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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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Bouqoufi A, Lahlou L, Ait El Hadj F, Abdessadek M, Obtel M, Khabbal Y. Prevalence, motivation, and associated factors of medicinal herbs consumption in pregnant women from Eastern Mediterranean Regional Office: a systematic review. PHARMACEUTICAL BIOLOGY 2023; 61:1065-1081. [PMID: 37452524 DOI: 10.1080/13880209.2023.2229388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
CONTEXT Worldwide access to medication remains a major public health problem that forces pregnant women to self-medicate with several sources, such as medicinal plants. This alternative medicine is increasing in many low- and high-income countries for several reasons. OBJECTIVE This a systematic literature review on the prevalence of herbal use during pregnancy from the World Health Organization (WHO) Eastern Mediterranean Regional Office. METHODS Cross-sectional studies were searched from January 2011 to June 2021 on PubMed, Scopus, and Web of Science. We used the Rayyan website to identify the relevant studies by screening the abstracts and titles. These were followed by reading the full texts to identify the final studies to be included. The data were extracted, and the quality of the studies was assessed using the quality appraisal tool. RESULTS Of the 33 studies included in this review, 19 were conducted in Iran, 5 in Saudi Arabia, 4 in Palestine, 2 in Egypt, and 1 each in Oman, Iraq, and Jordan; the prevalence of herbal medicine use among pregnant women varied from 19.2% to 90.2%. Several plants were mentioned for pain management during the pregnancy period. The findings suggest family and friends are major motivating sources for the use of herbal medicine. CONCLUSIONS The wide variety of herbal products used in this study reflects the traditions and geographic diversity of the region. Despite the importance of literature-based data about the use of herbal medicine, it is necessary to obtain knowledge, attitude, and motivation for herbal consumption among pregnant women.
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Affiliation(s)
- Afaf Bouqoufi
- Laboratory of Innovation Research in Health Sciences, Therapeutic Innovation, Translational Research, and Epidemiology, Ibn Zohr University, Agadir, Morocco
| | - Laila Lahlou
- Laboratory of Innovation Research in Health Sciences, Therapeutic Innovation, Translational Research, and Epidemiology, Ibn Zohr University, Agadir, Morocco
| | - Fatima Ait El Hadj
- Laboratory of Innovation Research in Health Sciences, Therapeutic Innovation, Translational Research, and Epidemiology, Ibn Zohr University, Agadir, Morocco
| | - Mohammed Abdessadek
- Laayoune Higher School of Technology, Ibn Zohr University, Laayoune, Morocco
| | - Majdouline Obtel
- Social Medicine, Public Health, Hygiene and Preventive Medicine Laboratory, Department of Public Health, Mohammed V University, Rabat, Morocco
| | - Youssef Khabbal
- Laboratory of Innovation Research in Health Sciences, Therapeutic Innovation, Translational Research, and Epidemiology, Ibn Zohr University, Agadir, Morocco
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Vignato J, Mehner B, Negrete A, Segre LS. Over-the-Counter Pain Medication Use During Pregnancy. MCN Am J Matern Child Nurs 2023; 48:209-214. [PMID: 37365704 DOI: 10.1097/nmc.0000000000000929] [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: 06/28/2023]
Abstract
PURPOSE To examine over-the-counter pain medication use in pregnancy. STUDY DESIGN AND METHODS Secondary analysis of a weighted surveillance survey using the 2019 Iowa Pregnancy Risk Assessment Monitoring System (PRAMS) data. A sample of 759 pregnant women of childbearing age from Iowa was weighted to represent 31,728 Iowa mothers. The weighted sample represents 80% non-Hispanic White mothers, with smaller percentages of Hispanic (10%) mothers and non-Hispanic Black (7%) mothers, consistent with the population of Iowa. Approximately two-thirds of women had commercial insurance (66%), some college or greater education (62%), and were from urban areas (59%). ANALYSIS Descriptive statistics were calculated. Variables include over-the-counter pain reliever usage among all respondents and by race/ethnicity and education level. RESULTS Seventy-six percent of women reported taking over-the-counter pain relievers during pregnancy. Of these, 71% reported taking acetaminophen, 11% reported taking ibuprofen, 8% aspirin, and 3% naproxen. Nearly 80% of non-Hispanic White mothers reported taking an over-the-counter pain reliever during pregnancy compared to just 64% of mothers reported as Hispanic. Iowa mothers with a college education or greater were more likely to report over-the-counter pain reliever use during pregnancy (84%) than their counterparts with a high school education or less (64%). CLINICAL IMPLICATIONS Some medications may cause harm to the fetus if taken at specific time during pregnancy. Reinforcement of current pain medication education, including risks to fetus throughout pregnancy may be needed.
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Pasalar M, Vardanjani H, Steel A, Mofarrahi D, Jaladat A, Amini F, Zeraatpishe M. Use of complementary and alternative medicine and its related factors among pregnant women in Shiraz, South of Iran: A cross-sectional study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:53-59. [DOI: 10.4103/ijnmr.ijnmr_301_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/11/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
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Head SK, Doamekpor L, South EM, Louie C, Zakharkin S, Vasisht K, Bersoff-Matcha S. Behaviors Related to Medication Safety and Use During Pregnancy. J Womens Health (Larchmt) 2023; 32:47-56. [PMID: 36251939 DOI: 10.1089/jwh.2022.0205] [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: 11/06/2022] Open
Abstract
Background: Most women take medication during pregnancy despite limited scientific evidence on safety. We investigated medication use, including changes in and reasons for changes in use during pregnancy, with attention to medication use in pregnant women with chronic conditions. Materials and Methods: We conducted an online survey of pregnant women aged ≥18 years (n = 1,226). We calculated descriptive statistics for aspects of medication use and performed multivariable logistic regression to examine associations between change in use and chronic conditions. Results: Seventy-nine percent of women took at least one medication during pregnancy. Among those, 63.2% made at least one medication change: 42.0% started, 34.9% stopped, 30.0% missed dose(s), and 18.1% lowered dose(s) from that originally prescribed or recommended. More than a third (36.5%) of women who stopped, lowered, or missed medication did so independent of health care provider advice; 54.0% cited concern about birth or developmental defects as reasons for change. Odds of medication change were higher for women with chronic conditions: digestive conditions-starting (adjusted odds ratio [AOR] = 1.8, 95% confidence interval [CI] = 1.1-2.7), stopping (AOR = 2.1, 95% CI = 1.4-3.3), and lowering (AOR = 2.4, 95% CI = 1.7-3.3) medication; mental health conditions-starting (AOR = 1.6, 95% CI = 1.2-2.2), stopping (AOR = 3.0, 95% CI = 2.3-4.0), or missing (AOR = 2.1, 95% CI = 1.6-2.8) medication; pain conditions-stopping (AOR = 2.9, 95% CI = 2.0-4.2); and respiratory conditions-starting (AOR = 2.0, 95% CI = 1.3-3.1), stopping (AOR = 1.7, 95% CI = 1.1-2.6), and missing (AOR = 2.2, 95% CI = 1.4-3.4) medication. Conclusions: Most pregnant women take medication and many, including those with chronic conditions, change their medication use during pregnancy. Medication change may occur independent of health care provider advice and due to women's safety concerns.
