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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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Obi OC, Anosike C. A cross-sectional study on the knowledge, attitude, and practice of pregnant women regarding medication use and restriction during pregnancy. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100308. [PMID: 37533757 PMCID: PMC10392609 DOI: 10.1016/j.rcsop.2023.100308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
Background The use of medication during pregnancy is a complex issue that requires careful consideration to avoid potential harm to the developing fetus. Despite the existence of guidelines and restrictions on medication use during pregnancy, pregnant women in Nigeria often have limited access to information regarding drug use and may rely on their own judgment or the advice of non-professionals when making decisions about medication use. Objectives To assess Nigerian pregnant women's knowledge, attitude, and practice toward the use of drugs and restriction/contraindications in pregnancy. Methods A descriptive cross-sectional study was conducted among pregnant women who visited the Federal Medical Center, Umuahia, from January to February 2023. A self-administered questionnaire was answered by conveniently sampled participants. Data were collected about their sociodemographic characteristics, knowledge, attitude, and practice. Descriptive statistics and inferential statistics utilizing the Pearson's chi-Square test were used for data analysis. The level of significance was set at p < 0.05. Results One hundred and fifty-two pregnant women completed the questionnaire (60.8% response rate) and were mostly married (n = 148; 95.0%). Majority were between the age of 25 to 35 years (n = 107; 70.4%), had a university/bachelor's degree (n = 94; 61.8%), and were business women (n = 85; 56.0%). About 35.5% of the respondents had good knowledge of medication restrictions in pregnancy. The majority of the respondents had a positive attitude (n = 98; 64.5%) and good practice (n = 139; 91.4%). Conclusion The findings established that a substantial proportion of the women had a positive attitude and good practice of medication use and restrictions in pregnancy. However, the level of knowledge was surprisingly poor among the study group. There is a need to educate pregnant women on safe medication use and avoidance during pregnancy.
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Affiliation(s)
- Ogechi C. Obi
- Department of Clinical Pharmacy & Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
- Federal Medical Center Umuahia, Nigeria
| | - Chibueze Anosike
- Department of Clinical Pharmacy & Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
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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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Alqathama A, Alhomoud F, Alsadiq Y, Almehmadi A, Fallatah W, Alharbi O, Abdulhakim B, Alsubhi R, Alluqmani R. Complementary and alternative medicine from the perspective of pregnant and lactating women. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Hsu CY, Chen CL, Tsai LY, Tsai JM. Pregnancy-Related Stress Among Pregnant Women Receiving Tocolytic and Non-Tocolytic Treatments Where Both Used Complementary Medicine. Front Pharmacol 2022; 13:870659. [PMID: 35721134 PMCID: PMC9201384 DOI: 10.3389/fphar.2022.870659] [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: 02/07/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This study aimed to compare the pregnancy stress among pregnant women in receiving tocolytic and non-tocolytic treatments where both used complementary medicine. Methods: A cross-sectional survey was conducted among 35 pregnant women receiving tocolytic treatment and 35 receiving non-tocolytic treatment, where both used complementary medicine in a medical center in central Taiwan. A basic information questionnaire that contained demographic variables and types of complementary medicine used and the Pregnancy Stress Rating Scale were used for the analysis. Results: The types of complementary medicines were surveyed using the multiple-choice questionnaire. Natural products (77.5%) were most commonly used by pregnant women receiving tocolytic treatment, followed by alternative medicine (13.75%), manipulative and body-based practices (5%), and mind and body medicine (3.75%). In pregnant women who were receiving non-tocolytic treatment, natural products (59.1%) were most commonly used, followed by manipulative and body-based practices (16.4%), alternative medicine (15.4%), mind and body medicine (7.3%), and energy therapy (1.8%). According to the analysis of covariance test results, while both used complementary medicine in groups, pregnant women receiving tocolytic treatment were less stressed than those who were receiving non-tocolytic treatment (Pregnancy Stress Rating Scale score, p = 0.038), especially in dimension 2 (stress caused by infant care and changes in family relationships) (p = 0.015) and dimension 5 (stress caused by changes in physical appearance and function) (p = 0.008), which showed statistically significant differences (p < 0.05). Linear regression analysis results showed that the gestational age significantly associated with pregnancy stress (Pregnancy Stress Rating Scale score, p = 0.029; dimension 2, p = 0.016; and dimension 5, p = 0.001). Conclusion: Among both who used complementary medicine, pregnancy stress was significantly lower in pregnant women who were receiving tocolytic treatment than in those who were receiving non-tocolytic treatment. This finding can be used as a reference for future pregnant women’s health studies.
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Affiliation(s)
- Chen-Yuan Hsu
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan
| | - Ching-Li Chen
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan.,Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan
| | - Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan.,Mackay Memorial Hospital, Taipei, Taiwan.,Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Department of Nursing, Mackay Medical College, New Taipei, Taiwan
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Belayneh YM, Yoseph T, Ahmed S. A cross-sectional study of herbal medicine use and contributing factors among pregnant women on antenatal care follow-up at Dessie Referral Hospital, Northeast Ethiopia. BMC Complement Med Ther 2022; 22:146. [PMID: 35610698 PMCID: PMC9131662 DOI: 10.1186/s12906-022-03628-8] [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: 07/31/2019] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Herbal medicines are widely used in the world especially in developing countries. Pregnant women use herbal products to treat pregnancy related illnesses due to prior experience of herbal medicine use and easy accessibility of the products with less cost. However, herbal products could affect fetal growth and contribute to maternal and fetal morbidity and mortality. Herbal drug use during pregnancy is not well studied in Ethiopia specifically in northeast Ethiopia. Methods A cross-sectional survey was conducted among 254 pregnant women on antenatal care follow-up at Dessie referral hospital. Semi-structured questionnaires were used for data collection. After collection, data were coded, entered and analyzed by SPSS version 20. Chi squared test and Logistic regression were used to evaluate the association between dependent and independent variables. Result Among the total of 254 respondents, 130 (51.2%) used herbal drugs during current pregnancy. The most commonly mentioned reason for herbal drug use was “herbal medicines are accessible without prescription” (43.1%). The herbal medicines used were Ginger (Zingiber officinale Roscoe) (43.8%), followed by Garlic (Allium sativum L.) (23.8%), Damakese (Ocimum lamiifolium Hochst. ex Benth.) (21.5%) and Tena-adam (Ruta chalepensis L.) (10.8%). The indications for herbal drug use were nausea/vomiting (43.8%), headache (30.8%) and common cold (25.4%). The most commonly mentioned sources of information on herbal medicine were families and friends (80.0%) followed by neighbors (12.3%), and the most commonly cited sources of herbal products were market (67.7%) and self-preparation (20.0%). Being illiterate or having only primary school education (Adjusted Odds Ratio [AOR]: 3.717, 95% CI: 0.992-13.928), having secondary school education background (AOR: 3.645, 95% CI: 1.394-9.534), and poor monthly income (AOR: 7.234, 95% CI: 2.192-23.877) were the variables that showed significant association with herbal drug use during current pregnancy. Conclusion This study showed that half of the sampled pregnant women used herbal medicine during current pregnancy, and education status and monthly income level of the women were associated with herbal drug use. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03628-8.
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Affiliation(s)
- Yaschilal Muche Belayneh
- Department of Pharmacy, College of medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia.
| | - Tewodros Yoseph
- Department of Pharmacy, College of medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia
| | - Solomon Ahmed
- Department of Pharmacy, College of medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia
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Sarecka-Hujar B, Szulc-Musioł B. Herbal Medicines-Are They Effective and Safe during Pregnancy? Pharmaceutics 2022; 14:171. [PMID: 35057067 PMCID: PMC8802657 DOI: 10.3390/pharmaceutics14010171] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/13/2021] [Accepted: 01/08/2022] [Indexed: 02/05/2023] Open
Abstract
Since the teratogenicity of Thalidomide has been proven, herbal products are more commonly used in pregnancy to not only relieve morning sickness but also to fight infections. These products are frequently considered as natural and therefore harmless. However, herbs contain a number of active substances that, when used during pregnancy, can affect the development of the fetus. Often, pregnant women do not consult the usage of herbal medicines with a physician. The access to these products is easy and treatment of certain ailments with the use of herbs is common in many countries. The aim of the present literature review was to discuss available data regarding the efficacy and safety of cranberry, chamomile, Echinacea purpurea, garlic, ginger, Ginkgo biloba, and peppermint, which are used to counteract the most common ailments during pregnancy, i.e., infections and pregnancy-related ailments (e.g., nausea and vomiting, dizziness, and headache). Analysis of available data showed that ginger is one of the most extensively analyzed herbal remedies. The dose of ginger below 1000 mg per day may help to relief hypereremesis gravidarum, and such an amount of ginger did not increase frequency of adverse effects for either woman or developing fetus. Data regarding other herbs are most often heterogeneous and give conflicting results with no clear conclusions. However, all herbal products should be used with a special caution in pregnancy. Further high-quality human studies should be determined to confirm the safe doses of herbal products which could be used by pregnant or breast-feeding women.
