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Maunder A, Arentz S, Armour M, Costello MF, Ee C. Effectiveness of naturopathy for pregnancy in women with diminished ovarian reserve: feasibility randomized controlled trial. Reprod Biomed Online 2024; 48:103844. [PMID: 38579664 DOI: 10.1016/j.rbmo.2024.103844] [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: 10/30/2023] [Revised: 12/20/2023] [Accepted: 01/11/2024] [Indexed: 04/07/2024]
Abstract
RESEARCH QUESTION Is conducting a randomized control trial (RCT) to assess the effectiveness of whole-system naturopathy in improving pregnancy rates among women with diminished ovarian reserve (DOR) feasible? DESIGN A two-arm, parallel group, assessor-blinded feasibility RCT was conducted. Women with DOR, trying to conceive naturally or by ART, were randomly assigned to naturopathy plus usual care, or usual care alone for 16 weeks. Primary outcomes were feasibility (recruitment, adherence, retention rates), acceptability and safety. Secondary outcomes included ongoing pregnancy rates, live birth rates and health-related outcomes (mental health, quality of life, diet, exercise, sleep and weight). Statistical significance of the differences between the two groups (P-values) were exploratory. RESULTS One hundred and fifteen women completed the screening survey between March and November 2022. Of these, 66 women were assessed for eligibility and 41 (62%) consented. Recruitment resulted in seven enrolments each month. All 41 participants (100%) adhered to the intervention, 38 (93%) completed end-point questionnaires, 32 (78%) found study participation to be acceptable and 18 out of 21 (86%) from the intervention group would recommend a naturopathic intervention to other women with DOR. The naturopathic treatment was associated with only mild and temporary adverse events. No between-group differences were observed for pregnancy and live birth rates. CONCLUSION The evaluation of whole-system naturopathy through a RCT was feasible and the treatment was acceptable and well tolerated according to women with DOR. Outcomes from this study will help inform sample size calculations powered for fertility outcomes for future RCTs on this topic.
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Affiliation(s)
- Alison Maunder
- NICM Health Research Institute, Western Sydney University, Penrith NSW Australia..
| | - Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith NSW Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith NSW Australia
| | - Michael F Costello
- Women's Health, UNSW and Royal Hospital for Women and Monash IVF, Sydney NSW Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith NSW Australia
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Maunder A, Arentz S, Armour M, Costello MF, Ee C. Establishing key components of naturopathic management of women with diminished ovarian reserve: A Delphi study. Complement Ther Clin Pract 2024; 55:101839. [PMID: 38316080 DOI: 10.1016/j.ctcp.2024.101839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Alison Maunder
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Michael F Costello
- Women's Health, UNSW and Royal Hospital for Women and Monash IVF, Sydney, NSW, Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
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Friedman J, Sheeder J, Lazorwitz A, Polotsky AJ. Herbal supplement use among reproductive-aged women in an academic infertility practice. F S Rep 2023; 4:104-111. [PMID: 36959959 PMCID: PMC10028423 DOI: 10.1016/j.xfre.2022.12.001] [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: 08/24/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To address the knowledge gap surrounding herbal medicine and supplement usage patterns and supplement-prescription medication interactions among patients seeking treatment for infertility. Design Cross-sectional survey study. Setting Academic infertility practice. Patients Ninety-five reproductive-aged patients. Interventions Not applicable. Main Outcome Measures Use of herbal medications and supplements, baseline demographics, history of infertility treatments, and potential supplement-medication interactions. Results We surveyed 95 participants with a median age of 35 years. Overall, 68.4% of patients reported ever having used supplements or herbal medicines in the past. Current use of herbal supplements and vitamins was reported by 53.7% and 93.7% of participants, respectively, with a median of 2 (range 19) supplements used per person. There were no significant associations between patient demographics, comorbidities, or infertility treatments with increased rates of supplement