Lorraine S Cordeiro
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
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Ariffin SH, A Wahab I, Hassan Y, Abd Wahab MS. Adulterated Traditional-Herbal Medicinal Products and Its Safety Signals in Malaysia. Drug Healthc Patient Saf 2021; 13:133-140. [PMID: 34135639 PMCID: PMC8197568 DOI: 10.2147/dhps.s305953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Usage of traditional-herbal medicines (THM) for various illnesses has been increased around the world, so does the adulteration of these products with hazardous compounds. There are limited Malaysian data that have been published on the characteristics trend and adverse events associated with adulterated THM products. AIM This study described characteristics of adulterated THM products in Malaysia and aimed to quantify THM products' safety signals of adverse reactions (ARs). METHODS THM products that were seized by Pharmacy Enforcement Division between 2008 and 2014 were extracted and analysed for 59,440 THM products. Of these, only 6452 THM products with complete information were included in the final analyses. Safety signalling tools were used to measure AR signals from AR reports obtained from the National Pharmaceutical Regulatory Agency Adverse Drug Reaction Database. RESULTS More than half of adulterated THM products originated from countries outside of Malaysia, with the majority were from Indonesia. The most common claimed indication of adulterated THM products was for pain and fever relief, while steroids were the most common adulterant. AR signals were generated for cough and cold products for respiratory and thoracic disorders, weight-loss products for cardiac disorders, and women's health products for reproductive and breast disorders. CONCLUSION Health authorities from various fields can work collaboratively by implementing strategic actions that include the use of safety signalling tools to curb the increasing number of adulterated THM products in the Malaysian market.
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Affiliation(s)
- Suriana Hanim Ariffin
- Pharmacy Enforcement Division, National Pharmaceutical Regulatory Agency, Petaling Jaya, 46200, Selangor, Malaysia
| | - Izyan A Wahab
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Malaya, Kuala Lumpur, 50603, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Yahaya Hassan
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Puncak Alam, 42300, Selangor, Malaysia
| | - Mohd Shahezwan Abd Wahab
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Puncak Alam, 42300, Selangor, Malaysia
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14
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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: 38] [Impact Index Per Article: 7.6] [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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The Impact of the Postpartum "Doing-the-Month" Practice on Human Milk Microbiota: A Pilot Study in Taiwan. Microorganisms 2020; 8:microorganisms8091283. [PMID: 32842688 PMCID: PMC7564682 DOI: 10.3390/microorganisms8091283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 12/26/2022] Open
Abstract
Human milk microorganisms could benefit the healthy development of the immune system in infants. In Asia, the practice of “doing-the-month” indicates a month-long period of postpartum recuperation for new mothers. This is composed of cultural practices, traditional beliefs, behavioral, dietary, and herbal therapies. In this pilot study, we evaluated the effect of “doing-the-month” on the human milk microbiota using a molecular approach. We collected two “doing-the-month” milk groups from randomly recruited mothers who had completed their “doing-the-month” program in either postpartum care center A (milk-PCA, n = 14) or postpartum care center B (milk-PCB, n = 27) for 20 to 30 days. As for the control group, milk samples were selected from postpartum mothers (milk-H, n = 46), who did not conduct the “doing-the-month” program. We found that the “doing-the-month” milk samples were associated with more diverse and unique milk microbiota and that these samples were also linked with more abundant Lactobacillus (milk-PCB) and prevalent Bifidobacteria (milk-PCA and milk-PCB). In addition, the milk samples from “doing-the-month” mothers could be enriched with more Archaea bacterial members, but the “non-doing-the-month” milk samples were enriched with more common skin-, oral-, and environmental-related bacterial members. This study highlights the impact maternal practices may have on the milk microbiome. More research is needed to investigate the effects this may have on infant immune health.