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Affiliation(s)
- Beata Sarecka-Hujar
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa Str. 3, 41-200 Sosnowiec, Poland
| | - Beata Szulc-Musioł
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa Str. 3, 41-200 Sosnowiec, Poland;
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Jahan S, Mozumder ZM, Shill DK. Use of herbal medicines during pregnancy in a group of Bangladeshi women. Heliyon 2022; 8:e08854. [PMID: 35128116 PMCID: PMC8810368 DOI: 10.1016/j.heliyon.2022.e08854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/29/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pregnancy-related illnesses are commonly treated by herbal medicines in our country as well as around the world. OBJECTIVES The purpose of this study was to find out how common herbal use is among Bangladeshi pregnant women, what factors influence it, and how it affects pregnancy outcomes. METHODS Random sampling was done among women who gave birth between July and September 2021 in the maternity ward of an NGO-based clinic and were requested to participate in the face-to-face questionnaire-based survey. RESULTS 275 women (71.80%) out of 383 used herbs during their pregnancy. Only 27.42% of women who used herbs informed their doctors, and 91.03% of users reported no side effects. Most users thought that herbs were safer than allopathic medications (71.8%). The ground behind the choosing herb was suggestion from family members or self-medication (34.73% and 31.83%, respectively). Ginger (Zingiber officinale Roscoe) (73.10%), lemon (Citrus limon L. Burm. F) (71.27%), black seed (Nigella sativa) (66.55%), mustard oil (Brassica Juncea Mane Kancor) (65.45%), and prune (Prunus domestica) (41.45%) were the most widely utilized herbs. The majority of women used herbs on a daily basis. There were statistically significant differences in several socio-demographic characteristics and pregnancy outcomes between herb users and non-users. CONCLUSIONS The usage of herbs throughout pregnancy is quite prevalent amid Bangladeshi womenfolk, according to this study. Herbs appear to be safe when used often during pregnancy. Furthermore, physicians or medical practitioners have to play a vital role in ensuring the safe usage of herbs among pregnant women.
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Affiliation(s)
- Sadia Jahan
- Department of Pharmacy, Faculty of Science, Comilla University, Bangladesh
| | | | - Diponkor Kumar Shill
- Department of Pharmacy, Faculty of Science and Engineering, East West University, Bangladesh
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Feigel ML, Kennard A, Lannaman K. Herbalism for Modern Obstetrics. Clin Obstet Gynecol 2021; 64:611-634. [PMID: 34323236 DOI: 10.1097/grf.0000000000000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
More pregnant and nursing mothers are using herbal remedies than health care providers realize. Lack of familiarity with herbalism in addition to the sparsity of high-quality research for many complementary and alternative medicines are barriers for the western practitioner to engage a patient about herbal therapies. This review provides historical information and available evidence for Traditional Chinese and Western herbal medicines commonly sought by pregnant and nursing mothers. We will review herbs commonly used for: nausea and vomiting, constipation, gestational diabetes, threatened miscarriage, immune system support, parturition preparation, postpartum depression, postpartum bleeding and pain, wound healing, and lactation support.
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Affiliation(s)
| | - Anne Kennard
- Marian Regional Medical Center, Santa Maria, California
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Bergien S, Petersen CM, Lynning M, Kristiansen M, Skovgaard L. "I need personal experiences or some sort of documentation": a qualitative study on where people with multiple sclerosis seek information on dietary and herbal supplements. BMC Complement Med Ther 2021; 21:213. [PMID: 34419015 PMCID: PMC8379853 DOI: 10.1186/s12906-021-03377-0] [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: 12/01/2020] [Accepted: 07/06/2021] [Indexed: 11/25/2022] Open
Abstract
Background The use of dietary and herbal supplements (DIHES) is widespread among people with multiple sclerosis (PwMS). PwMS are a highly informed patient group, and they use several types of sources to seek information on subjects related to their disease. However, it is still unknown where PwMS seek information about DIHES. It is important that PwMS make decisions about DIHES based on accurate, useful and accessible information. Therefore, the aim of this study was to explore where PwMS seek information on DIHES and how they experience and engage with this information. Methods Semi-structured interviews were conducted with eighteen PwMS using DIHES. Participants were selected from a cross-sectional survey. Diversity sampling was used, based on relevant characteristics such as gender and number of DIHES used during the past 12 months. The interviews were conducted face-to-face or over the telephone and lasted between 30 min and 1 hour. The interviews were recorded, transcribed verbatim, and analyzed using thematic network analysis in NVivo 12 Pro software. Results Three main themes emerged in the analysis: i) engaging with healthcare professionals (HCPs) regarding DIHES, ii) social networks as a source of information regarding DIHES, and iii) reliance on bodily sensations. Most participants navigated all three types of sources. All participants had at some point discussed DIHES with an HCP. Information from HCPs was considered reliable and valuable, but HCPs were viewed as uncommitted to the dialogue about DIHES. Recommendations from others were often the driver of decisions regarding use of DIHES. However, the information from PwMS’ networks could be overwhelming and difficult to navigate. Finally, PwMS relied on their own experiences regarding DIHES and let their bodily sensations guide their use of DIHES. Conclusions Participants often rely on all three types of information sources to create a nuanced and comprehensive information base. However, PwMS may feel overwhelmed or confused with all the information they have gathered. These findings indicate the need for better guidance for PwMS concerning DIHES and an openness among HCPs to engage in dialogue. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03377-0.
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Affiliation(s)
- Sofie Bergien
- The Danish Multiple Sclerosis Society, Poul Bundgaards Vej 1, Valby, Denmark.
| | - Clara M Petersen
- The Danish Multiple Sclerosis Society, Poul Bundgaards Vej 1, Valby, Denmark
| | - Marie Lynning
- The Danish Multiple Sclerosis Society, Poul Bundgaards Vej 1, Valby, Denmark
| | - Maria Kristiansen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen K, Denmark
| | - Lasse Skovgaard
- The Danish Multiple Sclerosis Society, Poul Bundgaards Vej 1, Valby, Denmark
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Gindri dos Santos B, Peres Klein C, Scortegagna Crestani M, Moura Maurmann R, Mateus Hözer R, dos Santos Rodrigues K, Maciel August P, Matté C. Naringin Supplementation during Pregnancy Induces Sex and Region-Specific Alterations in the Offspring's Brain Redox Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094805. [PMID: 33946307 PMCID: PMC8124438 DOI: 10.3390/ijerph18094805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022]
Abstract
Research has shown the beneficial effects of naringin supplementation to adult rodents, which can ameliorate oxidative stress in disease models. However, evidence has demonstrated that polyphenol supplementation induced detrimental effects when consumed during sensitive periods of development, such as pregnancy. Therefore, we investigated the effect of maternal naringin supplementation during pregnancy on the offspring’s cerebral redox status. Pregnant Wistar rats were divided into control and naringin groups and supplemented from gestational day 15 to gestational day 21. On postnatal days 1, 7, and 21, offspring were euthanized, and the prefrontal cortex, hippocampus, striatum, and cerebellum dissected. On postnatal day 1, maternal naringin supplementation positively modulated the pups’ brain redox status. On postnatal day 7, a pro-oxidative milieu was observed in the offspring’s striatum and cerebellum in a sex-dependent manner, even though the prefrontal cortex and hippocampus were not negatively affected. Besides, the alterations observed on postnatal day 7 did not persist up to weaning. Our findings demonstrated that the effect induced by naringin supplementation in the brain redox status differed according to the period of development in which naringin was consumed since the beneficial effects usually found in the adult rodents became detrimental when the supplementation was applied during pregnancy.
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Affiliation(s)
- Bernardo Gindri dos Santos
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (C.P.K.); (R.M.H.); (K.d.S.R.); (P.M.A.); (C.M.)
- Correspondence:
| | - Caroline Peres Klein
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (C.P.K.); (R.M.H.); (K.d.S.R.); (P.M.A.); (C.M.)
| | - Mariana Scortegagna Crestani
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (M.S.C.); (R.M.M.)
| | - Rafael Moura Maurmann
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (M.S.C.); (R.M.M.)
| | - Régis Mateus Hözer
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (C.P.K.); (R.M.H.); (K.d.S.R.); (P.M.A.); (C.M.)
| | - Karoline dos Santos Rodrigues
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (C.P.K.); (R.M.H.); (K.d.S.R.); (P.M.A.); (C.M.)
| | - Pauline Maciel August
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (C.P.K.); (R.M.H.); (K.d.S.R.); (P.M.A.); (C.M.)
| | - Cristiane Matté
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (C.P.K.); (R.M.H.); (K.d.S.R.); (P.M.A.); (C.M.)
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-000, Brazil; (M.S.C.); (R.M.M.)