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Affiliation(s)
- Sara K Head
- Office of Women's Health, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Laurén Doamekpor
- Office of Women's Health, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Erin M South
- Office of Women's Health, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | | | | | - Kaveeta Vasisht
- Office of Women's Health, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Susan Bersoff-Matcha
- Office of Women's Health, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Use of Medicinal Plants during Pregnancy, Childbirth and Postpartum in Southern Morocco. Healthcare (Basel) 2022; 10:healthcare10112327. [DOI: 10.3390/healthcare10112327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/08/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022] Open
Abstract
Southern Morocco, particularly the Guelmim-Oued Noun region, is rich in a wide diversity of plant species. Pregnant women in this region use medicinal plants during pregnancy and childbirth for various purposes; however, the use of these plants has never been documented. The objectives of this study are threefold: to estimate the prevalence of medicinal plant uses by pregnant women in the province of Guelmim, Morocco, to describe the traditional practices of self-medication and to determine the associated factors. This is a multicenter cross-sectional study with descriptive and analytical approaches. Data were collected using an interview questionnaire, which was administered to pregnant women at health care centers and hospitals in the province of Guelmim. A total of 560 women participated in this study. The prevalence of medicinal plant use was 66.96%. Artemisia herba-alba Asso, Thymus maroccanus Ball., Trigonella foenum-graecum L., Aloysia citriodora Palau, Lepidium sativum L. and Cuminum cyminum L. were the plants with the highest UV. Pain, the induction and facilitation of childbirth, flu syndrome and anemia were the most listed reasons for use. The use of medicinal plants was significantly associated with the level of education (chi-square = 15.651; p = 0.004), and pregnancy monitoring (chi-square = 5.283; p = 0.028). In the province of Guelmim, the prevalence of the use of medicinal plants by women during pregnancy and childbirth is high. Further research is necessary in order to explore potential associated risks and complications.
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Alosaimi AAM, Zamzam SM, Berdida DJE, Villagracia HN. Perceived risks of over-the-counter medication use among pregnant Saudi mothers: A cross-sectional study. J Taibah Univ Med Sci 2022; 17:755-764. [PMID: 36050964 PMCID: PMC9396048 DOI: 10.1016/j.jtumed.2022.03.001] [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: 08/03/2021] [Revised: 02/16/2022] [Accepted: 03/04/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives Many women use over-the-counter (OTC) medicines, particularly during pregnancy. Therefore, this study investigated the perceived risks of using OTC medicines among pregnant Saudi mothers. Methods With a cross-sectional design and purposive sampling, the 28-item Drug Use Health Belief Scale was used to collect data from pregnant Saudi mothers (n = 366) in a general tertiary hospital. The data were analyzed with descriptive and inferential statistics. After normality testing, the percentages, mean scores, and standard deviations were used to examine the demographic data. One-way ANOVA was used to identify the relationships between perceived risks on the Health Belief Scale and the participants' sociodemographic profile variables. Post-hoc tests were used to identify differences in the independent variables among groups. The statistical significance threshold was set at p ≤ 0.05. Results Across the five domains of the Health Belief Scale, the perceived susceptibility domain had the highest rank (0.36). Significant differences were observed between the mean scores of pregnant Saudi mothers' perceptions of susceptibility and the benefits of using OTC medications (p = 0.05), perceptions of susceptibility (p < 0.001), and benefits while using OTC medications (p = 0.018) than those who did not use OTC medications. However, no significant differences were observed in the degree of perceived severity, barriers, and self-efficacy in mothers using OTC medications (p > 0.05). Conclusion Notable differences were found in pregnant women's perceptions of the risks of using OTC medications. Greater awareness of the risks of OTC medication use during pregnancy is required. To ensure mothers' safety, a collaboration between prenatal multidisciplinary team of professionals (e.g., doctors, nurses, midwives) in community and hospital settings should be prioritized.
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Affiliation(s)
| | - Sahar M. Zamzam
- Maternity and Gynecologic Nursing, Alexandria University, Alexandria, Egypt
| | | | - Hazel N. Villagracia
- Medical-Surgical Nursing Department, College of Nursing, University of Ha'il, Ha'il City, KSA
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Abdurahman A, Alchalidi A, Lina L, Nora N, Mutia C. Analysis of the Use of Herbal Therapy to Reduce Labor Pain (Literature Review). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background:. labor pain can stress the mother and cause pain impulses to multiply and potentially weaken uterine muscle contractions. Pain can cause distress to the baby. One way to reduce pain is by giving herbal therapy or aromatherapy. Aromatherapy is one of the non-pharmacological methods to reduce labor pain. Aromatherapy often used to reduce labor pain is Lavender, Rose, Jasmine, Citrus Aurantium.
AIM: This study aims to determine the use of herbal therapy to reduce labor pain.The purpose of this study is to analyze the challenges in implementing health education in elementary schools in Banda Aceh
Methods: the design in this study was a literature review article. Search for articles using relevant ones obtained from data based on Pubmed, Proquest, Ebsco, ScienceDirect, and Google Scholar in the past ten years (2011–2021) received 121 articles.
Results: The study results show several challenges in implementing health education. Lack of understanding about School Health Services, School Health Services is not considered a strategic program, Low attention from policymakers, School Health Services Program has not been understood as part of the national target, Implementation of UKS program in schools is only a formality, Implementation and development School Health Services program is not evenly distributed. Barriers to the Implementation of School Health Services in Elementary School are the lack of optimal inter-sectoral cooperation, lack of trained personnel, high workload, and the impact of conflicting health issues, causing various School Health Services activities to be hampered in their Implementation
CONCLUSION: Utilization of herbal therapies such as Lavender, Mawar, Jasmine, Citrus, Aurantium has been proven to reduce labor pain which can be used in various methods such as inhalation, bath, massage, and foot soak. The easy use of aromatherapy can be an alternative to reduce labor pain.
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Koivuniemi E, Hart K, Mazanowska N, Ruggeri S, Egan B, Censi L, Roccaldo R, Mattila L, Buonocore P, Löyttyniemi E, Raats MM, Wielgos M, Laitinen K. Food Supplement Use Differs from the Recommendations in Pregnant Women: A Multinational Survey. Nutrients 2022; 14:2909. [PMID: 35889867 PMCID: PMC9322729 DOI: 10.3390/nu14142909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/01/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
The aim was to investigate, among pregnant women, (1) the use of food supplements and (2) the awareness of food supplement recommendations and beliefs about food supplement use in four European countries: Finland, Italy, Poland, and the United Kingdom. The participants (n = 1804) completed an online questionnaire with predefined statements. Daily intakes of vitamins and minerals were calculated using uploaded pictures or weblinks of the supplement packages. Country differences were assessed. Most participants (91%) used at least one food supplement during pregnancy. A prenatal multivitamin was the most commonly used supplement type (84% of the users), and 75% of the participants thought consumption of multivitamin is recommended. Of the participants, 81% knew that folic acid is recommended during pregnancy while 58% knew the recommendation for vitamin D. In 19% of the supplement users, the daily safe upper intake limit of at least one nutrient was exceeded. Nevertheless, most participants agreed that they knew which supplements (91%) and doses of supplements (87%) needed to be used during pregnancy. To conclude, the majority of the participants used food supplements, but lower proportions knew and adhered to the recommended intakes. Between-country differences were observed in the use and knowledge of and beliefs regarding supplements. The results suggest a need for assessment and monitoring of supplement use in antenatal care to ensure appropriate use.