use. The most commonly used herbal supplements were: green tea (n = 14), chamomile (n = 12), peppermint (n = 9), turmeric (n = 8), elderberry (n = 7), ginger (n = 7), maca (6) with the most common modalities being pills/capsules (23.8%) and tea (42.3%). The most common reasons for use were: general health and wellness (24.5%), immune support (16.2%), stress (14.0%), and fertility (15.0%). Patients used maca (n = 5), chasteberry (n = 3), goji berry (n = 2), ginger (n = 2), yam-based progesterone (n = 2), and combination product (n = 2) for fertility purposes. A total of 7.9% of patients learned about these products from their general health care provider, and 33.3% of supplements were disclosed by patients to their provider. We identified 41 moderate-risk supplement-drug interactions, with 12 of these interactions attributed to infertility therapies. Based on the interaction checker, the most commonly proposed mechanisms of interaction were CYP3A4 and CYP2C19 inhibition. In terms of safety in pregnancy, cannabidiol and chasteberry were suggested to be "possibly unsafe in pregnancy," and red raspberry leaf "likely unsafe in pregnancy" without direct medical supervision. Conclusions We found over two thirds of women seeking treatment for infertility reported past and over half reported current herbal medicine and supplement use. Notably, the Natural Medicines Interaction Checker suggested high rates of moderate-risk supplement-drug interactions and possible harmful effects in early pregnancy. Our results call for further investigation of clinically relevant supplement interactions with infertility therapies.
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Affiliation(s)
- Julie Friedman
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado
| | - Jeanelle Sheeder
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado
| | - Aaron Lazorwitz
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado
| | - Alex Joel Polotsky
- Shady Grove Fertility, Greenwood Village, Colorado
- Reprint requests: Alex Joel Polotsky, Shady Grove Fertility, 8200 E Belleview Ave Suite 615-E, Greenwood Village, Colorado 80111.
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“We Are Having a Huge Problem with Compliance”: Exploring Preconception Care Utilization in South Africa. Healthcare (Basel) 2022; 10:healthcare10061056. [PMID: 35742106 PMCID: PMC9223298 DOI: 10.3390/healthcare10061056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Preconception care (PCC), a policy directive from the World Health Organisation (WHO), comprises all the health interventions offered to women and couples before conception and is intended to improve their overall health status and the pregnancy outcomes. Although PCC should be an essential part of maternal and child health services in most African countries, its provision and utilization are not widely documented. Hence, this study aimed to explore the factors influencing preconception care utilization among high-risk women in South Africa. Methods: A descriptive qualitative study of 29 purposively selected women and healthcare workers was conducted through individual in-depth interviews using a semi-structured interview guide. The interviews were transcribed verbatim, and the analyses were performed using Nvivo version 12. The Social-Ecological Model (SEM) guided the data analysis. Four levels of factors (the individual, the interpersonal, the community and social, and the policy and institutional) were used to assess what can influence PCC utilization. Findings: The availability of PCC services, the intrahospital referral of women, the referral practices of other healthcare workers, the underutilization of the PCC facility, and resources emerged at the institutional levels, while compliance with PCC appointments, socioeconomic factors, pregnancy planning, assumptions, and knowledge was at the individual levels. Conclusion: The utilization of the preconception care services was inadequate. The primary influencer of preconception care utilization was at the individual, policy, and institutional levels. The availability of preconception care services and the intrahospital referral of women at high risk of adverse pregnancy outcomes positively influenced the women’s PCC utilization, while poor pregnancy planning, and unavailability of PCC policies and guidelines negatively influenced preconception care utilization. Therefore, interventions to improve PCC utilization should focus on the four SEM levels for effectiveness. There is a need to raise PCC awareness and develop policy and guidelines to ensure consistent, standardized practice among healthcare workers.