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Wen SH, Chang WC, Shen HS, Wu HC. Prescription patterns and factors influencing the use of Chinese herbal medicine among pregnant women in Taiwan: a population-based retrospective study. BMC Complement Med Ther 2020; 20:240. [PMID: 32731888 PMCID: PMC7391530 DOI: 10.1186/s12906-020-03032-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/24/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The use of Chinese herbal medicine (CHM) has been widely promoted as a natural and safe way to treat illness during pregnancy. However, prescription patterns and factors influencing its use are largely unknown. Therefore, we conducted a population-based study to address these questions. METHODS Pregnant women aged 18-50 years were selected from Taiwan's National Health Insurance Research Database between 2001 to 2011. CHM prescriptions and diagnostic records were collected. Demographic data and pre-existing diseases were compared between CHM users and non-users. A multivariate logistic regression analysis was performed to identify possible factors influencing the use of CHM during pregnancy. RESULTS A total of 81,873 eligible prescription records were identified, and 16,553 pregnant women were prescribed CHM during pregnancy, yielding a CHM prescription rate of 20.2%. The three most frequently used herbs were Scutellariae Radix (Huang Qin) (4.4%), Eucommiae cortex (Du Zhong) (2.5%), and Atractylodes Rhizome (Bai Zhu) (2.4%). The most frequently used herbal formulae were Dang-Guei-Shao-Yao-San (4.1%), Jia-Wei-Xiao-Yao-San (3.5%), and Xiang-Sha-Liu-Jun-Zi-Tang (2.6%). Multivariate logistic regression revealed that subjects with an older age, a university education, a pre-pregnancy history of CHM use, asthma, chronic renal disease, and cardiac valvular disease and living in a residential area other than northern Taiwan had an increase in adjusted odds ratio for CHM use during pregnancy. CONCLUSIONS In this population-based study, we found that demographic factors and pre-existing diseases were associated with the use of CHM among pregnant women. It is worth noting that Leonuri Herba (Yi Mu Cao) and Shao-Fu-Zhu-Yu-Tang should be used with caution in the first trimester. Further research is needed to explore the safety and effectiveness of the use of CHM in pregnant women.
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Affiliation(s)
- Shu-Hui Wen
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Wei-Chuan Chang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Hsuan-Shu Shen
- Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,School of Post-baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hsien-Chang Wu
- School of Post-baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan. .,Department of Chinese Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, No. 289, Jianguo Rd., Xindian Dist, New Taipei City, 23142, Taiwan.
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Nik Yusof Fuad NF, Ching SM, Awg Dzulkarnain DH, Cheong AT, Zakaria ZA. Complementary alternative medicine use among postpartum mothers in a primary care setting: a cross-sectional study in Malaysia. BMC Complement Med Ther 2020; 20:197. [PMID: 32586306 PMCID: PMC7318471 DOI: 10.1186/s12906-020-02984-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background Complementary alternative medicine (CAM) is widely used among postpartum mothers to maintain their well-being. This study aims to determine the prevalence and factors associated with CAM use among postpartum mothers in a primary-care clinic in Malaysia. Methods This is a cross-sectional study of 725 postpartum mothers, aged 18 and above, attending a primary-care clinic. The systematic sampling method was used to recruit patients through a structured, self-administered questionnaire. Data analysis was conducted using SPSS version 23. Multiple logistic regression was used to identify the predictors of CAM use among postpartum mothers. Results The prevalence of CAM use among postpartum mothers was 85.5%. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping were the most widely used methods of CAM (84.1%) among postpartum mothers, followed by biological-based therapies (33.1%). More than half of the respondents (52.1%) opted to use CAM, as they had observed good results from other CAM users. However, our study showed that 57.1% of mothers who consumed herbal medicine reported neonatal jaundice in their newborn. The median of the expenditure on CAM usage was 250 Malaysian Ringgits, or USD 61.3 per month. According to multiple logistic regression analyses, being Muslim (OR = 5.258, 95% CI: 2.952–9.368), being Malay (OR = 4.414, 95% CI: 1.18–16.56), having a higher educational level (OR = 2.561, 95% CI: 1.587–4.133) and having delivered via spontaneous vaginal delivery (OR: 5.660, 95% CI: 3.454–9.276) had a significantly positive association with CAM use among postpartum mothers. Conclusions The prevalence of CAM use was high (8 out of 10) among postpartum mothers. Postpartum mothers who are Malay, Muslim, have a higher educational level and who have had spontaneous vaginal delivery tended to use CAM more. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping, were the most widely used forms of CAM, followed by biological-based therapies. More than half of the mothers who consumed herbal medicine reported neonatal jaundice in their newborn. Thus, education to increase awareness regarding the consumption of herbs is urgently required in this country.