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Affiliation(s)
- Ella Koivuniemi
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
| | - Kathryn Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK;
| | - Natalia Mazanowska
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.M.); (M.W.)
| | - Stefania Ruggeri
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Bernadette Egan
- Food, Consumer Behaviour and Health (FCBH) Research Centre, University of Surrey, Guildford GU2 7XH, UK; (B.E.); (M.M.R.)
| | - Laura Censi
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Romana Roccaldo
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Lilja Mattila
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
| | - Pasquale Buonocore
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Eliisa Löyttyniemi
- Biostatistics, Department of Clinical Medicine, University of Turku, 20014 Turku, Finland;
| | - Monique M. Raats
- Food, Consumer Behaviour and Health (FCBH) Research Centre, University of Surrey, Guildford GU2 7XH, UK; (B.E.); (M.M.R.)
| | - Miroslaw Wielgos
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.M.); (M.W.)
| | - Kirsi Laitinen
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
- Functional Foods Forum, University of Turku, 20014 Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, 20521 Turku, Finland
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Thipanyane MP, Nomatshila SC, Oladimeji O, Musarurwa H. Perceptions of Pregnant Women on Traditional Health Practices in a Rural Setting in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074189. [PMID: 35409871 PMCID: PMC8998603 DOI: 10.3390/ijerph19074189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/15/2022] [Accepted: 03/30/2022] [Indexed: 12/21/2022]
Abstract
Though there are prenatal and perinatal protocols across the African continent, traditional practices are commonly used. Improving maternal health requires an understanding of local cultural approaches and traditional health systems. The purpose of this study was to determine the perceptions of pregnant mothers of various ages and gravidities towards traditional maternal health practices during pregnancy. A descriptive phenomenological study was carried out with 27 purposively selected pregnant women from the King Sabatha Dalindyebo health sub-district. Discussion from three focus groups yielded three major themes and eight sub-themes. Content analysis revealed strong opinions and support for traditional practices. Although specialist practitioners were mentioned, family members were the primary source of information on traditional perinatal health practices. African mahogany bark, herbal decoctions, and holy water were allegedly used to treat labor pains, postnatal care, and the warding off of evil spirits. During pregnancy, these were thought to be beneficial and necessary. Nonetheless, the protection of some traditional practices’ know-how prevents integration of the traditional health system into the national health system. Consequently, there is a need for dialogue to facilitate the exchange of ideas on maternal health between the two health systems in order to facilitate more efficient policy formulation and implementation.
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Affiliation(s)
- Mvulakazi Patricia Thipanyane
- Preventive Medicine and Health Behavior Unit, Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
- Correspondence: (M.P.T.); (H.M.)
| | - Sibusiso Cyprian Nomatshila
- Preventive Medicine and Health Behavior Unit, Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
| | - Olanrewaju Oladimeji
- Community Medicine Unit, Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
| | - Hannibal Musarurwa
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
- Correspondence: (M.P.T.); (H.M.)
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Aba Y, Basak T, Sevimli S. The relationship between health literacy and patterns of drug use in pregnancy. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2022. [DOI: 10.4103/jnms.jnms_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Evaluation of knowledge of the new Pregnancy and Lactation Labeling Rule among pharmacists and physicians. J Am Pharm Assoc (2003) 2021; 62:427-431. [PMID: 34863633 DOI: 10.1016/j.japh.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study aimed to assess and evaluate knowledge and application of the Food and Drug Administration (FDA) Pregnancy and Lactation Labeling Rule (PLLR) among pharmacists and physicians. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study was conducted to evaluate the knowledge of and attitudes toward the new FDA PLLR among pharmacists and physicians. The primary outcome for this study was knowledge of the FDA PLLR. Descriptive statistical analysis was conducted for all study variables, and linear regression analyses were conducted to assess predictive factors of knowledge of the FDA PLLR. SPSS version 25 was used, and all analyses were conducted at an alpha value of 0.05. RESULTS In a cross-sectional study that included 167 pharmacists and physicians, majority were pharmacists (78.4%), and the rest were physicians (21.6%). The overall knowledge score was low with the average number of items answered correctly being 3.03 out of 7. Of all explored predictors, only gender (P < 0.01) and pregnancy letter category knowledge score (P < 0.05) were significant predictors of PLLR knowledge, adjusting for the other factors. CONCLUSION The study's findings showed several gaps in the knowledge of the new PLLR among physicians and pharmacists, thus demonstrating a need to have concerted continuing pharmacy and medical education efforts. Increasing knowledge in this area will lead to better risk communication and quality of care for expectant and nonexpectant women of reproductive age.
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Fan Q, Chen F, Zhang W, Du E, Zhao N, Huang S, Guo W, Yan X, Chen M, Wei J. Maternal magnolol supplementation alters placental morphology, promotes placental angiogenesis during mid-gestation and improves offspring growth in a pregnant mouse model. Reprod Biol 2021; 21:100567. [PMID: 34653815 DOI: 10.1016/j.repbio.2021.100567] [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: 05/18/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
The placenta is the organ that determines the growth of the fetus and the outcome of pregnancy. Magnolol is a multifunctional polyphenol with antioxidant, anti-inflammatory, anticancer and neuroprotective functions. However, there is less knowledge of the effects or complications in the placenta and the mechanism underlying the effect of magnolol when used during pregnancy. The aim of this study was to explore the effects of maternal magnolol supplementation on pregnancy outcomes and placental alterations in a pregnant mouse model. A total of 128 pregnant mice were randomly divided into 4 groups supplemented with 0, 40, 80 and 160 μM magnolol from gestational day 0 (GD0) to delivery. Our results revealed that the number of large-for-gestation-age fetuses on GD13 and the weaning weight of offspring were increased in the magnolol treatment groups. Moreover, maternal magnolol supplementation increased superoxide dismutase (SOD), decreased malondialdehyde (MDA) in maternal serum, and promoted the expression of heme oxygenase-1 (HO-1) in the placenta. Furthermore, magnolol significantly increased the area of the junctional zone and decidua in the placentas and increased the expression of interferon-γ (INF-γ), tumor necrosis factor-α (TNF-α), chemokine (CC Motif) Ligand 3 (CCL3), chemokine (CXC motif) ligand 10 (CXCL10), insulin-like growth factor-1 (IGF-1) and T-box transcription factor 21 (T-bet) in the placenta during GD13 in pregnant mice, while suppressor of cytokine signaling 1 (SOCS1) was reduced. Moreover, the ratio of blood space in the labyrinth area, hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were all increased in the magnolol treatment groups on GD13. Taken together, these results indicate that magnolol can improve the growth of offspring, which might be due to the alteration of placental morphology and the promotion of placental angiogenesis during mid-gestation.
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Affiliation(s)
- Qiwen Fan
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Fang Chen
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Wei Zhang
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Encun Du
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Na Zhao
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Shaowen Huang
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Wanzheng Guo
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China
| | - Xianghua Yan
- College of Animal Sciences and Technology, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Mingxin Chen
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China.
| | - Jintao Wei
- Key Laboratory of Animal Embryo Engineering and Molecular Breeding of Hubei Province, Wuhan, 430064, Hubei, China; Key Laboratory of Prevention and Control Agents for Animal Bacteriosis (Ministry of Agriculture), Wuhan, 430064, Hubei, China.