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Cox CM, Johnson CL. Engagement in Nonbiomedical Practices for Fertility Enhancement: A Scoping Review. J Altern Complement Med 2020; 26:1000-1014. [PMID: 32609536 DOI: 10.1089/acm.2020.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: This scoping review aims to (1) describe the scope and coverage of the body of literature on nonbiomedical practices used for enhancing fertility, (2) summarize and map the existing evidence on the extent and types of nonbiomedical practices used, and (3) examine how the research on this topic has been conducted with particular attention paid to how participants are asked about their use of nonbiomedical practices for fertility enhancement. Design: We conducted a scoping review by which four databases were searched (PubMed, Psychinfo, Socindex, and CINHAL). Articles were screened for inclusion by two researchers through a title and abstract screening followed by a full-text screening. Data were extracted from included articles and results summarized and compared across studies and regions. Results: A total of 32 studies were identified from 16 countries in five regions of the world. The majority of studies were clinic-based, primarily recruiting participants from fertility clinics in urban and suburban areas. More than half of the studies included only women, a few studies included only men, and the remainder of studies included both men and women. Most quantitative studies reported the prevalence of nonbiomedical practice use, which ranged from 8% to 83%; however, there was variation across studies regarding the time frame for which these percentages were derived. Few studies reported on other measures of the extent of use such as duration or frequency. A variety of nonbiomedical practices were identified with biologically based treatments, particularly herbal medicine use, being the most common followed by religious and spiritual interventions. Regional differences were identified. Variation in the wording and format of the question(s) used in survey instruments asking participants about their use of nonbiomedical practices exists and may impact participants' reporting of use. Conclusions: Infertility affects millions of individuals worldwide often with severe social, emotional, and financial consequences. To enhance fertility and, in some cases, overcome infertility, many individuals and couples are engaging in a variety of nonbiomedical practices. This scoping review describes the scope and nature of the existing literature on the use of nonbiomedical practices for fertility enhancement and highlights important gaps and limitations in the conduct of this research. A more comprehensive and inclusive investigation of nonbiomedical practices for enhancing fertility is needed to improve our understanding of how individuals and couples are managing infertility, identify educational and counseling needs, and to improve research related to effectiveness and safety of nonbiomedical practices.
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Affiliation(s)
| | - Courtney L Johnson
- Department of Public Health, St. Catherine University, St. Paul, MN, USA
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Sumankuuro J, Soyen C, Crockett J, Ibrahim M, Ngmenkpieo F, Wulifan JK. Women’s Motivation and Associated Factors for Herbal Medicine Use during Pregnancy and Childbirth: A Systematic Review. Health (London) 2020. [DOI: 10.4236/health.2020.126044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kieu V, Healey M, Vollenhoven B. Oral complementary medicine use and first‐cycle
in vitro
fertilisation – What are the effects on the oocyte, the embryo and the pregnancy rate? Aust N Z J Obstet Gynaecol 2019; 59:712-716. [DOI: 10.1111/ajo.13023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Violet Kieu
- Women's and Newborn Program Monash Health Melbourne Victoria Australia
| | - Martin Healey
- The Royal Women's Hospital Melbourne Victoria Australia
- Department of Obstetrics & Gynaecology The University of Melbourne Melbourne Victoria Australia
- Monash IVF Clayton Victoria Australia
| | - Beverley Vollenhoven
- Women's and Newborn Program Monash Health Melbourne Victoria Australia
- Monash IVF Clayton Victoria Australia
- Department of Obstetrics & Gynaecology Monash University Melbourne Victoria Australia
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Kam PC, Barnett DW, Douglas ID. Herbal medicines and pregnancy: A narrative review and anaesthetic considerations. Anaesth Intensive Care 2019; 47:226-234. [PMID: 31124378 DOI: 10.1177/0310057x19845786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The use of herbal medicines by pregnant women varies among different countries, ranging from 4.3% in Sweden to 69% in Russia. The aim of this narrative review is to evaluate the benefits and safety of common herbal medicines used during pregnancy. A systematic literature search (from 1995 to February 2018) was performed using a variety of electronic databases. The levels of evidence of the clinical studies were graded using the Oxford Centre for Evidence-Based Medicine levels of evidence guidelines. From the 736 articles retrieved, 69 articles were used for this review. Ginger has been investigated extensively and has been consistently found to decrease nausea and vomiting associated with pregnancy (Level 2). There is insufficient evidence concerning the efficacy of other herbal medicines such as garlic, cranberry and raspberry in pregnancy (Level 3–4). Much of the literature is based on case reports with limited pharmacodynamic/kinetic studies. There are no clear data on the adverse herb–drug interactions during anaesthesia. As the risks of these interactions are unknown, it would be prudent for anaesthetists to explicitly ask their patients about their use of herbal medicines before surgery and prior to labour and birth. The European Society of Anaesthesiology and American Society of Anesthesiologists recommend that patients cease taking herbal medicines two weeks before surgery.