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Affiliation(s)
- Nik Farah Nik Yusof Fuad
- Klinik Kesihatan AU2 Keramat, Ministry of Health Malaysia, Taman Sri Keramat, Jalan AU2, Putrajaya, 54200, Selangor, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia. .,Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
| | | | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Zainul Amiruddin Zakaria
- Department of Biomedical Science Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
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18
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Zheng T, Chen W, Hu H, Wang Y, Harnett JE, Ung COL. The prevalence, perceptions and behaviors associated with traditional/complementary medicine use by breastfeeding women living in Macau: a cross-sectional survey study. BMC Complement Med Ther 2020; 20:122. [PMID: 32316951 PMCID: PMC7175520 DOI: 10.1186/s12906-020-02921-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/07/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is a long history of traditional/complementary medicine (T/CM) use by women during lactation. While it is important to evaluate such use within a scientific paradigm to ensure efficacy and safety, knowledge about the prevalence and characteristics of T/CM use during lactation is limited. This study aimed to generate preliminary data on the prevalence, perceptions and behaviors related to T/CM use by women living in Macau during lactation. METHODS Between April to June 2018, women aged 18 years or above who had breastfed within the previous 12 months were invited to complete a questionnaire which asked about their perceptions and behaviors related to the use of T/CM while breastfeeding. Chi-square analysis and logistic regressions were used to conduct data analysis. RESULTS A total of 500 women completed the survey with 62.6% (95% CI 58.37-66.83) reporting use of at least 1 T/CM while breastfeeding. Of these 48.9% (95% CI 44.67 to 53.13) believed T/CM were safe to take during lactation and 55.6% (95% CI 51.37 to 59.83) suggested there were inadequate resources to assist making an informed decision. Working status, monthly family income and the presence of a breastfeeding-related health problems were associated with T/CM use (all p < 0.05). The most commonly used T/CM were Tetrapanax papyriferus, lecithin, Vaccaria segetalis, docosahexaenoic acid and Trigonella foenum-graecum commonly referred to as Fenugreek. The most common reasons for using T/CM were "to unblock milk ducts", "to increase milk supply" and "to improve baby development". Women were recommended to use T/CM from multiple sources; 15.0% from health personnel (HP) only, 40.0% received recommendations from non-HP only; and 42.2% from both. CONCLUSIONS The use of T/CM by women during lactation is common in Macau. The current support and resources available to women during the breastfeeding period to make informed decisions about T/CM use is not standardized nor integrated. The gaps identified in this study provide an opportunity to develop resources and a more defined role for HPs to ensure the appropriate and safe use of T/CM in this population.
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Affiliation(s)
- Tingyun Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Weijie Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Yitao Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
| | - Joanna E. Harnett
- The University of Sydney School of Pharmacy, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China
- The University of Sydney School of Pharmacy, The Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Chen JY, Brockmöller J, Tzvetkov MV, Wang LJ, Chen XJ. An in vitro study on interaction of anisodine and monocrotaline with organic cation transporters of the SLC22 and SLC47 families. Chin J Nat Med 2020; 17:490-497. [PMID: 31514980 DOI: 10.1016/s1875-5364(19)30070-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Indexed: 11/28/2022]
Abstract
Current study systematically investigated the interaction of two alkaloids, anisodine and monocrotaline, with organic cation transporter OCT1, 2, 3, MATE1 and MATE2-K by using in vitro stably transfected HEK293 cells. Both anisodine and monocrotaline inhibited the OCTs and MATE transporters. The lowest IC50 was 12.9 µmol·L-1 of anisodine on OCT1 and the highest was 1.8 mmol·L-1 of monocrotaline on OCT2. Anisodine was a substrate of OCT2 (Km = 13.3 ± 2.6 µmol·L-1 and Vmax = 286.8 ± 53.6 pmol/mg protein/min). Monocrotaline was determined to be a substrate of both OCT1 (Km = 109.1 ± 17.8 µmol·L-1, Vmax = 576.5 ± 87.5 pmol/mg protein/min) and OCT2 (Km = 64.7 ± 14.8 µmol·L-1, Vmax = 180.7 ± 22.0 pmol/mg protein/min), other than OCT3 and MATE transporters. The results indicated that OCT2 may be important for renal elimination of anisodine and OCT1 was responsible for monocrotaline uptake into liver. However neither MATE1 nor MATE2-K could facilitate transcellular transport of anisodine and monocrotaline. Accumulation of these drugs in the organs with high OCT1 expression (liver) and OCT2 expression (kidney) may be expected.