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King SE, Yeh PT, Rhee DK, Tuncalp Ö, Rogers LM, Narasimhan M. Self-management of iron and folic acid supplementation during pre-pregnancy, pregnancy and postnatal periods: a systematic review. BMJ Glob Health 2021; 6:bmjgh-2021-005531. [PMID: 33990359 PMCID: PMC8127969 DOI: 10.1136/bmjgh-2021-005531] [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: 02/28/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction While the use of folic acid pre-pregnancy and iron and folic acid (IFA) during pregnancy and postnatal have been demonstrated to be effective and are recommended interventions by WHO, ensuring individuals adhere to the supplementation regimen can be a challenge. Self-care interventions that support an individual’s ability to promote their own health with or without the support of health workers could help promote the uptake and adherence to supplementation. This systematic review assessed the evidence around self-management of IFA or folic acid supplementation accessed over-the-counter during pre-pregnancy, pregnancy and postnatal periods. Methods Peer-reviewed studies were included if they compared self-management of IFA or folic acid supplementation with health worker-initiated supplement use on maternal and/or fetal and newborn health outcomes, end-users’ or health workers’ values and preferences, or cost and/or cost-effectiveness. We searched PubMed, CINAHL, LILACS and EMBASE for articles published through November 2020, hand-searched clinical trial registries, reviewed databases and contacted experts in the field. Abstract screening and full-text review were conducted independently by two reviewers. Results Overall, 2344 results were identified, and 28 studies were identified for full-text review. All studies were excluded, as they were not primary research, lacked the outcomes of interest, lacked specificity in supplement type, and/or lacked a comparison group. Conclusion No evidence was identified that distinguishes self-management of folic acid supplements pre-pregnancy and of IFA supplements during pregnancy and postnatal, highlighting a gap in our current understanding of self-care related to dietary supplementation in pregnancy. The findings of this review identify an area for further research to support the current movement towards self-care interventions as an added choice to help individuals more fully attain their reproductive health and rights. Systematic review registration number PROSPERO CRD42020205548
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Affiliation(s)
- Shannon E King
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ping Teresa Yeh
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dong Keun Rhee
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Özge Tuncalp
- Department of Sexual and Reproductive Health and Research, World Health Organization, includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction - HRP, Geneva, Switzerland
| | - Lisa M Rogers
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, World Health Organization, includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction - HRP, Geneva, Switzerland
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15
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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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Bernstein N, Akram M, Yaniv-Bachrach Z, Daniyal M. Is it safe to consume traditional medicinal plants during pregnancy? Phytother Res 2020; 35:1908-1924. [PMID: 33164294 DOI: 10.1002/ptr.6935] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 10/04/2020] [Accepted: 10/18/2020] [Indexed: 12/24/2022]
Abstract
The popularity of natural medicine is growing worldwide. Unlike conventional licensed medicines, herbal medicine practices are usually not supported by effectiveness, efficacy, or safety studies, which raise concerns about potential risks involved in their usage, particularly in high-risk patients such as pregnant women where teratogenicity is a concern. Despite a lack of science-based evidence, the use of herbal products for the management of pregnancy-associated challenges is common, due to the common notion that they are free of toxic effects and adverse reactions because they are "natural." The lack of concern about utilizing herbal remedies during pregnancy is strengthened by the lack of regulation in most countries for their marketing. However, plant-based remedies are not free of adverse reactions. Medicinal plants and herbal remedies contain substances that can be toxic to the human body and the fetus. Potential effects of indiscriminate use of medicinal plants are embryotoxicity, teratogenic, and abortifacient effects. Some plant constituents can cross the placenta and reach the fetus. Phytochemicals and their metabolites are known to induce stimulation of uterine contraction and hormone imbalance that could result in abortion. The alterations to the hormonal profile can affect conception, induce teratogenic activity, and halt the pregnancy or produce a congenital malformation. Due to the wide range of modes of action of phytochemicals, some medicinal plants may be safe to use during certain trimesters of pregnancy and harmful at other stages. This manuscript reviews available scientific information concerning potential health hazards associated with the consumption of herbal medicines during pregnancy, highlighting those herbs that should be avoided due to their potential abortifacient and/or teratogenic activity. We focused on plants that were tested by preclinical studies, and studies of these plants are summarized. Common therapeutic use of these herbs, estimated effects, toxicological effects, and animal studies of these plants is summarized. The literature reviewed suggests that consumption of the following medicinal plants should be avoided during pregnancy: Abrus precatorius, Achyranthes aspera, Ailanthus excelsa, Aloe vera, Aristolochia indica, Areca catechu, Bambusa vulgaris, Cassia occidentalis, Cicer arietinum, Cimicifuga racemose, Dolichandrone falcate, Ginkgo biloba, Hydrastis canadensis, Indigofera trifoliate, Lavandula latifolia, Maytenus ilicifolia, Momordica cymbalaria, Moringa oleifera, Musa rosacea, Oxalis corniculate, Phytolacca dodecandra, Plumeria rubra, Ricinus communis, Ruta graveolens, Stachys lavandulifolia, Senna alata, Trigonella foenum-graecum, Vitus agnus-castus, and Valeriana officinalis.
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Affiliation(s)
- Nirit Bernstein
- Institute of Soil, Water and Environmental Sciences, Volcani Center, Rishon LeZion, Israel
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | | | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation & Development Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China.,College of Biology, Hunan Province Key Laboratory of Plant Functional Genomics and Developmental Regulation, Hunan University, Changsha, China
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17
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Zafeiri A, Mitchell RT, Hay DC, Fowler PA. Over-the-counter analgesics during pregnancy: a comprehensive review of global prevalence and offspring safety. Hum Reprod Update 2020; 27:67-95. [PMID: 33118024 DOI: 10.1093/humupd/dmaa042] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/16/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Analgesia during pregnancy is often necessary. Due to their widespread availability, many mothers opt to use over-the-counter (OTC) analgesics. Those analgesic compounds and their metabolites can readily cross the placenta and reach the developing foetus. Evidence for safety or associations with adverse health outcomes is conflicting, limiting definitive decision-making for healthcare professionals. OBJECTIVE AND RATIONALE This review provides a detailed and objective overview of research in this field. We consider the global prevalence of OTC analgesia during pregnancy, explain the current mechanistic understanding of how analgesic compounds cross the placenta and reach the foetus, and review current research on exposure associations with offspring health outcomes. SEARCH METHODS A comprehensive English language literature search was conducted using PubMed and Scopus databases. Different combinations of key search terms were used including 'over-the-counter/non-prescription analgesics', 'pregnancy', 'self-medication', 'paracetamol', 'acetaminophen', 'diclofenac', 'aspirin', 'ibuprofen', 'in utero exposure', 'placenta drug transport', 'placental transporters', 'placenta drug metabolism' and 'offspring outcomes'. OUTCOMES This article examines the evidence of foetal exposure to OTC analgesia, starting from different routes of exposure to evidence, or the lack thereof, linking maternal consumption to offspring ill health. There is a very high prevalence of maternal consumption of OTC analgesics globally, which is increasing sharply. The choice of analgesia selected by pregnant women differs across populations. Location was also observed to have an effect on prevalence of use, with more developed countries reporting the highest consumption rates. Some of the literature focuses on the association of in utero exposure at different pregnancy trimesters and the development of neurodevelopmental, cardiovascular, respiratory and reproductive defects. This is in contrast to other studies which report no associations. WIDER IMPLICATIONS The high prevalence and the challenges of reporting exact consumption rates make OTC analgesia during pregnancy a pressing reproductive health issue globally. Even though some healthcare policy-making authorities have declared the consumption of some OTC analgesics for most stages of pregnancy to be safe, such decisions are often based on partial review of literature. Our comprehensive review of current evidence highlights that important knowledge gaps still exist. Those areas require further research in order to provide pregnant mothers with clear guidance with regard to OTC analgesic use during pregnancy.
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Affiliation(s)
- Aikaterini Zafeiri
- Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
| | - David C Hay
- MRC Centre for Regenerative Medicine, Institute of Regeneration and Repair, University of Edinburgh, Edinburgh, UK
| | - Paul A Fowler
- Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
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18
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Ceulemans M, Fortuin M, Van Calsteren K, Allegaert K, Foulon V. Prevalence and characteristics of pregnancy- and lactation-related calls to the National Poison Centre in Belgium: A retrospective analysis of calls from 2012 to 2017. J Eval Clin Pract 2020; 26:911-917. [PMID: 31298801 DOI: 10.1111/jep.13228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 06/20/2019] [Indexed: 12/23/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVE In the absence of a Teratology Information Service in Belgium, the National Poison Centre might act as a substitute centre for answering pregnancy- and lactation-related questions regarding medication use. The aim of this study was to define the prevalence and characteristics of pregnancy- and lactation-related calls to the National Poison Centre in Belgium, as well as the type of health products involved during these calls. METHOD A retrospective, descriptive study on pregnancy- and lactation-related calls involving health products received by the Belgian Poison Centre between January 2012 and December 2017 was performed. Health products were categorized as registered medicines or non-registered health products; medicines were further classified according to the Anatomical Therapeutic Chemical classification system. RESULTS The Poison Centre annually received about 361 calls related to pregnancy and lactation. Pregnant and lactating women mainly called the Poison Centre themselves in case of exposure, while relatives were the predominant type of caller when preventive information was requested. The Poison Centre was mostly contacted for information about medicines and especially for preventive questions during lactation. Many questions involved over-the-counter medicines such as paracetamol and ibuprofen. Given the safety issues related to some involved products (eg, ibuprofen, zolpidem, benzodiazepines, and pseudoephedrine), seeking for advice was justified. CONCLUSIONS The Belgian Poison Centre received almost daily calls from patients and health care professionals on medication exposure during pregnancy and lactation. These findings underline the importance of evidence-based counselling of pregnant and lactating women and should encourage health care professionals to engage themselves more actively when counselling on the rational use of medicines during pregnancy and lactation. The findings also contribute to the ongoing discussion to establish a Teratology Information Service in Belgium.