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Affiliation(s)
- Peter Ca Kam
- 1 Discipline of Anaesthetics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Denise Wy Barnett
- 2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Ian D Douglas
- 2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
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Miner SA, Robins S, Zhu YJ, Keeren K, Gu V, Read SC, Zelkowitz P. Evidence for the use of complementary and alternative medicines during fertility treatment: a scoping review. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:158. [PMID: 29764413 PMCID: PMC5952848 DOI: 10.1186/s12906-018-2224-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/30/2018] [Indexed: 03/26/2024]
Abstract
BACKGROUND Complementary and alternative medicines (CAM) are sometimes used by individuals who desire to improve the outcomes of their fertility treatment and/or mental health during fertility treatment. However, there is little comprehensive information available that analyzes various CAM methods across treatment outcomes and includes information that is published in languages other than English. METHOD This scoping review examines the evidence for 12 different CAM methods used to improve female and male fertility outcomes as well as their association with improving mental health outcomes during fertility treatment. Using predefined key words, online medical databases were searched for articles (n = 270). After exclusion criteria were applied, 148 articles were analyzed in terms of their level of evidence and the potential for methodological and author bias. RESULTS Surveying the literature on a range of techniques, this scoping review finds a lack of high quality evidence that complementary and alternative medicine (CAM) improves fertility or mental health outcomes for men or women. Acupuncture has the highest level of evidence for its use in improving male and female fertility outcomes although this evidence is inconclusive. CONCLUSION Overall, the quality of the evidence across CAM methods was poor not only because of the use of research designs that do not yield conclusive results, but also because results were contradictory. There is a need for more research using strong methods such as randomized controlled trials to determine the effectiveness of CAM in relation to fertility treatment, and to help physicians and patients make evidence-based decisions about CAM use during fertility treatment.