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90050-170, Brazil
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Evaluation of the pregnant women's approaches regarding drug utilization. North Clin Istanb 2021; 8:49-56. [PMID: 33623873 PMCID: PMC7881424 DOI: 10.14744/nci.2020.27003] [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: 04/16/2020] [Accepted: 08/27/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE: Drug utilization habits of the pregnant are a critical aspect of rational use of the medicine (RUM). This study aimed to analyze the RUM related attitudes and the behaviors of women during their pregnancies. METHODS: The data were collected between May 2016–October 2016 by conducting surveys to 71 pregnant women admitted to the private and governmental hospitals in five districts of Northern Cyprus. The sociodemographic characteristics of the pregnant as well as their attitudes and behaviors concerning drug use were evaluated. RESULTS: The mean age and the gestational week of the patients was 29.7±4.3 years and 25.7±11.2 weeks, respectively. Planned pregnancies constituted 71.8% of all. The percentage of patients with an unplanned pregnancies who were using drugs at the time of the survey (25.0%) was lower than that in those with planned pregnancies (49.0%, p<0.05). Almost two-thirds (66.2%) of the women were exposed to a drug during pregnancy, mostly for “vitamin/mineral prophylaxis” (38.3%) and agents controlling nausea/vomiting (19.1%). Two out of eleven women (18.2%) were using folic acid when they learned about their pregnancy. One of the drugs used for the chronic disorder in the third trimester was acetylsalicylic acid (11.1%), a category D drug in this setting. Most of the patients stated that they frequently read the instructions (60.9%), “often” paying attention to side effects (56.5%). Considering some of the habits related to drug use, 8.7% and 10.9% of pregnant women declared that they sometimes “did not follow the instructions” and “dosage/duration of the drug usage”, respectively. Seven patients (15.2%) declared that they did not consider side effects on the medication guide while more than half (56.5%) did it “often”. Near one in five (19.6%) of the pregnant women stated that they hesitated about the drug usage due to teratogenicity risks. CONCLUSION: Our study highlights the drug utilization attitudes and behaviors of pregnant women during pregnancy in Northern Cyprus, indicating several shortcomings, including insufficient prenatal folic acid use, occasional use of risky drugs, and unsatisfactory medication guide handling. Available findings underline the necessity of education not only for patients but also for healthcare providers to disseminate RUM in pregnancy.
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Bowman R, Taylor J, Muggleton S, Davis D. Biophysical effects, safety and efficacy of raspberry leaf use in pregnancy: a systematic integrative review. BMC Complement Med Ther 2021; 21:56. [PMID: 33563275 PMCID: PMC7871383 DOI: 10.1186/s12906-021-03230-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 01/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background Childbearing women have been using various herbs to assist with pregnancy, labour and birth for centuries. One of the most common is raspberry leaf. The evidence base for the use of raspberry leaf is however under-developed. It is incumbent on midwives and other maternity care providers to provide women with evidence-based information so they can make informed choices. The aim of this study was to review the research literature to identify the evidence base on the biophysical effects, safety and efficacy of raspberry leaf in pregnancy. Methods A systematic, integrative review was undertaken. Six databases were searched to identify empirical research papers published in peer reviewed journals including in vitro, in vivo, human and animal studies. The search included the databases CINAHL, MEDLINE, Cochrane Library, Scopus and Web of Science Core Collection and AMED. Identified studies were appraised independently by two reviewers using the MMAT appraisal instrument. An integrative approach was taken to analysis. Results Thirteen studies were included. Five were laboratory studies using animal and human tissue, two were experiments using animals, and six were human studies. Included studies were published between 1941 and 2016. Raspberry leaf has been shown to have biophysical effects on animal and human smooth muscle including the uterus. Toxity was demonstrated when high doses were administered intravenously or intaperitoneally in animal studies. Human studies have not shown any harm or benefit though one study demonstrated a clinically meaningful (though non-statistically significant) reduction in length of second stage and augmentation of labour in women taking raspberry leaf. Conclusions Many women use raspberry leaf in pregnancy to facilitate labour and birth. The evidence base supporting the use of raspeberry leaf in pregnancy is weak and further research is needed to address the question of raspberry leaf’s effectiveness.
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Affiliation(s)
- Rebekah Bowman
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia
| | - Jan Taylor
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia
| | - Sally Muggleton
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia
| | - Deborah Davis
- University of Canberra, 11 Kirinari St, Bruce ACT, 2617, Australia. .,ACT Government, Health Directorate, 4 Bowes St, Phillip ACT, 2606, Australia.
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Ahmed M, Im HB, Hwang JH, Han D. Disclosure of herbal medicine use to health care providers among pregnant women in Nepal: a cross-sectional study. BMC Complement Med Ther 2020; 20:339. [PMID: 33172473 PMCID: PMC7654584 DOI: 10.1186/s12906-020-03142-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/31/2020] [Indexed: 12/30/2022] Open
Abstract
Background Pregnant women’s disclosure of herbal medicine (HM) use to their health care providers during pregnancy is crucial, as misuse of HM can have a detrimental effect on both pregnant woman and the fetus. However, the lack of disclosure of HM use to physicians remains a public health concern in developing countries such as Nepal. Methods A cross-sectional study was conducted among 400 postpartum women admitted at Maternity and Women’s Hospital located in Kathmandu, Nepal. The survey instrument included 30 questions on the use of HM during pregnancy, sociodemographic and health characteristics, and pregnancy outcomes. Chi-square test and logistic regression were conducted for data analysis using SPSS ver. 21.0., and a p-value of less than 0.05 was considered statistically significant for all analyses. Results 60.3% of respondents used at least one herbal remedy during their previous pregnancy, and the overall disclosure rate of HM use to healthcare providers was 54.6%. Women with secondary education level and four or more antenatal care visits were more likely to disclose their HM use to healthcare providers. Conclusions This study highlights that despite the popular use of HM among pregnant women in Nepal, most women obtained HM-related information from informal sources and did not disclose their HM use to physicians. To ensure the safe use of HM, physicians should integrate questions regarding patients’ HM use into their routine patient assessments to facilitate active communication and improve the quality of care. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-020-03142-9.
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Affiliation(s)
- Mansoor Ahmed
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan.,Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea
| | - Hyea Bin Im
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Jung Hye Hwang
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea.,Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, South Korea
| | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea. .,Institute of Health Services Management, Hanyang University, Seoul, South Korea. .,Department of Preventive Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 133-791, South Korea.
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15
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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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Herbal medicine use among pregnant women attending antenatal clinics in Lusaka Province, Zambia: A cross-sectional, multicentre study. Complement Ther Clin Pract 2020; 40:101218. [PMID: 32891293 DOI: 10.1016/j.ctcp.2020.101218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND PURPOSE: The study of herbal medicine (HM) use which is related to maternal health, a public health priority in many sub-Saharan African countries including Zambia, has been limited. Accordingly, we aimed to determine the prevalence and patterns of HM use during pregnancy in Lusaka Province, Zambia. MATERIALS AND METHODS A survey-based (interviewer-administered), cross-sectional, multicentre study was conducted in 446 adult pregnant women attending antenatal clinics in June/July 2019. RESULTS Overall, 57.8% of participants reported using HM during their current pregnancy, with a mean of 2.0 ± 1.5 remedies/woman. Logistic regression analysis showed that HM use was significantly associated with HM use in prior pregnancies (p < 0.001) and willingness to use HM in the future (p < 0.001). The most commonly used herbs were lemon for nausea/vomiting and common cold, soybean to boost energy, ginger for common cold and nausea/vomiting, and Aloe vera for skin care. The perceived safety of HM (37.6%) and its complementary action with conventional medicines (35.3%) were the main reasons for HM use. CONCLUSION HM use among pregnant women attending antenatal clinics in Lusaka Province, Zambia is common, and a wide range of herbs is used.
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Nsibirwa S, Anguzu G, Kamukama S, Ocama P, Nankya-Mutyoba J. Herbal medicine use among patients with viral and non-viral Hepatitis in Uganda: prevalence, patterns and related factors. BMC Complement Med Ther 2020; 20:169. [PMID: 32493310 PMCID: PMC7268757 DOI: 10.1186/s12906-020-02959-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 05/19/2020] [Indexed: 02/03/2023] Open
Abstract
Background There is some evidence that patients with liver diseases commonly use complementary and alternative therapies to address general and liver-disease specific health concerns. The purpose of this study was to assess and describe prevalence, patterns and related factors of herbal medicine use among adults diagnosed with viral and non-viral hepatitis in Kampala, Uganda. Methods A cross-sectional study was conducted on 310 adult patients attending the gastrointestinal clinic in Mulago hospital referral hospital in Kampala. Data on prevalence, types and reasons for herbal medicine use was collected using standardized questionnaires and focus group discussions. Modified Poisson regression analyses were used to examine factors related to use. Results Usage of various herbal remedies within 12 months prior to April 2018 was reported by 46.1% (143/310) of patients with 27.3% (39/143) of these reporting having used conventional and herbal therapies concurrently. Herbal remedies were used to treat various health conditions including hepatitis. Patients with hepatitis C virus infection (PRR = 1.16, p = 0.02) compared to those with hepatitis B virus infection, and those who believed that it was safe to use herbal and conventional therapies concurrently (PRR = 1.23, p = 0.008) had higher prevalence odds of herbal medicine use. Conversely, patients who had been newly diagnosed with hepatitis (PRR = 0.69, p = 0.03) compared to those who had been diagnosed more than one-year prior, had lower prevalence odds of herbal medicine use. Various types of local herbs were reported as most commonly used however most patients did not know the ingredients of commercially prepared herbal therapies. Conclusion A high prevalence of herbal medicine use was found among newly-diagnosed patients and patients with hepatitis C more likely to use herbal remedies after adjusting for other factors. Usage was influenced by the belief that herbal medicine is safe and effective. Health workers need to consistently elicit information about herbal remedy use. Research is needed on benefits, adverse effects and outcomes in patients who use herbal remedies to treat primary liver diseases in order to facilitate evidence of efficacy and product safety.