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Affiliation(s)
- Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Marijke Fortuin
- Hospitaal Centrum van de basis Koningin Astrid, National Poison Centre, Brussel, Belgium
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Leuven, Belgium.,Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
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19
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The Culture of Herbal Preparations Among Pregnant Women: A Remedy or a Suicide Potion? A Case Report and Mini Review. Case Rep Pathol 2020; 2020:6186147. [PMID: 32231835 PMCID: PMC7091521 DOI: 10.1155/2020/6186147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/21/2020] [Indexed: 11/18/2022] Open
Abstract
In general, use of herbal remedies and preparations is on the ascendency in recent times among the general population and especially in young pregnant women, and this may be very dangerous due to adverse effects and interactions with drugs. A survey by the World Health Organization revealed that 70-80% of the world population resort to nonconventional medicines especially, herbal medicines in their primary healthcare. A lot of work has been done on the positive effects of herbs on the human body but very few publications on the potential side effects of consuming crude herbal preparations especially among pregnant women or the awareness of the medical team of this problem. Herbal remedies may come with many adverse effects and potentially serious interactions with some conventional medications. However, little is known about the dangers associated with consumption of herbal remedies by pregnant patients. Herbal medicines like their orthodox counterparts act through some mechanisms to bring about their curative effects in the body, and this usually goes out of order when these remedies interact with chemical drugs as a result of a combination of both by the victims. This is a case study to review the use of herbal medicine products among pregnant women, especially adolescent girls for abortive purposes, and also attempts to discuss some of the dangers associated with the use of herbal medicinal products together with conventional drugs during pregnancy.
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20
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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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21
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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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22
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Güler B, Bilgiç D, Okumuş H, Yağcan H, Alan M. An investigation of vitamin and mineral supplement recommendation among first-trimester pregnancies. J Perinat Med 2019; 47:958-962. [PMID: 31622252 DOI: 10.1515/jpm-2019-0178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/17/2019] [Indexed: 11/15/2022]
Abstract
Background Healthy and balanced nutrition in pregnancy can affect the mother's and the fetus' health. Therefore, health professionals should provide information about this issue to pregnant women. The aim of the study was to examine the rate of vitamin and mineral supplement recommendation among first-trimester pregnant women. Methods The study sample consisted of 697 first-trimester pregnant women between 18 and 40 years of age. The pregnant women who registered to an obstetric outpatient clinic between January and June 2018 were retrospectively reviewed, and data were collected from patient medical records using a questionnaire. Results Physician's laboratory test orders from the women included the following: ferritin was 18.4%, mean corpuscular hemoglobin (MCH) was 99.7%, folic acid was 10.2%, vitamin D was 6.3%, vitamin B12 was 17.2% and calcium was 20.4%. All of the women's hemoglobin levels had been examined. A total of 58.8% of the women were recommended to take folic acid, 32.7% iron, 25.7% iodine, 18.8% calcium, 17.2% vitamin A, 21.1% vitamin B12, 17.4% vitamin C, 31.6% vitamin D and 17.5% vitamin E supplements. Conclusion It was determined that ferritin, vitamins B12 and D, calcium, folic acid, iron and iodine levels were not examined routinely in this study. Folic acid and iron supplementation were the most commonly suggested nutrient supplements in the first trimester.
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Affiliation(s)
- Buse Güler
- Department of Gynecology and Obstetric Nursing, Dokuz Eylul University, Faculty of Nursing, Balçova, İzmir, Turkey
| | - Dilek Bilgiç
- Department of Gynecology and Obstetric Nursing, Dokuz Eylul University, Faculty of Nursing, Balçova, İzmir, Turkey
| | - Hülya Okumuş
- Department of Gynecology and Obstetric Nursing, Dokuz Eylul University, Faculty of Nursing, Balçova, İzmir, Turkey
| | - Hande Yağcan
- Department of Gynecology and Obstetric Nursing, Dokuz Eylul University, Faculty of Nursing, Balçova, İzmir, Turkey
| | - Murat Alan
- Sağlık Bilimleri University, Tepecik Education and Research Hospital, Konak, İzmir, Turkey
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Ceulemans M, Van Calsteren K, Allegaert K, Foulon V. Health products' and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross-sectional study. Pharmacoepidemiol Drug Saf 2019; 28:1231-1238. [PMID: 31342605 DOI: 10.1002/pds.4862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/07/2019] [Accepted: 06/27/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate the prevalence and type of health products used among pregnant women visiting a tertiary hospital in Belgium, as well as who advises these products, where women buy these products, which determinants are associated with medication and pregnancy vitamin intake, and preconception lifestyle changes such as folic acid intake and substance use. METHODS A cross-sectional study was performed at the outpatient obstetrics clinics of the University Hospital Leuven, Belgium between November 2016 and March 2017. All pregnant women 18 years and older and understanding Dutch, French, or English were asked to participate in an online survey. RESULTS In total, 379 pregnant women participated. Prevalence of medication use during the preceding week was 52%. Paracetamol (14%), levothyroxine (13%), and antacids (9%) were the most frequently used medicines. Pregnancy vitamins were used by 86% of women, and 97% had used a pregnancy vitamin somewhere during pregnancy. Only 56% initiated folic acid supplementation at least 1 month before pregnancy. Preconception use of folic acid among women following assisted reproductive technology was 73%. Inappropriate use of health products was observed among 3% of women. Prevalence of alcohol use and/or smoking during the preceding week was 6%. Alcohol and smoking cessation mainly occurred after pregnancy diagnosis. CONCLUSION Pregnant women living in Belgium frequently use medicines, pregnancy vitamins, and other health products. Preconception lifestyle changes such as folic acid intake and alcohol and smoking cessation are poorly implemented. Public campaigns and interventions are needed to improve preconception care and counselling.
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Affiliation(s)
- Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospital Gasthuisberg Leuven, Leuven, Belgium.,Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
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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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25
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Wolgast E, Lindh-Åstrand L, Lilliecreutz C. Women's perceptions of medication use during pregnancy and breastfeeding-A Swedish cross-sectional questionnaire study. Acta Obstet Gynecol Scand 2019; 98:856-864. [PMID: 30739330 DOI: 10.1111/aogs.13570] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/09/2019] [Accepted: 01/20/2019] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Use of medication for different kinds of symptoms and diseases during pregnancy is common. When counseling the pregnant woman, an understanding of her perceptions concerning the use of medication as well as possible associated anxiety and obstacles is important to ensure high adherence to the treatment regimen. MATERIAL AND METHODS A questionnaire was developed regarding the use of medication, perceptions on use of medication, as well as perceptions about pregnancy outcomes in association with medication use during pregnancy. In total, 850 pregnant women in gestational weeks 25-29 participated in the study. RESULTS The response rate was 92.7% (n = 832/898). About 19.4% of the respondents (n = 160/824) were frequent users (medication use daily to several times a week) and 28.4% (n = 234/824) were non-frequent users (medication use once a week to once a month). The majority perceived medication use during early pregnancy (61.4%, n = 501/816), late pregnancy (55.6%, n = 455/819) and breastfeeding (57.7%, n = 474/821) as probably harmful or harmful. These findings were more common in non-users (medication used rarely or never) than frequent users (P-value <0.001, <0.001 and 0.007). The pregnant women had great confidence in advice from a physician (83.8%, n = 666/795) or a midwife (77.0%, n = 620/805) concerning medication during pregnancy. CONCLUSIONS The majority of pregnant women in Sweden consider the use of medication during pregnancy either 'probably harmful' or 'harmful' and this perception is associated with non-use of medication. The pregnant women in our study had high confidence in healthcare professionals when seeking advice; thus, actively asking about perceptions could lead to better counseling.