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Affiliation(s)
- Jia-Yin Chen
- Department of Pharmacy, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Jürgen Brockmöller
- Institute for Clinical Pharmacology, University Medical Center Göttingen, Georg-August University, Göttingen 37075, Germany
| | - Mladen V Tzvetkov
- Institute for Clinical Pharmacology, University Medical Center Göttingen, Georg-August University, Göttingen 37075, Germany
| | - Li-Jun Wang
- Department of Pharmacy, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Xi-Jing Chen
- Clinical Pharmacokinetics Lab, China Pharmaceutical University, Nanjing 211198, China.
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Illamola SM, Amaeze OU, Krepkova LV, Birnbaum AK, Karanam A, Job KM, Bortnikova VV, Sherwin CM, Enioutina EY. Use of Herbal Medicine by Pregnant Women: What Physicians Need to Know. Front Pharmacol 2020; 10:1483. [PMID: 31998122 PMCID: PMC6962104 DOI: 10.3389/fphar.2019.01483] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/15/2019] [Indexed: 12/13/2022] Open
Abstract
About 80% of the consumers worldwide use herbal medicine (HMs) or other natural products. The percentage may vary significantly (7%-55%) among pregnant women, depending upon social status, ethnicity, and cultural traditions. This manuscript discusses the most common HMs used by pregnant women, and the potential interactions of HMs with conventional drugs in some medical conditions that occur during pregnancy (e.g., hypertension, asthma, epilepsy). It also includes an examination of the characteristics of pregnant HM consumers, the primary conditions for which HMs are taken, and a discussion related to the potential toxicity of HMs taken during pregnancy. Many cultures have used HMs in pregnancy to improve wellbeing of the mother and/or baby, or to help decrease nausea and vomiting, treat infection, ease gastrointestinal problems, prepare for labor, induce labor, or ease labor pains. One of the reasons why pregnant women use HMs is an assumption that HMs are safer than conventional medicine. However, for pregnant women with pre-existing conditions like epilepsy and asthma, supplementation of conventional treatment with HMs may further complicate their care. The use of HMs is frequently not reported to healthcare professionals. Providers are often not questioning HM use, despite little being known about the HM safety and HM-drug interactions during pregnancy. This lack of knowledge on potential toxicity and the ability to interact with conventional treatments may impact both mother and fetus. There is a need for education of women and their healthcare professionals to move away from the idea of HMs not being harmful. Healthcare professionals need to question women on whether they use any HMs or natural products during pregnancy, especially when conventional treatment is less efficient and/or adverse events have occurred as herbal-drug interactions could be the reason for these observations. Additionally, more preclinical and clinical studies are needed to evaluate HM efficacy and toxicity.