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Affiliation(s)
- Sara Nsibirwa
- Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Godwin Anguzu
- Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Sam Kamukama
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ponsiano Ocama
- Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joan Nankya-Mutyoba
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Steel A, Diezel H, Frawley J, Wardle J, Adams J. Providing maternity care from outside the system: perspectives of complementary medicine practitioners. J Interprof Care 2020:1-9. [PMID: 32130068 DOI: 10.1080/13561820.2020.1711717] [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: 11/05/2018] [Revised: 08/02/2019] [Accepted: 01/02/2020] [Indexed: 10/24/2022]
Abstract
One in two women in Australia use complementary medicine (CM) during pregnancy including consulting with CM practitioners for pregnancy-related health concerns. Yet, very little is known about the everyday care and practice of this group of health professionals as it relates to the provision of care to childbearing women. As such, this study aims to examine the perceptions and experiences of CM practitioners who provide care to childbearing women. Semi-structured interviews were conducted with 23 practitioners from six CM professions (acupuncturists, doulas, chiropractors, massage therapists, naturopaths, and osteopaths) who identified as providing care to pregnant and birthing women in their clinical practice. The participants described professional issues affecting their provision of care to childbearing women including scope of practice, regulation and standards, and practice-specific issues, all of which they linked back to their profession and the reputation of their profession among other health professionals and the community. The study results draw attention to the importance of considering the perspectives of CM maternity care providers and place on interprofessional collaboration, as well as the barriers they face to achieving this collaboration. The insights afforded by this study have the capacity to inform new policy and practice initiatives to support improved interprofessional maternity care.
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Affiliation(s)
- Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, Sydney, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Helene Diezel
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, Sydney, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, Sydney, Australia
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, Sydney, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, Sydney, Australia
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Tefera YG, Gebresillassie BM, Getnet Mersha A, Belachew SA. Beliefs and Risk Awareness on Medications Among Pregnant Women Attending the Antenatal Care Unit in Ethiopia University Hospital. Overestimating the Risks Is Another Dread. Front Public Health 2020; 8:28. [PMID: 32195214 PMCID: PMC7062669 DOI: 10.3389/fpubh.2020.00028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 01/29/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Most studies on drug use during pregnancy were generally focused on potential teratogenic effects. However, beliefs and risk awareness of medications can also influence medication use and fetal well-being. Objective: This study aimed at assessing the risk awareness and beliefs on medication use among pregnant women attending antenatal care unit in an Ethiopian university hospital. Method: A cross-sectional study was employed in pregnant women who were attending for antenatal care service at Gondar University Referral Hospital from March 15, to April 15, 2016. A pretested structured interview questionnaire adopted from the Beliefs About Medicines Questionnaire (BMQ) was used for data collection. Chi-square test and binary logistic regression were used to identify possible predictors influencing the outcome variables. Result: Of the 423 women approached, 384 agreed to complete the questionnaire (90.8% response rate), and the mean age of the participants was 27.22 ± 5.5 years. More than two-thirds of the respondents had two to three (46.1%) or greater than three (25.8%) pregnancy histories. A third and nearly half (45.6%) of the respondents were on the first trimester and second trimester of their gestational age, respectively. The majority (70%) of pregnant women thought all drugs are harmful if taken during pregnancy. Only few (4.2%) of the participants did not mind taking drugs without professional advice. Most (90%) of the respondents were not willing to take drugs without professional advice. Pregnant women who came from rural areas had 25% less likelihood to self-medicate, with an adjusted odds ratio of 95% CI, 0.75 (0.37, 0.96). Conclusion: In this study, overestimated and exaggerated beliefs of medication risks during pregnancy are a concern, though cautious drug use is necessary and warranted. Adequate counseling has to be provided by physicians, pharmacists, and other healthcare professionals to change pregnant women's conservative attitudes and misinformed beliefs on medication risk.
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Affiliation(s)
- Yonas Getaye Tefera
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Begashaw Melaku Gebresillassie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amanual Getnet Mersha
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sewunet Admasu Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Dimene L, Fadzai M, Chifamba J, Nyakatawa G, Mahachi C, Marume A, Bhebhe M, Taderera T. A cross-sectional study to determine the use of alternative medicines during pregnancy in the district hospitals in Manicaland, Zimbabwe. Afr Health Sci 2020; 20:64-72. [PMID: 33402894 PMCID: PMC7750077 DOI: 10.4314/ahs.v20i1.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Traditional medicines are widely used in the rapidly growing health system and are of economic importance. The study aimed at determining the frequency, pattern of use and factors that influence traditional medicines use during pregnancy. Materials and methods A cross-sectional study was carried out at four district hospitals in Manicaland, Zimbabwe, using questionnaire based convenience sampling. Results Traditional medicines use was found to be high with 54% (n = 337) of pregnant women using traditional medicines during pregnancy. The major purpose of use of traditional medicine was found to be preparation for delivery; cervical dilation in particular. The following factors showed a significant statistical association for use of traditional medicines: previous mode of delivery (p = 0.006), level of education (p = 0.016), family income (p = 0.007), and residential settlement (p =0.026). Some of the common traditional medicines used during pregnancy include Camellia sinensis, Aloe, Spirostachys Africana, Thumbergia lancifolia, Dalbergiella nyasae, Steganotaenia oraliacea, Stomatostemma monteiroae and Cussonia arborea Conclusion A number of pregnant women use traditional medicines as partus preparators (labour aids) throughout the entire pregnancy period. This calls for obstetricians, general practitioners and midwives to inquire about use of traditional medicine in history.
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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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Eid AM, Jaradat N. Public Knowledge, Attitude, and Practice on Herbal Remedies Used During Pregnancy and Lactation in West Bank Palestine. Front Pharmacol 2020; 11:46. [PMID: 32116721 PMCID: PMC7034419 DOI: 10.3389/fphar.2020.00046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/14/2020] [Indexed: 12/23/2022] Open
Abstract
The use of herbal products by pregnant and lactating mothers without awareness of their harmful effects may expose both mother and fetus or infant to great dangers, such as abortion, premature delivery, uterine bleeding, and physical and mental retardation of the fetus. Thus, the aim of this study was to investigate the extent to which herbal product treatment is used and the reason for which such products are used and to ensure that these reasons are correct. An ethnopharmacological survey (cross-sectional observational design study) using a pre-piloted questionnaire was undertaken on herbal products used by pregnant and lactating women in the West Bank area of Palestine. A questionnaire was distributed to 350 pregnant and lactating women. The informed consent forms, ethics, and aims of the present study were reviewed and approved by the Institutional Review Board (IRB) at An-Najah National University. To identify the most important species used, the use value (UV) index was employed, while the SPSS program was used to analyze the data. Collected data revealed that 13 medicinal plants are utilized, while 12 plants are not used during pregnancy. Moreover, 15 plants are utilized and 9 plants are not used during lactation for treating and dealing with various problems. The most commonly used plants belonged to 14 families, including Lamiaceae, Apiaceae, Leguminosae, and Rubiaceae. The plants most used during pregnancy were sage (Salvia fruticosa), anise (Pimpinella anisum), and peppermint (Mentha × piperita). Castor (Ricinus communis) oil, ginger (Zingiber officinale), saffron (Crocus sativus), and senna (Senna alexandrina) mostly were not used by pregnant women. Moreover, cinnamon (Cinnamomum verum), anise (P. anisum), peppermint (M. piperita), and sage (S. fruticosa) were mostly used during lactation. Castor (R. communis) oil, ginger (Z. officinale), garlic (Allium sativum), and aloe (Aloe vera) mostly were not used during lactation. This study is of great importance in order to decrease the possibility of endangering the lives of fetuses and infants. A combined effort among researchers, scientists, lactating women, and pregnant women may help in changing wrong uses and thoughts about medicinal plants and help to improve the overall health of both mother and fetus.