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Affiliation(s)
- Emelie Wolgast
- Department of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Lotta Lindh-Åstrand
- Department of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Caroline Lilliecreutz
- Department of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Lynch MM, Squiers LB, Kosa KM, Dolina S, Read JG, Broussard CS, Frey MT, Polen KN, Lind JN, Gilboa SM, Biermann J. Making Decisions About Medication Use During Pregnancy: Implications for Communication Strategies. Matern Child Health J 2018; 22:92-100. [PMID: 28900803 DOI: 10.1007/s10995-017-2358-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective To explore women's perceptions of the risks and benefits associated with medication use during pregnancy and to better understand how women make decisions related to medication use in pregnancy. Methods We conducted online focus groups with 48 women who used medication during pregnancy or while planning a pregnancy, and 12 in-depth follow-up interviews with a subset of these women. Results We found that women were aware of general risks associated with medication use but were often unable to articulate specific negative outcomes. Women were concerned most about medications' impact on fetal development but were also concerned about how either continuing or discontinuing medication during pregnancy could affect their own health. Women indicated that if the risk of a given medication were unknown, they would not take that medication during pregnancy. Conclusion This formative research found that women face difficult decisions about medication use during pregnancy and need specific information to help them make decisions. Enhanced communication between patients and their providers regarding medication use would help address this need. We suggest that public health practitioners develop messages to (1) encourage, remind, and prompt women to proactively talk with their healthcare providers about the risks of taking, not taking, stopping, or altering the dosage of a medication while trying to become pregnant and/or while pregnant; and (2) encourage all women of childbearing age to ask their healthcare providers about medication use.
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Affiliation(s)
- Molly M Lynch
- RTI International, Center for Communication Science, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA.
| | - Linda B Squiers
- RTI International, Center for Communication Science, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Katherine M Kosa
- RTI International, Center for Communication Science, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Suzanne Dolina
- RTI International, Center for Communication Science, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Jennifer Gard Read
- RTI International, Center for Communication Science, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Cheryl S Broussard
- Centers for Disease Control and Prevention, Division of Congenital and Developmental Disorders, Atlanta, GA, 30341, USA
| | - Meghan T Frey
- Centers for Disease Control and Prevention, Division of Congenital and Developmental Disorders, Atlanta, GA, 30341, USA
| | - Kara N Polen
- Centers for Disease Control and Prevention, Division of Congenital and Developmental Disorders, Atlanta, GA, 30341, USA
| | - Jennifer N Lind
- Centers for Disease Control and Prevention, Division of Congenital and Developmental Disorders, Atlanta, GA, 30341, USA.,United States Public Health Service, Atlanta, GA, USA
| | - Suzanne M Gilboa
- Centers for Disease Control and Prevention, Division of Congenital and Developmental Disorders, Atlanta, GA, 30341, USA
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Laadraoui J, Aboufatima R, El Gabbas Z, Ferehan H, Bezza K, Ait Laaradia M, Marhoume F, Wakrim EM, Chait A. Effect of Artemisia herba-alba consumption during pregnancy on fertility, morphological and behaviors of mice offspring. JOURNAL OF ETHNOPHARMACOLOGY 2018; 226:105-110. [PMID: 30118834 DOI: 10.1016/j.jep.2018.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/28/2018] [Accepted: 08/13/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Pregnant women prefer herbal medicines more than pharmaceutical drugs due to the cultural belief that herbs are more suffer during pregnancy for an accurate foetus development. Artemisia herba-alba (Asteraceae) is one of the most used plants in the Mediterranean region to treat various diseases including diabetes, hypertension, spasmodic dysphonia and some bacterial infection. AIM OF THE STUDY The present study aimed to investigate the effect of Artemisia herba-alba consumption during pregnancy on fertility, physical and behavior developments of mice offspring from birth-to-weaning days. MATERIALS AND METHODS Female pregnant mice were divided into three groups and orally administrated with 80 and 150 mg/kg/day of the methanol extract of Artemisia h.a respectively, during the entire period of gestation. At birth, total fertility rate was counted. Body development; neuromotor reflex and behavior were also examined in mice offspring RESULTS: Artemisia h.a (Aha) exposure significantly decreased the fertility ratio in both Aha-treated groups and increased the weight and length of mice offspring in 80 mg/kg/day Aha-exposed group. Moreover, Aha administration prolonged the time of completing the reflex response of surface righting, negative geotaxis, cliff avoidance and jumping test of mice offspring in Aha-exposed groups. CONCLUSION The present study provides strong evidence that discourage the use of Artemisia h.a during gestation period.
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Affiliation(s)
- Jawad Laadraoui
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Rachida Aboufatima
- Laboratory of Génie Biologique, Sultan Moulay Slimane University, Faculty of Sciences and Techniques, Béni Mellal, Morocco
| | - Zineb El Gabbas
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Hind Ferehan
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Kenza Bezza
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Mehdi Ait Laaradia
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Fatimazahra Marhoume
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - El Mehdi Wakrim
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Abderrahman Chait
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco.
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Navaro M, Vezzosi L, Santagati G, Angelillo IF. Knowledge, attitudes, and practice regarding medication use in pregnant women in Southern Italy. PLoS One 2018; 13:e0198618. [PMID: 29920515 PMCID: PMC6007931 DOI: 10.1371/journal.pone.0198618] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/22/2018] [Indexed: 12/31/2022] Open
Abstract
The study assessed knowledge, attitudes, and medication use of a random sample of pregnant women attending outpatient Gynecology and Obstetrics clinics at randomly selected public General and Teaching hospitals in Naples, Italy. A total of 503 women participated. Those more likely to know that a pregnant woman with chronic condition must discuss whether or not to take a medication with the physician were Italian, aged 31-40 years, employed, with no history of abortion, having had a medical problem within the previous year, with a better self-perceived health status, who knew how to use medications during pregnancy, and who needed information on medications. The knowledge of the potential risk of using non-prescribed medications during pregnancy was significantly higher in employed women, who received information from physicians, who knew how to use medications during pregnancy, and who knew the possible damages related to medications use. More than half had used at least one medication. Those aged 26-35 years, Italian, non-graduated, in the third trimester, having had a medical problem within the previous year, with a risky pregnancy, and with a knowledge that women with chronic condition must discuss whether or not to take a medication with the physician were more likely to use medication. Less than half had used medication without a physician's advice. Those who were more likely to self-medicate were older, Italian, multiparous, with no history of abortion, who knew that women with chronic condition must discuss whether or not to take a medication with the physician, who did not know the potential risk of using non-prescribed medication during pregnancy, who had used prescribed medication during pregnancy, and who needed information about medications. Educational programs for women about medication use are important to increase their knowledge of the potential risks to the pregnant women and the unborn child in order to reduce self-medication.