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Affiliation(s)
- Sílvia M. Illamola
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States
| | - Ogochukwu U. Amaeze
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
| | - Lubov V. Krepkova
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Angela K. Birnbaum
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States
| | - Ashwin Karanam
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States
| | - Kathleen M. Job
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Valentina V. Bortnikova
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Catherine M.T. Sherwin
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Elena Y. Enioutina
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
- Department of Pathology, School of Medicine, University of Utah, Salt Lake City, UT, United States
- Pharmaceutics & Pharmaceutical Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
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Kam PC, Barnett DW, Douglas ID. Herbal medicines and pregnancy: A narrative review and anaesthetic considerations. Anaesth Intensive Care 2019; 47:226-234. [PMID: 31124378 DOI: 10.1177/0310057x19845786] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The use of herbal medicines by pregnant women varies among different countries, ranging from 4.3% in Sweden to 69% in Russia. The aim of this narrative review is to evaluate the benefits and safety of common herbal medicines used during pregnancy. A systematic literature search (from 1995 to February 2018) was performed using a variety of electronic databases. The levels of evidence of the clinical studies were graded using the Oxford Centre for Evidence-Based Medicine levels of evidence guidelines. From the 736 articles retrieved, 69 articles were used for this review. Ginger has been investigated extensively and has been consistently found to decrease nausea and vomiting associated with pregnancy (Level 2). There is insufficient evidence concerning the efficacy of other herbal medicines such as garlic, cranberry and raspberry in pregnancy (Level 3–4). Much of the literature is based on case reports with limited pharmacodynamic/kinetic studies. There are no clear data on the adverse herb–drug interactions during anaesthesia. As the risks of these interactions are unknown, it would be prudent for anaesthetists to explicitly ask their patients about their use of herbal medicines before surgery and prior to labour and birth. The European Society of Anaesthesiology and American Society of Anesthesiologists recommend that patients cease taking herbal medicines two weeks before surgery.
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Affiliation(s)
- Peter Ca Kam
- 1 Discipline of Anaesthetics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Denise Wy Barnett
- 2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Ian D Douglas
- 2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
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Cardoso BS, Amaral VCS. [The use of phytotherapy during pregnancy: a global overview]. CIENCIA & SAUDE COLETIVA 2019; 24:1439-1450. [PMID: 31066846 DOI: 10.1590/1413-81232018244.07472017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 06/27/2017] [Indexed: 11/22/2022] Open
Abstract
The scope of this study is to present an integrative review of the prevalence of the use of phytotherapy during pregnancy. A review of the topic was made by research in the Scielo, Medline and Science Direct databases using the following key words: "herbs and pregnancy," "plant and gestation," with their respective terms in Portuguese. Forty-six articles published between 2000 and 2015 met the study's inclusion and exclusion criteria and were included in this review. Of these, 11 were carried out in Europe, 10 in Asia, 5 in Africa, 3 in Oceania, 16 in America and only one of which was a multinational study. In most of these (67.39%), the interview method was used. A substantial variability in the prevalence of phytotherapy use was reported in the articles. In addition, camomile, ginger, garlic, mint and echinacea were the species most used by pregnant women. Despite the socioeconomic and ethnic-cultural variables among women worldwide, phytotherapy use during gestation is a widespread practice.
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Affiliation(s)
- Bruce Soares Cardoso
- Programa de Pós-Graduação em Ciências Aplicadas a Produtos para a Saúde. Universidade Estadual de Goiás (UEG). Br 153 3105, Campus Anápolis de Ciências Exatas e Tecnológicas. 75132-400 Anápolis GO Brasil.
| | - Vanessa Cristiane Santana Amaral
- Programa de Pós-Graduação em Ciências Aplicadas a Produtos para a Saúde. Universidade Estadual de Goiás (UEG). Br 153 3105, Campus Anápolis de Ciências Exatas e Tecnológicas. 75132-400 Anápolis GO Brasil.