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Affiliation(s)
- Ahmad M Eid
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nidal Jaradat
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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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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Welz AN, Emberger-Klein A, Menrad K. The importance of herbal medicine use in the German health-care system: prevalence, usage pattern, and influencing factors. BMC Health Serv Res 2019; 19:952. [PMID: 31823758 PMCID: PMC6905107 DOI: 10.1186/s12913-019-4739-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/12/2019] [Indexed: 11/10/2022] Open
Abstract
Background Prevalence rates for herbal medicine (HM) have been increasing worldwide. However, little is known about prevalence, user characteristics, usage pattern and factors influencing HM usage for the general German population. Methods A nationwide online survey on HM usage was conducted in Germany. The 2906 participants were categorised into three groups: the ones who used HM in the last 12 months, the ones who did not use HM in the last 12 months but in their lifetime, and the ones who did not use HM until now. Data were analysed by descriptive statistics, Chi Square tests and binary hierarchical logistic regression analyses. Results Prevalence rates of HM were found to be very high for the general German population. Self-medication appeared as a common praxis, when at the same time HM users responded that they do not inform their physician about it, rate their knowledge about HM as somewhat poor, and use the internet as the most frequent source of information. The HM user in the last 12 months was found to include people that were more likely female, highly educated, privately insured, employed, and engaged in a more health-oriented lifestyle. While certain sociodemographic- and health-related variables influence HM usage vs. non-usage, they explain variance only to a limited extent. For distinguishing the user in the last 12 months vs. the less recent user who did not use HM in the last 12 months, ratings on different reasons for HM usage were found to perform better as predictors than sociodemographic- and health-related variables. Conclusions This study demonstrated that HM usage plays an essential role in the German health-care system. Furthermore, the HM usage pattern may be potentially harmful for patients, as it included self-medication, little knowledge on interaction- and side-effects of HM, and a lack of communication with physicians about the usage. Moreover, prediction of HM usage in the previous year is impacted by variables beyond conventional sociodemographic- and health-related ones. In view of the high prevalence rates of HM in Germany, medical as well as health service providers should be aware of these issues.
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Affiliation(s)
- Alexandra N Welz
- Technical University of Munich, TUM Campus Straubing for Biotechnology and Sustainability, Chair of Marketing and Management of Biogenic Resources, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315, Straubing, Germany
| | - Agnes Emberger-Klein
- Technical University of Munich, TUM Campus Straubing for Biotechnology and Sustainability, Chair of Marketing and Management of Biogenic Resources, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315, Straubing, Germany
| | - Klaus Menrad
- Technical University of Munich, TUM Campus Straubing for Biotechnology and Sustainability, Chair of Marketing and Management of Biogenic Resources, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315, Straubing, Germany.
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Barnes LA, Barclay L, McCaffery K, Aslani P. Complementary medicine products: Information sources, perceived benefits and maternal health literacy. Women Birth 2019; 32:493-520. [DOI: 10.1016/j.wombi.2018.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/15/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Women's health literacy and the complex decision-making process to use complementary medicine products in pregnancy and lactation. Health Expect 2019; 22:1013-1027. [PMID: 31116500 PMCID: PMC6803395 DOI: 10.1111/hex.12910] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/27/2019] [Accepted: 04/22/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Little is known about women's decision-making processes regarding using complementary medicine products (CMPs) during pregnancy or lactation. OBJECTIVES To explore the decision-making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions. DESIGN, SETTING AND PARTICIPANTS In-depth interviews and focus group discussions were held with twenty-five pregnant and/or breastfeeding women. Data were analysed using thematic analysis. RESULTS Key to women's decision making was the desire to establish a CMPs safety and to receive information from a trustworthy source, preferably their most trusted health-care practitioner. Women wanted positive therapeutic relationships with health-care practitioners and to be highly involved in the decisions they made for the health of themselves and their children. Two overarching components of the decision-making process were identified: (a) women's information needs and (b) a preference for CMP use. Women collated and assessed information from other health-care practitioners, other mothers and published research during their decision-making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies. DISCUSSION AND CONCLUSIONS Complex decision-making processes to use CMPs in pregnancy and lactation were identified. The participants showed high levels of communicative and critical health literacy skills in their decision-making processes. These skills supported women's complex decision-making processes.
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Affiliation(s)
- Larisa A. J. Barnes
- School of PharmacyThe University of SydneySydneyNew South WalesAustralia
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
| | - Lesley Barclay
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten McCaffery
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Parisa Aslani
- School of PharmacyThe University of SydneySydneyNew South WalesAustralia
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Truong MBT, Ngo E, Ariansen H, Tsuyuki RT, Nordeng H. Community pharmacist counseling in early pregnancy-Results from the SafeStart feasibility study. PLoS One 2019; 14:e0219424. [PMID: 31323048 PMCID: PMC6641474 DOI: 10.1371/journal.pone.0219424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/24/2019] [Indexed: 11/18/2022] Open
Abstract
Background Community pharmacists are available to counsel women in early pregnancy, but no studies have assessed the feasibility of such a service. Objective To test the feasibility of a pharmacist consultation in early pregnancy and to inform the design of a definitive trial. Setting Six community pharmacies in Norway from Oct. to Dec. 2017. Method We evaluated recruitment approaches and an automatic data preprocessing system (ADPS) to enroll, assign participants, and distribute questionnaires. Women (≥18 years) in early pregnancy were eligible for inclusion. Participants were assigned to a pharmacist consultation (intervention group) or standard care (control group). The intervention aimed to address each woman’s concerns and needs regarding medications and ailments in pregnancy, and was documented on a standard form. The women’s acceptability of the intervention was measured by a questionnaire. Main outcome measures Appropriate recruitment approaches, workflow of the ADPS, and women’s acceptability of the intervention. Results Of the 35 participants recruited, 19 were recruited through Facebook. The ADPS worked well. Treatment of nausea and vomiting (NVP) (10/11) and general information about medications (8/11) were frequently discussed during the consultations (n = 11). The women reported high satisfaction with the consultation. Having the option of telephone and follow-up consultations was important to the women. Conclusion It is feasible to provide community pharmacist consultations in early pregnancy. In a definitive study, the consultations should focus on NVP and general medication use and further explore social media as a recruiting tool. Both in-pharmacy and telephone consultations should be offered to deliver the intervention.
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Affiliation(s)
| | - Elin Ngo
- Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Hilde Ariansen
- Department of Pharmacy, University of Oslo, Oslo, Norway
- The Norwegian Pharmacy Association, Oslo, Norway
| | - Ross T. Tsuyuki
- Department of Pharmacology, University of Alberta, Edmonton, Canada
| | - Hedvig Nordeng
- Department of Pharmacy, University of Oslo, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Complementary medicine products information-seeking by pregnant and breastfeeding women in Australia. Midwifery 2019; 77:60-70. [PMID: 31255910 DOI: 10.1016/j.midw.2019.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/04/2019] [Accepted: 06/20/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Complementary medicine product use in pregnancy and lactation is common but little is known about women's health literacy and information-seeking regarding this. The objectives of this study were to identify and explore pregnant or breastfeeding women's sources of, and rationale for seeking complementary medicine products information, the types of information sought, and how women felt their health care practitioners can help them receive information that meets their needs. DESIGN A qualitative research design consisting of in-depth interviews and focus group discussions was conducted. Data were thematically analysed. Participants also completed two validated health literacy screening tools. SETTING Communities in regional and metropolitan settings in Sydney and Northern New South Wales, and South-East Queensland, Australia. PARTICIPANTS Twenty-five women (n = 7 pregnant, n = 17 breastfeeding, n = 1 both pregnant and breastfeeding) who currently used complementary medicine products participated. Eleven women were pregnant with or breastfeeding their first child; 14 had between one and four older children. FINDINGS Twenty-four participants had high health literacy according to the validated screening tools. Around half of the participants had used complementary medicine products for most of their lives and 17 had used complementary medicine products to resolve or manage complex health conditions in adulthood or childhood. Women sought complementary medicine products information from three main sources. 1) Practical and safety information on complementary medicine products was sought from health care practitioners and published research; 2) health care practitioners were also sources of information on reasons for complementary medicine products recommendations and physiological actions; and 3) sharing experiences of complementary medicine products use with other mothers appeared to help women understand what to expect when taking complementary medicine products, support social-emotional wellbeing and encourage participants to look after their own health. Participants strongly expressed the desire for their mainstream biomedical health care practitioners to be more informed in, and open to, complementary medicine product use in pregnancy and breastfeeding. KEY CONCLUSIONS Participants' high health literacy skills may have influenced them to seek comprehensive information on complementary medicine products from a variety of professional and lay sources. Their use of complementary medicine products in pregnancy and breastfeeding was a natural consequence from previous positive experiences with complementary medicine products and/or therapies. IMPLICATIONS FOR PRACTICE Maternity care practitioners can positively enhance their interactions with pregnant or breastfeeding women who use complementary medicine products by respectfully discussing use within the context of these women's values and health goals, and by furthering their own education in complementary medicine products' safety, efficacy and indications in pregnancy and breastfeeding.
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Affiliation(s)
- Larisa A J Barnes
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Rd, The University of Sydney NSW 2006, Australia; The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia.
| | - Lesley Barclay
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia; Faculty of Medicine and Health, The University of Sydney School of Public Health, Edward Ford Building (A27), NSW 2006, Australia.