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Affiliation(s)
- Skye A. Miner
- Department of Sociology, McGill University, Room 712, Leacock Building, 855 Sherbrooke Street West, Montreal, QC H3A 2T7 Canada
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Stephanie Robins
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Yu Jia Zhu
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
- Department of Dentistry, McGill University, 2001 McGill College Ave, Montreal, QC H3A 1G1 Canada
| | - Kathelijne Keeren
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Vivian Gu
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
- Department of Medicine, University of British Columbia Medical School, 2275 Laurel Street, 10th Floor, British Columbia, BC V5Z 1M9 Canada
| | - Suzanne C. Read
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, Jewish General Hospital, 4333 Chemin de la Cote-Ste-Catherine, Room 223, Montreal, QC H3T 1E4 Canada
- Lady Davis Institute, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC H3T 1E2 Canada
- Department of Psychiatry, McGill University, Ludmer Research and Training Building, 1033 Pine Ave. West., Montreal, QC H3A 1A1 Canada
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Preconception health behaviours: A scoping review. Prev Med 2017; 96:1-15. [PMID: 27939264 DOI: 10.1016/j.ypmed.2016.11.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/20/2016] [Accepted: 11/24/2016] [Indexed: 11/20/2022]
Abstract
Preconception health refers to the health of males and females at any point in time prior to a potential pregnancy. A goal of preconception health research is to use preventive behaviour and healthcare to optimize the health of future offspring that result from both planned and unplanned pregnancies. This paper briefly reviews evidence of the importance of various preconception health behaviours, and examines the extent to which specific preconception health behaviours have been included in recent studies of such knowledge, behaviours, and intentions. To describe this recent research in highly developed countries, a scoping review of the literature was completed of studies published within the past seven years. A total of 94 studies on preconception health were identified and reviewed: (a) 15 examined knowledge and attitudes, (b) 68 studied behaviours, (c) 18 examined interventions designed to improve knowledge or behaviour, and (d) no studies examined intentions to engage in preconception health behaviours. Over 40% of studies examining preconception health behaviour focussed exclusively on folic acid. Overall, folic acid, alcohol, and cigarettes have consistently been topics of focus, while exposure to harmful environmental substances, stress, and sleep have been largely neglected. Despite strong evidence for the importance of men's health during the preconception period, only 11% of all studies included male participants. Based on existing gaps in the research, recommendations are provided, such as including men in future research, assessing a wider variety of behaviours, consideration of behavioural intentions, and consideration of the relationships between preconception health knowledge, intentions, and behaviour.
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The Relationship between Constitution of Traditional Chinese Medicine in the First Trimester and Pregnancy Symptoms: A Longitudinal Observational Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3901485. [PMID: 27087821 PMCID: PMC4818819 DOI: 10.1155/2016/3901485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/03/2016] [Indexed: 11/17/2022]
Abstract
Objective. We report on the distribution of traditional Chinese medicine (TCM) constitution in the first trimester and on the association between TCM constitution and maternal symptoms related to pregnancy. Methods. Participants were followed up until delivery to observe primary measures (gestational hypertension and gestational diabetes mellitus) and secondary measures (signs of miscarriage, miscarriage, nausea and vomiting, and sleepiness and defecation during pregnancy). Descriptive analysis, t-tests, chi-square tests, and logistic regression analysis were used in this study. Results. 61.8% of the participants had unbalanced constitutions. We did not find a significant association between the TCM constitution and gestational hypertension, gestational diabetes, miscarriage, signs of miscarriage, and defecation during pregnancy. And we found that women with unbalanced constitutions in early pregnancy had a greater likelihood of severe nausea and vomiting and poor sleep during pregnancy in the logistic regression analysis. Conclusions. These results have implications for female health care providers and policy makers. Identification of TCM constitution may be helpful for understanding nausea and vomiting and poor sleepiness during pregnancy, especially in the condition that can not be explained by modern medical science, and be helpful for making program to improve these uncomfortable symptoms.
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Shand AW, Walls M, Chatterjee R, Nassar N, Khambalia AZ. Dietary vitamin, mineral and herbal supplement use: a cross-sectional survey of before and during pregnancy use in Sydney, Australia. Aust N Z J Obstet Gynaecol 2015; 56:154-61. [DOI: 10.1111/ajo.12414] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 09/11/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Antonia W. Shand
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
- Department of Obstetrics; Royal Hospital for Women; Randwick New South Wales Australia
| | - Mariyam Walls
- Department of Obstetrics; Royal Hospital for Women; Randwick New South Wales Australia
| | - Rahul Chatterjee
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
- University of Sydney; Sydney New South Wales Australia
| | - Natasha Nassar
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
| | - Amina Z. Khambalia
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
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Dickinson JE. Nonprescription and complementary medication in obstetrics. Aust N Z J Obstet Gynaecol 2015; 55:199-200. [PMID: 26084193 DOI: 10.1111/ajo.12365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jan E Dickinson
- Australian and New Zealand Journal of Obstetrics and Gynaecology, School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia.
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