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Zheng T, Yao D, Chen W, Hu H, Ung COL, Harnett JE. Healthcare providers' role regarding the safe and appropriate use of herbal products by breastfeeding mothers: A systematic literature review. Complement Ther Clin Pract 2019; 35:131-147. [DOI: 10.1016/j.ctcp.2019.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/08/2019] [Accepted: 01/22/2019] [Indexed: 12/18/2022]
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Yuvaci HU, Yazici E, Yazici AB, Cevrioglu S. How often do women use non-drug treatment methods for psyschiatric symptoms during pregnancy and postpartum periods? Ment Illn 2019; 11:7988. [PMID: 31007882 PMCID: PMC6452226 DOI: 10.4081/mi.2019.7988] [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: 01/14/2019] [Accepted: 01/24/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the prevalence of complementary and alternative medical applications (CAM) and non-drug treatments of women during their pregnancies, postpartum periods and the changes between these periods. The Screening Form for Non-pharmacologic Methods Used during Pregnancy and Postpartum period was administered to the participants. Passiflora (Incarnata), Hypericum perforatum (St. John's Wort), omega 3 supplements, bright light treatment, transmagnetic stimulation, S-adenosyl- methionine, herbal teas, biofeedback/neurofeedback, amulets, exercise, acupuncture and psychotherapy were investigated. The ratio of the use of one of the CAM methods for psychiatric complaints during people's lifetime was found to be 33.3% (n=162). Herbal teas were the main practice used during pregnancy (58.8%) and the postpartum. The use of CAM according to the utilization periods of the participants statistically significantly decreased in those who were currently pregnant (Cochran's Q=298.007; P<0.05). The use of participants' non-drug treatments in the periodical follow-up decreased in those who are currently pregnant and increased during the postpartum period.
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Affiliation(s)
| | - Esra Yazici
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Turkey
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25
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Xu YXZ, Xi S, Qian X. Evaluating Traditional Chinese Medicine and Herbal Products for the Treatment of Gestational Diabetes Mellitus. J Diabetes Res 2019; 2019:9182595. [PMID: 31886289 PMCID: PMC6915007 DOI: 10.1155/2019/9182595] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/19/2019] [Indexed: 12/17/2022] Open
Abstract
Gestational diabetes mellitus is the most common metabolic disorder during pregnancy with health consequences for both lives during and after pregnancy. Studies found that many pregnant women turn to complementary and alternative medicine for health maintenance or symptom relief, such as herbal medicine and acupuncture from traditional Chinese medicine. With the growing popularity of traditional Chinese medicine, we conducted a systemic search in PubMed, Web of Science, and Embase databases on research studies that investigated traditional Chinese medicine during pregnancy. The resultant hits were further searched in relation to all diabetes mellitus. In total, we found three major herbal medicine/herbal products that were associated with glycemic control in gestational diabetes, including Zuo Gui Wan, red raspberry leaves, and Orthosiphon stamineus. We further reviewed them and their relatives in relation to type 2 diabetes mellitus and found more evidence of metabolic benefits. None of the herbal medicine and products examined reported toxicity in the experimental models. Overall, treatments of gestational diabetes by western or alternative interventions are grossly understudied. It is critical to have a standardized protocol when evaluating efficacy of herbal medicine and produce quality results for women and their health-care providers to make informed treatment decisions.
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Affiliation(s)
- Yang Xin Zi Xu
- Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - Shengyan Xi
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Xiaoyan Qian
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
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Binns CW, Lee MK, Lee AH. Problems and Prospects: Public Health Regulation of Dietary Supplements. Annu Rev Public Health 2018; 39:403-420. [DOI: 10.1146/annurev-publhealth-040617-013638] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Colin W. Binns
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia;,
| | - Mi Kyung Lee
- School of Health Professions, Murdoch University, Perth, Western Australia 6150, Australia
| | - Andy H. Lee
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia;,
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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: 0.9] [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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Morton A. What risks do herbal products pose to the Australian community? Med J Aust 2017; 207:134. [DOI: 10.5694/mja17.00153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/22/2017] [Indexed: 11/17/2022]
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Morton A. Traditional practices and adverse pregnancy outcomes in migrant women. Obstet Med 2017; 10:45-46. [PMID: 28491134 DOI: 10.1177/1753495x16681199] [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] [Received: 09/07/2016] [Accepted: 11/06/2016] [Indexed: 11/15/2022] Open
Abstract
Traditional practices during pregnancy may lead to adverse outcomes in migrant women. Very little is known regarding the efficacy or safety of many cultural practices during pregnancy, and research is required to address this deficiency in knowledge. Greater awareness of traditional practices by health professionals may result in improved pregnancy outcomes in migrant women.
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Affiliation(s)
- Adam Morton
- Mater Hospital, University of QLD and Mater Health, South Brisbane, QLD, Australia
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