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building (A27), NSW 2006, Australia.
| | - Parisa Aslani
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Rd, The University of Sydney NSW 2006, 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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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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Peprah P, Agyemang-Duah W, Arthur-Holmes F, Budu HI, Abalo EM, Okwei R, Nyonyo J. 'We are nothing without herbs': a story of herbal remedies use during pregnancy in rural Ghana. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:65. [PMID: 30876425 PMCID: PMC6419816 DOI: 10.1186/s12906-019-2476-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/06/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Herbal medicine has become the panacea for many rural pregnant women in Ghana despite the modern western antenatal care which has developed in most parts of the country. To our knowledge, previous studies investigating herbal medicine use have primarily reported general attitudes and perceptions of use, overlooking the standpoint of pregnant women and their attitudes, and utilisation of herbal medicine in Ghana. Knowledge of herbal medicine use among rural pregnant women and the potential side effects of many herbs in pregnancy are therefore limited in the country; this qualitative study attempts to address this gap by exploring the perceptions of herbal medicine usage among pregnant women in rural Ghana. METHODS A sample of 30, conveniently selected pregnant women, were involved in this study from April 11 to June 22, 2017. Data from three different focus group discussions were thematically analysed and presented based on an a posteriori inductive reduction approach. RESULTS The main findings were that pregnant women used herbal medicine, most commonly ginger, peppermint, thyme, chamomile, aniseeds, green tea, tealeaf, raspberry, and echinacea leaf consistently throughout the three trimesters of pregnancy. Cultural norms and health beliefs in the form of personal philosophies, desire to manage one's own health, illness perceptions, and a holistic healing approach were ascribed to the widespread use of herbs. CONCLUSION We recommend public education and awareness on disclosure of herbal medicine use to medical practitioners among pregnant women.
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Affiliation(s)
- Prince Peprah
- Department of Natural and Built Environment, Sheffield Hallam University, Sheffield, UK
| | - Williams Agyemang-Duah
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Hayford Isaac Budu
- Department of Nursing, Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Mawuli Abalo
- School of Geography and the Environment, University of Oxford, South-Parks Road, Oxford, GB OX1 3QY UK
| | - Reforce Okwei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Julius Nyonyo
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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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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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Complementary medicine products used in pregnancy and lactation and an examination of the information sources accessed pertaining to maternal health literacy: a systematic review of qualitative studies. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:229. [PMID: 30064415 PMCID: PMC6069845 DOI: 10.1186/s12906-018-2283-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/11/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The prevalence of complementary medicine use in pregnancy and lactation has been increasingly noted internationally. This systematic review aimed to determine the complementary medicine products (CMPs) used in pregnancy and/or lactation for the benefit of the mother, the pregnancy, child and/or the breastfeeding process. Additionally, it aimed to explore the resources women used, and to examine the role of maternal health literacy in this process. METHODS Seven databases were comprehensively searched to identify studies published in peer-reviewed journals (1995-2017). Relevant data were extracted and thematic analysis undertaken to identify key themes related to the review objectives. RESULTS A total of 4574 articles were identified; 28 qualitative studies met the inclusion criteria. Quantitative studies were removed for a separate, concurrent review. Herbal medicines were the main CMPs identified (n = 21 papers) in the qualitative studies, with a smaller number examining vitamin and mineral supplements together with herbal medicines (n = 3), and micronutrient supplements (n = 3). Shared cultural knowledge and traditions, followed by women elders and health care professionals were the information sources most accessed by women when choosing to use CMPs. Women used CMPs for perceived physical, mental-emotional, spiritual and cultural benefits for their pregnancies, their own health, the health of their unborn or breastfeeding babies, and/or the breastfeeding process. Two over-arching motives were identified: 1) to protect themselves or their babies from adverse events; 2) to facilitate the normal physiological processes of pregnancy, birth and lactation. Decisions to use CMPs were made within the context of their own cultures, reflected in the locus of control regarding decision-making in pregnancy and lactation, and in the health literacy environment. Medical pluralism was very common and women navigated through and between different health care services and systems throughout their pregnancies and breastfeeding journeys. CONCLUSIONS Pregnant and breastfeeding women use herbal medicines and micronutrient supplements for a variety of perceived benefits to their babies' and their own holistic health. Women access a range of CMP-related information sources with shared cultural knowledge and women elders the most frequently accessed sources, followed by HCPs. Culture influences maternal health literacy and thus women's health care choices including CMP use.
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Affiliation(s)
- Larisa Ariadne Justine Barnes
- Faculty of Pharmacy, The University of Sydney, Camperdown, NSW 2006 Australia
- University Centre for Rural Health, The University of Sydney, PO Box 3074, Lismore, NSW 2480 Australia
| | - Lesley Barclay
- University Centre for Rural Health, The University of Sydney, PO Box 3074, Lismore, NSW 2480 Australia
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Camperdown, NSW 2006 Australia
| | - Kirsten McCaffery
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Rm 128B, Edward Ford Building A27, Camperdown, NSW 2006 Australia
| | - Parisa Aslani
- Faculty of Pharmacy, The University of Sydney, Rm N502, Pharmacy & Bank Building (A15), Science Rd, Camperdown, NSW 2006 Australia
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Schürger N, Klein E, Hapfelmeier A, Kiechle M, Paepke D. Demand for integrative medicine among women in pregnancy and childbed: a German survey on patients' needs. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:187. [PMID: 29907100 PMCID: PMC6003184 DOI: 10.1186/s12906-018-2249-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/06/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although integrative medicine is gaining increasing attention and is claiming more and more its place in modern health care, it still plays a marginal role in conventional maternity care. The present study aims to examine the patterns of Complementary and Alternative Medicine (CAM) use and the demand for integrative therapies, including CAM, relaxation therapies, nutritional counseling, and psychological assistance, among women in pregnancy and childbed. METHODS The survey was conducted from April 2017 to July 2017 by means of a pseudo-anonymous 38-item questionnaire at the Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich. Eligible participants were women hospitalized due to pregnancy related complications and women in childbed. Descriptive statistics were generated to determine patterns of CAM use and demand for integrative therapeutic approaches. Univariate analysis was used to detect associations between patients' characteristics and their interest in the different integrative therapies. Furthermore, binary logistic regression was used to estimate the odds ratio of demand for CAM. RESULTS A total of 394 out of 503 patients participated in the survey (78%). 60% declared using CAM in general, 45% specifically in relation to their pregnancy or childbed. Most commonly used modalities were vitamins (31% of all patients), yoga (24%), and herbal supplements (23%). Most popular sources of recommendation of CAM use were midwives and gynecologists. Integrative therapy options patients would have wanted alongside conventional maternity care were CAM (64%), relaxation therapies (44%), dietary counseling (28%), and psychological counseling (15%). Furthermore, associations between patients' sociodemographic characteristics and their demand for integrative therapies were identified. CONCLUSIONS The results of this study demonstrate that there is a considerable demand for integrative medicine and widespread use of CAM among women during pregnancy and childbed in Germany. Maternity health care providers should be aware of these findings in order to be able to better address patients' needs and wishes. Our study findings should be interpreted with regard to patients in an hospital setting.
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Zamawe C, King C, Jennings HM, Fottrell E. Associations between the use of herbal medicines and adverse pregnancy outcomes in rural Malawi: a secondary analysis of randomised controlled trial data. Altern Ther Health Med 2018; 18:166. [PMID: 29801482 PMCID: PMC5970448 DOI: 10.1186/s12906-018-2203-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/16/2018] [Indexed: 12/18/2022]
Abstract
Background The use of herbal medicines during pregnancy is very high globally and previous studies have pointed out possible associations with adverse pregnancy outcomes. Nevertheless, the safety of herbal medicines in pregnancy is under-explored in low-income countries experiencing high maternal and neonatal complications. We investigated the associations between self-reported use of Mwanamphepo (a group of herbal medicines commonly used to induce or hasten labour) and adverse maternal and neonatal outcomes in rural Malawi. Methods We conducted a cross-sectional analysis of secondary household data relating to 8219 births that occurred between 2005 and 2010 in Mchinji district, Malawi. The data were collected as part of a cluster-randomised controlled trial (RCT) that evaluated community interventions designed to reduce maternal and neonatal mortality. Data were gathered on maternity history, demographic characteristics, pregnancy outcomes and exposure to Mwanamphepo. Associations between self-reported use of Mwanamphepo and maternal morbidity as well as neonatal death or morbidity were examined using mixed-effects models, adjusted for relevant covariates. All analyses were also adjusted for the clustered nature of the survey. Results Of the 8219 births, Mwanamphepo was used in 2113 pregnancies, representing an estimated prevalence of 25.7%. The self-reported use of Mwanamphepo was significantly associated with increased occurrence of maternal morbidity and neonatal death or morbidity. Specifically, the odds of maternal morbidity were 28% higher among self-reported users than non-users of Mwanamphepo (AOR = 1.28; 95% CI = 1.09–1.50) and the probabilities of neonatal death or morbidity were 22% higher (AOR =1.22; 95% CI = 1.06–1.40) among neonates whose mother reportedly used Mwanamphepo than those who did not. Conclusion The use of Mwanamphepo was associated with adverse pregnancy outcomes in rural Malawi. Thus, herbal medicines may not be safe in pregnancy. Where possible, pregnant women should be discouraged from using herbal medicines of unconfirmed safety and those who report to have used should be closely monitored by health professionals. The study was limited by the self-report of exposure and unavailability of data relating to some possible confounders.