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Affiliation(s)
- Monica Navaro
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Luigi Vezzosi
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gabriella Santagati
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Italo Francesco Angelillo
- Department of Experimental Medicine of the University of Campania “Luigi Vanvitelli”, Naples, Italy
- * E-mail:
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Self-medication practice in pregnant women from central Mexico. Saudi Pharm J 2018; 26:886-890. [PMID: 30202232 PMCID: PMC6128711 DOI: 10.1016/j.jsps.2018.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 03/14/2018] [Indexed: 12/13/2022] Open
Abstract
Self-medication during pregnancy represents a serious threat for mother and child health. The objective of this study was to evaluate the prevalence and the factors associated with self-medication among Mexican women living in the central region of Mexico. This is a descriptive interview-study of 1798 pregnant women or women who were pregnant no more than 3 years ago, when the interview was carried out. Data analysis was carried out with chi-square analysis and odds ratio. The prevalence of self-medication (allopathic drugs, medicinal plants, and other products, including vitamins, food supplements, among others) was 21.9%. The factors associated (p < 0.05) with self-medication were: higher education (college and postgraduate), smoking, and consumption of alcohol. Smoking was the strongest factor (OR: 2.536; 1.46–4.42) associated to self-medication during pregnancy, followed by consumption of alcohol (OR: 2.06; 1.38–3.08), and higher education (OR: 1.607; 1.18–2.19). Medicinal plant consumption was associated with nausea, constipation, migraine, and cold (p < 0.05), whereas he self-medication of allopathy was associated with gastritis and migraine (p < 0.05). Self-medication was influenced mainly by a relative or friend, who recommended the use of herbal medicine/allopathic medication. Two of the most common medicinal plants (arnica and ruda) here informed are reported to induce abortion or toxicity during pregnancy. The findings showed that self-medication (medicinal plants and allopathic medication) is a common practice among pregnant women from central Mexico. Adequate counselling of pregnant women by healthcare professionals about the potential risks of self-medication with herbal medicine and allopathic drugs during pregnancy is strongly warranted.
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Alrabiah Z, Al-Arifi MN, Alghadeer SM, Wajid S, AlQahtani A, Almotari N, AlHwerani A, Babelghaith SD. Knowledge of community pharmacists about the risks of medication use during pregnancy in central region of Saudi Arabia. Saudi Pharm J 2017; 25:1093-1096. [PMID: 29158721 PMCID: PMC5681324 DOI: 10.1016/j.jsps.2017.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/21/2017] [Indexed: 11/29/2022] Open
Abstract
Background Community pharmacists (CPs) are the most accessible health care provider to the public, and they have huge duties to improve medication use especially among the pregnant women in their community. The objective of this study was to evaluate knowledge of CPs about the medication safety during pregnancy. Methods A prospective cross-sectional survey was carried out over practicing community pharmacists in a capital of Saudi Arabia (SA). Pharmacists were asked about the safety of each medicine during pregnancy. It involved both prescription-only medications (POM) and over-the-counter (OTC) medications. Both descriptive and analytic statistics were utilized. For descriptive analysis, results were expressed as numbers, percentages and mean (±SD and 95% CI). Results The response rate was (71.1%). Most of the respondents (69.6%) believed that alprazolam is not safe while 22% of respondents believed that it is used on basis of risk-benefit assessment. Also, most of CPs (65.2%) said that amoxicillin is safe, but a very few of CPs (11.7%) knew that tetracycline should be used only if potential benefits may outweigh the risk. Among non-prescribed analgesics, majority of CPs (92.6%) knew that acetaminophen is safe. About dietary supplements, 48.4% of CPs reported that Vitamin A supplements are not safe. There was significant difference observed between age groups of CPs in scores of knowledge test (P = 0.001). Conclusion Community Pharmacists are the most accessible health care providers who can help pregnant women with their medications use there are still gaps in knowledge where educational interventions are needed.
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Affiliation(s)
- Ziyad Alrabiah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed N Al-Arifi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sultan M Alghadeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Syed Wajid
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ali AlQahtani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Naif Almotari
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - AbdAllh AlHwerani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Salmeen D Babelghaith
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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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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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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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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Frawley J, Sibbritt D, Broom A, Gallois C, Steel A, Adams J. Complementary and alternative medicine practitioner use prior to pregnancy predicts use during pregnancy. Women Health 2016; 56:926-39. [DOI: 10.1080/03630242.2016.1145170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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John LJ, Shantakumari N. Herbal Medicines Use During Pregnancy: A Review from the Middle East. Oman Med J 2015; 30:229-36. [PMID: 26366255 DOI: 10.5001/omj.2015.48] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The prevalence of the herbal medicines use is on the rise across the world, especially amongst pregnant women. The scenario in the Middle Eastern region was reviewed to explore the prevalence, usage pattern, motivation, and attitude towards use of herbal medicine by pregnant women. Literature published up to December 2012 showed the prevalence of herbal medicine use varied between 22.3-82.3%, implying a rising trend in the utilization of herbal medicine during pregnancy. The most common herbs used were peppermint, ginger, thyme, chamomile, sage, aniseed, fenugreek, and green tea. The most common reasons for use included the treatment of gastrointestinal disorders and cold and flu symptoms. The majority of women used these products during their first trimester, and did not reveal this information to their physician. Most women were advised by family and friends to use herbal medicines and believed they were more effective and had fewer side effects than modern medicine especially during pregnancy. In conclusion, the use of herbal medicine is prevalent among pregnant women in the Middle Eastern region and healthcare providers need to seek information pertaining to their use.
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Affiliation(s)
- Lisha J John
- Department of Pharmacology, Gulf Medical University, Ajman, United Arab Emirates
| | - Nisha Shantakumari
- Department of Physiology, Gulf Medical University, Ajman, United Arab Emirates
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Frawley J, Adams J, Steel A, Broom A, Gallois C, Sibbritt D. Women's Use and Self-Prescription of Herbal Medicine during Pregnancy: An Examination of 1,835 Pregnant Women. Womens Health Issues 2015; 25:396-402. [PMID: 25935822 DOI: 10.1016/j.whi.2015.03.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 01/13/2015] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Recent research points to high levels of herbal medicine use during pregnancy. The objectives of this study were to elucidate the prevalence and understand the determinants of both the use and self-prescription of herbal medicine during pregnancy. METHODS The study sample was obtained via the Australian Longitudinal Study on Women's Health. Women who were pregnant or who had recently given were invited to complete a subsurvey in 2010 about pregnancy, and complementary and alternative medicine use. FINDINGS A response rate of 79.2% (n=1,835) was attained and 34.4% (n=588 of 1,835) of the sample were utilizing herbal medicine during pregnancy, of which 77.9% (n=458 of 588) were self-prescribing these products. The women in our study (aged 33-38) were more likely to use herbal medicine if they had anxiety (odds ratio [OR], 1.30; 95% CI, 1.02-1.64; p=.031), sleeping problems (OR, 1.55; 95% CI, 1.15-2.11; p=.005), or fatigue (OR, 1.32; 95% CI, 1.04-1.68; p=.025), but less likely to use herbal medicine if they had nausea (OR, 0.71; 95% CI, 0.56-0.91; p=.007). Women were more likely to self-prescribe herbal medicine if they suffered from varicose veins (OR, 2.46; 95% CI, 1.04-5.84; p=.041) and less likely to self-prescribe herbal medicine if they suffered from preeclampsia (OR, 0.23; 95% CI, 0.81-0.63; p=.005). Women who self-prescribed herbal medicine during pregnancy were also more likely to live in a rural environment (OR, 2.22; 95% CI, 1.32-3.73; p=.003). CONCLUSIONS Many Australian women are consuming herbal medicine during pregnancy. The self-prescription of herbal medicine by pregnant women is of particular concern owing to potential safety issues, and it is important that maternity health care providers have an open and nonjudgmental conversation with women about herbal medicine use during pregnancy.
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Affiliation(s)
- Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia; Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Alex Broom
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia
| | - Cindy Gallois
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
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Hatzopoulou K, Filis V, Grammatikopoulou MG, Kotzamanidis C, Tsigga M. Greek pregnant women demonstrate inadequate micronutrient intake despite supplement use. J Diet Suppl 2014; 11:155-65. [PMID: 24670119 DOI: 10.3109/19390211.2013.859210] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND/AIM Maternal diet is important in the outcome of pregnancy and the health of the children. The present cross-sectional study aimed to assess the use of dietary supplements during pregnancy and define the maternal characteristics associated with supplement use. METHODS The diet of 100 childbearing women was recorded for three consecutive days and micronutrient supplementation was added to the dietary intake and the median values were used in the analyses. RESULTS The majority of the participants (92%) consumed at least one supplement. Supplementation of folic acid (FA) was significantly lower during the third trimester compared to the second (p ≤ .007). Higher intake of Ca and Fe supplements was observed in the second trimester (p ≤ .001). The use of supplements contributed to an attenuated consumption of all reported micronutrients (Mg, Ca, FA, and Fe, p ≤ .001). The principal components analysis revealed that the most important factor contributing to supplementation was primiparity. CONCLUSIONS Overall, a high prevalence of micronutrient supplementation during pregnancy was observed without ensuring adequacy in the micronutrient intake. The increased rates of supplement users might be the result of an act for balancing diet in unplanned pregnancies.