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Welz AN, Emberger-Klein A, Menrad K. Why people use herbal medicine: insights from a focus-group study in Germany. Altern Ther Health Med 2018. [PMID: 29544493 DOI: 10.1186/s12906-018-2160-6]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of herbal medicine, as one element of complementary and alternative medicine, is increasing worldwide. Little is known about the reasons for and factors associated with its use. This study derives insights for the use of herbal medicine in Germany regarding the usage aims, role played by the type of illness, reasons for preferred usage and sources of information. METHODS Using a qualitative methodological approach, six focus groups (n = 46) were conducted. Two groups with young, middle-aged and elderly participants, respectively. After audiotaping and verbatim transcription, the data were analysed with a qualitative content analysis. RESULTS We found that treating illnesses was the most frequently discussed aim for using herbal medicine over all age groups. Preventing illnesses and promoting health were less frequently mentioned overall, but were important for elderly people. Discussions on herbal medicine were associated with either mild/moderate diseases or using herbal medicine as a starting treatment before applying conventional medicine. In this context, participants emphasized the limits of herbal medicine for severe illnesses. Dissatisfaction with conventional treatment, past good experiences, positive aspects associated with herbal medicine, as well as family traditions were the most commonly-mentioned reasons why herbal medicine was preferred as treatment. Concerning information sources, independent reading and family traditions were found to be equally or even more important than consulting medicinal experts. CONCLUSIONS Although herbal medicine is used mostly for treating mild to moderate illnesses and participants were aware of its limits, the combination of self-medication, non-expert consultation and missing risk awareness of herbal medicine is potentially harmful. This is particularly relevant for elderly users as, even though they appeared to be more aware of health-related issues, they generally use more medicine compared to younger ones. In light of our finding that dissatisfaction with conventional medicine was the most important reason for a preferred use of herbal medicine, government bodies, doctors, and pharmaceutical companies need to be aware of this problem and should aim to establish a certain level of awareness among users concerning this issue.
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Affiliation(s)
- Alexandra N Welz
- TUM Campus Straubing for Biotechnology and Sustainability, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315, Straubing, Germany
| | - Agnes Emberger-Klein
- TUM Campus Straubing for Biotechnology and Sustainability, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315, Straubing, Germany
| | - Klaus Menrad
- TUM Campus Straubing for Biotechnology and Sustainability, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315, Straubing, Germany.
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Welz AN, Emberger-Klein A, Menrad K. Why people use herbal medicine: insights from a focus-group study in Germany. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:92. [PMID: 29544493 PMCID: PMC5855977 DOI: 10.1186/s12906-018-2160-6] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 03/07/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND The use of herbal medicine, as one element of complementary and alternative medicine, is increasing worldwide. Little is known about the reasons for and factors associated with its use. This study derives insights for the use of herbal medicine in Germany regarding the usage aims, role played by the type of illness, reasons for preferred usage and sources of information. METHODS Using a qualitative methodological approach, six focus groups (n = 46) were conducted. Two groups with young, middle-aged and elderly participants, respectively. After audiotaping and verbatim transcription, the data were analysed with a qualitative content analysis. RESULTS We found that treating illnesses was the most frequently discussed aim for using herbal medicine over all age groups. Preventing illnesses and promoting health were less frequently mentioned overall, but were important for elderly people. Discussions on herbal medicine were associated with either mild/moderate diseases or using herbal medicine as a starting treatment before applying conventional medicine. In this context, participants emphasized the limits of herbal medicine for severe illnesses. Dissatisfaction with conventional treatment, past good experiences, positive aspects associated with herbal medicine, as well as family traditions were the most commonly-mentioned reasons why herbal medicine was preferred as treatment. Concerning information sources, independent reading and family traditions were found to be equally or even more important than consulting medicinal experts. CONCLUSIONS Although herbal medicine is used mostly for treating mild to moderate illnesses and participants were aware of its limits, the combination of self-medication, non-expert consultation and missing risk awareness of herbal medicine is potentially harmful. This is particularly relevant for elderly users as, even though they appeared to be more aware of health-related issues, they generally use more medicine compared to younger ones. In light of our finding that dissatisfaction with conventional medicine was the most important reason for a preferred use of herbal medicine, government bodies, doctors, and pharmaceutical companies need to be aware of this problem and should aim to establish a certain level of awareness among users concerning this issue.
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Affiliation(s)
- Alexandra N. Welz
- TUM Campus Straubing for Biotechnology and Sustainability, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315 Straubing, Germany
| | - Agnes Emberger-Klein
- TUM Campus Straubing for Biotechnology and Sustainability, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315 Straubing, Germany
| | - Klaus Menrad
- TUM Campus Straubing for Biotechnology and Sustainability, Weihenstephan-Triesdorf University of Applied Sciences, Petersgasse 18, 94315 Straubing, Germany
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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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Dawood OT, Hassali MA, Saleem F, Aljadhey H. Assessment of the medicines use pattern among the general public in the state of Penang, Malaysia. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2017. [DOI: 10.1002/jppr.1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Omar Thanoon Dawood
- Discipline of Social and Administrative Pharmacy; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Minden Penang Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy; School of Pharmaceutical Sciences; Universiti Sains Malaysia; Minden Penang Malaysia
| | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences; University of Baluchistan; Quetta Pakistan
| | - Hisham Aljadhey
- College of Pharmacy; King Saud University; Riyadh Saudi Arabia
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Jafari-Dehkordi E, Hashem-Dabaghian F, Aliasl F, Aliasl J, Taghavi-Shirazi M, Sadeghpour O, Sohrabvand F, Minaei B, Ghods R. Comparison of quince with vitamin B6 for treatment of nausea and vomiting in pregnancy: a randomised clinical trial. J OBSTET GYNAECOL 2017. [PMID: 28631509 DOI: 10.1080/01443615.2017.1322046] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This trial was performed to compare quince (Cydonia oblonga) fruit with vitamin B6 on 76 pregnant women with a gestational age of 6-14 weeks and mild-to-moderate nausea and vomiting (NVP) (40 in the quince and 36 in the B6 group). The 'Pregnancy-Unique Quantification of Emesis' (PUQE-24) scale was used to examine the severity of NVP. The quince syrup (1 tablespoon/TDS) or vitamin B6 tablets (20 mg/TDS) were used as intervention for 1 week. The mean (±SD) age was 27.5 (±5.2) years. The score of the PUQE was decreased from 9.5 (± 2) at baseline to 5.2 (±2.3) on the 7th day and 5.3 (±2.6) on the 14th day (p < .001) in the quince group. In the other group, the scores were 8.4 (±1.8), 7.3 (±2.4) and 7.7 (±3.8), respectively (p = .001). The change in symptoms were more marked in the quince group (p < .001). Quince syrup seems to be a suitable treatment for NVP. Impact statement What is already known on this subject: Pregnancy-induced nausea and vomiting (NVP) is one of the most common problems during gestation. Treatment is mainly symptomatic, ranging from dietary changes and oral pharmacological treatment to hospitalization in severe forms. In early pregnancy, the use of chemical drugs is avoided, so there is an increasing tendency to use alternative therapies. According to the literature review in Iranian Traditional Medicine (ITM), the quince fruit (Cydonia oblonga) can be useful in NVP. Quince has a wide range of pharmacological activities including antioxidant, antibacterial, antifungal, anti-inflammatory, hepatoprotective and antidepressant effects. ITM literature suggests some therapeutic effects of the quince fruit on important organs like brain, heart, liver and stomach. What the results of this study add: The results of this study demonstrated the significant efficacy of quince in comparison with vitamin B6. What the implications are of these findings for clinical practice and/or further research: This fruit is also safe to be administered in pregnant women suffering from NVP.
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Affiliation(s)
- Effat Jafari-Dehkordi
- a Research Institute for Islamic and Complementary Medicine , School of Iranian Traditional Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - Fataneh Hashem-Dabaghian
- a Research Institute for Islamic and Complementary Medicine , School of Iranian Traditional Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - Fatemeh Aliasl
- b Department of Traditional pharmacy, Faculty of Traditional Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Jaleh Aliasl
- a Research Institute for Islamic and Complementary Medicine , School of Iranian Traditional Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - Maryam Taghavi-Shirazi
- a Research Institute for Islamic and Complementary Medicine , School of Iranian Traditional Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - Omid Sadeghpour
- a Research Institute for Islamic and Complementary Medicine , School of Iranian Traditional Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - Farnaz Sohrabvand
- c Department of Obstetrics, Gynecology & Infertility , Vali-e-Asr Hospital, Tehran University of Medical Sciences , Tehran , Iran
| | - Bagher Minaei
- d Department of Histology , School of Medicine, Tehran University of Medical Sciences , Tehran , Iran
| | - Roshanak Ghods
- a Research Institute for Islamic and Complementary Medicine , School of Iranian Traditional Medicine, Iran University of Medical Sciences , Tehran , Iran
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Loree AM, Ondersma SJ, Grekin ER. Toward Enhancing Treatment for Pregnant Smokers: Laying the Groundwork for the Use of Complementary and Alternative Medicine Approaches. Nicotine Tob Res 2017; 19:562-571. [DOI: 10.1093/ntr/ntw262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 09/28/2016] [Indexed: 11/14/2022]
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Onyiapat JL, Okafor C, Okoronkwo I, Anarado A, Chukwukelu E, Nwaneri A, Okpala P. Complementary and alternative medicine use: Results from a descriptive study of pregnant women in Udi local Government area of Enugu state, Nigeria. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:189. [PMID: 28372550 PMCID: PMC5379706 DOI: 10.1186/s12906-017-1689-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/15/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of CAM by pregnant women is very popular in developed countries. The trend is increasing globally and lack of evidence of safety particularly when used during pregnancy may lead to complications. Pregnancy is a vulnerable period especially during the first trimester. There is scarcity of empirical evidence on CAM use particularly among women in Udi LGA of Enugu State and South East Nigeria. Moreover, studies carried out in Nigeria have been limited to herbal medicine use, which is one aspect of CAM. This study was designed to obtain information on the use of Complementary and Alternative Medicine among pregnant women. METHODS The study was a cross sectional descriptive survey of 396 pregnant women systematically drawn from twenty political wards in Udi Local Government Area (LGA) of Enugu State. Interviewer administered questionnaire developed by the researchers was used for data collection. Data were analyzed using descriptive statistics. RESULTS Majority (82.1%) of the pregnant women in Udi LGA used CAM during pregnancy out of which 53.8% had used CAM in previous pregnancies. CAM used ranges from one single type to sixteen different types with biological products eg, herbal tea, herbal mixture being the most commonly used CAM. Whereas most (89.5%) of the CAM used by pregnant women was consumed orally, approximately half of the pregnant women used CAM together with conventional medicine. CONCLUSION The use of CAM by women during pregnancy was high in Udi LGA. Therefore, maternity care providers especially midwives need to elicit CAM commonly used by women during pregnancy and counsel them appropriately for best care and safety. Researchers should focus on establishing the efficacy of CAM products.
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Kıssal A, Çevik Güner Ü, Batkın Ertürk D. Use of herbal product among pregnant women in Turkey. Complement Ther Med 2017; 30:54-60. [DOI: 10.1016/j.ctim.2016.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 08/05/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022] Open
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Determination of the concentration of major active anti-emetic constituents within commercial ginger food products and dietary supplements. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Yang Y, Wen J, Kong W, Liu Q, Luo H, Wang J, Yang M. Simultaneous determination of four aflatoxins and ochratoxin A in ginger after inoculation with fungi by ultra-fast liquid chromatography-tandem mass spectrometry. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2016; 96:4160-7. [PMID: 26762953 DOI: 10.1002/jsfa.7618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 07/09/2015] [Accepted: 01/05/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Aflatoxins (AFs) and ochratoxin A (OTA) have been detected frequently in food, agricultural products and traditional Chinese medicines, and their presence poses serious health and economic problems worldwide. Ginger can easily be polluted with mycotoxins. In this study, ginger samples were cultivated for 15 days after inoculation with fungi and were prepared based on ultrasound-assisted solid-liquid extraction using methanol/water followed by immunoaffinity column clean-up and analysed by ultra-fast liquid chromatography-tandem mass spectrometry (UFLC-MS/MS) for AFs and OTA. RESULTS The limits of detection and quantification of AFs and OTA were 0.04-0.30 µg mL(-1) and 0.125-1.0 µg mL(-1) , respectively. The recoveries were 82.0-100.2%. After 15 days' cultivation, no macroscopic mildew was found in ginger. But, the content of AFB1 expressed an increasing trend in ginger, peel [less than the limit of quantification (LOQ)] to the innermost layer (51.86 µ mL(-1) ), AFB2 was only detected in the innermost layer at the level of 0.87 µ mL(-1) . A small amount ( CONCLUSION The developed method was successfully applied to analyse five mycotoxins, and has many advantages including rapid determination and high sensitivity. Meanwhile, in practice, more attention should be paid to the safety and quality of ginger. © 2016 Society of Chemical Industry.
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Affiliation(s)
- Ying Yang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
| | - Jing Wen
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Weijun Kong
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
| | - Qiutao Liu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
- Pharmacy College, Liaoning Medical University, Jinzhou, Liaoning 121001, China
| | - Hongli Luo
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
| | - Jian Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Meihua Yang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
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Mollart L, Adams J, Foureur M. Pregnant women and health professional's perceptions of complementary alternative medicine, and participation in a randomised controlled trial of acupressure for labour onset. Complement Ther Clin Pract 2016; 24:167-73. [DOI: 10.1016/j.ctcp.2016.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
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Hwang JH, Kim YR, Ahmed M, Choi S, Al-Hammadi NQ, Widad NM, Han D. Use of complementary and alternative medicine in pregnancy: a cross-sectional survey on Iraqi women. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:191. [PMID: 27389024 PMCID: PMC4936269 DOI: 10.1186/s12906-016-1167-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 06/29/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Due to the lack of strong evidence on safety and efficacy of complementary and alternative medicine (CAM) approaches, the use of CAM in women during pregnancy could be hazardous for mother and fetus. Meanwhile, little is known regarding the patterns, the reasons and the factors affecting use of CAM among pregnant women in Iraq. METHODS A cross sectional survey design was used to carry out face-to-face interviews with 335 consecutive pregnant women. The questionnaire comprised of three sections: socio-demographic characteristics, pregnancy-related aspects and the patterns and attitudes towards use of CAM. Determinants of CAM use were assessed through the logistic regression analysis. RESULTS Three hundred thirty-five pregnant women completed the questionnaire. 56.7 % reported using at least one form of CAM modalities. In total, 24 different types of CAM were used; with herbal medicine (53.7 %) and multivitamins (36.3 %) the most commonly used modalities. From the logistic regression analysis, the variables positively associated with CAM use were: rural residence (odds ratio (OR) 2.0, p < 0.01), no occupation (OR 2.7, p < 0.05), high income (OR 2.0, p < 0.05), perceived healthy status (OR 2.6, p < 0.05) and ever use of contraception (OR 2.0, p < 0.01). Only 0.5 % of CAM users disclosed their CAM use to physicians. CONCLUSIONS The proportion of CAM users among pregnant women is relatively high and it is important to learn what types of CAM they use. However, disclosure of CAM use was extraordinarily low. Given the low rate of disclosure, it should be ensured that physicians establish good level of communication with pregnant women and have adequate knowledge of CAM.
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Affiliation(s)
- Jung Hye Hwang
- />Department of Obstetrics and Gynecology, University of Hanyang College of Medicine, Seoul, South Korea
- />Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Yu-Rim Kim
- />Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Mansoor Ahmed
- />Institute of Health Services Management, Hanyang University, Seoul, South Korea
- />Department of Global Health and Development and Department of Preventive Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763 South Korea
| | - Soojeung Choi
- />Institute of Health Services Management, Hanyang University, Seoul, South Korea
- />Department of Global Health and Development and Department of Preventive Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763 South Korea
| | | | | | - Dongwoon Han
- />Institute of Health Services Management, Hanyang University, Seoul, South Korea
- />Department of Global Health and Development and Department of Preventive Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763 South Korea
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Budzynska K, Filippelli AC, Sadikova E, Low Dog T, Gardiner P. Use and Factors Associated With Herbal/Botanical and Nonvitamin/Nonmineral Dietary Supplements Among Women of Reproductive Age: An Analysis of the Infant Feeding Practices Study II. J Midwifery Womens Health 2016; 61:419-26. [PMID: 27336953 DOI: 10.1111/jmwh.12482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Little is known about the changes in prevalence of dietary supplement use in pregnancy, postpartum, and in a comparison group of nonpregnant women. METHODS We conducted a secondary analysis of the Infant Feeding Practices II study. The purpose of this study is to report the prevalence of herbal or botanical and nonvitamin, nonmineral dietary supplement use by US women with respect to demographic, behavioral, and health factors. We compared pregnant and postpartum women to a comparison group of nonpregnant women who had not given birth in the past 12 months. Our main outcome was the prevalence of dietary supplements. Multiple logistic regression models were used to examine factors associated with herbal or botanical and nonvitamin, nonmineral dietary supplement use during reproductive age, pregnancy, and postpartum. RESULTS The total sample included 1444 women assessed during the prenatal period, 1422 from the postpartum period, and 1517 women in a comparison group. In terms of herb or botanical use, 15% of the prenatal group, 16% of the postpartum group, and 22% of the comparison group reported using herbs or botanicals. The most frequently used nonvitamin, nonmineral supplement was omega-3 fatty acid. Among the total prenatal group and comparison group, women eating 5 or more servings of fruits or vegetables were less likely to report using herbs or botanicals. Women in the comparison group self-identifying as black were 4 times as likely to report using herbs or botanicals compared to participants self-identifying as white. In addition, women identifying as a race other than white were almost twice as likely to report herb or botanical use across all study groups. DISCUSSION This is one of the rare studies that shows the changing prevalence of herbs or botanicals and nonvitamin, nonmineral dietary supplement use in women in the reproductive stage of their lives.
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Gyasi RM, Asante F, Yeboah JY, Abass K, Mensah CM, Siaw LP. Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana. Int J Qual Stud Health Well-being 2016; 11:29667. [PMID: 27018431 PMCID: PMC4808739 DOI: 10.3402/qhw.v11.29667] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 11/14/2022] Open
Abstract
The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of one's health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, New Territories, Hong Kong SAR.,Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;
| | - Felix Asante
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Yaw Yeboah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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