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Affiliation(s)
- Konstantina Hatzopoulou
- Department of Human Nutrition & Dietetics, Alexander Technological Educational Institute, GR-57400 Thessaloniki, Greece
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Pallivalappila AR, Stewart D, Shetty A, Pande B, Singh R, Mclay JS. Complementary and alternative medicine use during early pregnancy. Eur J Obstet Gynecol Reprod Biol 2014; 181:251-5. [DOI: 10.1016/j.ejogrb.2014.08.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/23/2014] [Accepted: 08/07/2014] [Indexed: 11/29/2022]
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Abstract
PURPOSE OF REVIEW The aim of this article is two-fold: to report the prevalence of herbal products used by pregnant women and to evaluate the evidence of efficacy and safety of the most popular remedies. RECENT FINDINGS Of the 671 articles identified, 15 randomized controlled trials (RCTs) and 16 non-RCTs were eligible. Ginger was the most investigated remedy and it was consistently reported to ameliorate nausea and vomiting in pregnancy. Although raspberry, blue cohosh, castor oil, and evening primrose oil are believed to facilitate labor in traditional medicine, very few scientific data support such indication. Moreover, they have been associated with severe adverse events. Data on the safety of Hypericum perforatum in pregnancy or lactation are reassuring, whereas efficacy was demonstrated only in nonpregnant individuals. There is still insufficient evidence regarding the efficacy and safety of Echinacea, garlic, and cranberry in pregnancy. SUMMARY Epidemiological studies reported a wide range of use of herbal remedies in pregnancy. Too few studies have been devoted to the safety and efficacy of singular herbs. With the exception of ginger, there are no consistent data to support the use of any other herbal supplement during pregnancy. Severe adverse events have been reported using blue cohosh and evening primrose oil.
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Affiliation(s)
- Giulia Dante
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
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Baraka M, Steurbaut S, Coomans D, Dupont AG. Determinants of medication use in a multi-ethnic population of pregnant women: A cross-sectional study. EUR J CONTRACEP REPR 2014; 19:108-20. [DOI: 10.3109/13625187.2013.879568] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Complementary and Alternative Medicine use in women during pregnancy: do their healthcare providers know? BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:85. [PMID: 24592860 PMCID: PMC3945795 DOI: 10.1186/1472-6882-14-85] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 02/26/2014] [Indexed: 12/03/2022]
Abstract
Background The National Institutes of Health reported in 2007 that approximately 38% of United States adults have used at least one type of Complementary and Alternative Medicine (CAM). There are no studies available that assess general CAM use in US pregnant women. The objectives of our study were to determine the prevalence and type of CAM use during pregnancy at one medical center; understand who is using CAM and why they are using it; and assess the state of patients’ CAM use disclosure to their obstetrical providers. Methods A cross-sectional survey study of post-partum women was done to assess self-reported CAM use during pregnancy. Results of this survey were compared to results from a previous survey performed by this research team in 2006. Data were analyzed using binary logistic regression. Results In 2013, 153 women completed the survey, yielding a response rate of 74.3%. Seventy-two percent and 68.5% of participants reported CAM use during their pregnancies in 2006 and 2013 respectively. The percentage of participants who reported discussing CAM use with their obstetrical providers was less than 1% in 2006 and 50% in 2013. Increased use of different CAM therapies was associated with increased maternal age, primagravida, being US-born, and having a college education (p ≤ 0.05). However, these factors were poor predictors of CAM use. Conclusions Given the frequency of CAM use and the difficulty in predicting who is using it, obstetrical providers should consider being informed about CAM and incorporating discussions about its use into routine patient assessments.
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Mohammed MA, Bushra AW, Aljadhey HS, Ahmed JH. Supplement Use Among Pregnant Women in Ethiopia: Prevalence and Predictors. Ther Innov Regul Sci 2013; 47:416-423. [PMID: 30235523 DOI: 10.1177/2168479013485078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this article was to assess the pattern of supplement use and associated factors among pregnant women in Ethiopia. Methods A facility-based cross-sectional study was conducted. A total of 339 pregnant women were included in the study, 63 (18.3%) and 23 (6.8%) of whom used at least 1 supplement during pregnancy and 2 to 4 weeks prior to pregnancy, respectively. Only 3 women were prescribed folic acid during pregnancy. The pregnant women were interviewed to collect supplements use and pregnancy-related information through a pretested semistructured questionnaire. Subsequent charts of prescribed supplements were reviewed using a pretested data collection format. Results The majority (76.4%) of the women claimed no awareness about the benefits of early supplementation. Supplement use was about 8 times higher among women with > 3 children (adjusted odds ratio, 7.85; 95% confidence interval, 1.69-36.28; P = .008) than among nulliparous women, and about 6 times higher among women in their second trimester (adjusted odds ratio, 6.26; 95% confidence interval, 1.91-20.55; P = .03) of pregnancy compared to those women in their first trimester. Conclusion Overall supplement use, particularly folic acid intake, was found to be negligible during the prenatal as well as antenatal periods. The majority of the women in the study lacked awareness about the benefits of supplementation and potential risks associated with the absence of folic acid during pregnancy. Information by the media and health care personnel given to childbearing women about the need to take folic acid to prevent neural tube defects seems to improve the intake of folic acid during the protective period.
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Affiliation(s)
- Mohammed Adem Mohammed
- 1 Department of Public Health and Clinical Sciences, Faculty of Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Abdulhalik Workicho Bushra
- 2 Department of Epidemiology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Hisham S Aljadhey
- 3 Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Jemal Hussein Ahmed
- 4 Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
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Gardiner P, Jarrett K, Filippelli A, Pecci C, Mauch M, Jack B. Herb use, vitamin use, and diet in low-income, postpartum women. J Midwifery Womens Health 2013; 58:150-7. [PMID: 23590486 DOI: 10.1111/j.1542-2011.2012.00240.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Little is known about herb use among underserved postpartum women and their patterns of communication about herb use with prenatal providers. METHODS We interviewed women from the postpartum unit at an urban hospital about herb use during pregnancy, socioeconomic factors, prenatal vitamin use, and diet. We asked women if they discussed use of herbs and vitamins with their prenatal care providers and asked about their satisfaction with these discussions. We reviewed inpatient chart medication lists for herb use. RESULTS Of 160 women surveyed, 39% reported using herbs during pregnancy. Sixty-five percent of participants took a prenatal vitamin. Fifty-seven percent of herb users (n = 40) reported taking prenatal vitamins. Herb users were significantly more likely to report making any dietary change during their pregnancies than non-herb users (P = .03). Only 38% of herb users discussed it with their prenatal providers, and 82% were satisfied with the conversation. Of all 160 participants, 125 had prenatal vitamin use documented, and no women had herbal medicine use documented in the medical record during their birth hospitalization. DISCUSSION We report a higher frequency of herb use during pregnancy than other studies. The fact that women of all backgrounds and economic statuses report using herbs during pregnancy makes it even more important for all women to be asked about their use of herbs.
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Affiliation(s)
- Paula Gardiner
- Department of Family Medicine, Boston University Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118,
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Al-Ramahi R, Jaradat N, Adawi D. Use of herbal medicines during pregnancy in a group of Palestinian women. JOURNAL OF ETHNOPHARMACOLOGY 2013; 150:79-84. [PMID: 23933314 DOI: 10.1016/j.jep.2013.07.041] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 07/28/2013] [Accepted: 07/29/2013] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The use of herbal medicines during pregnancy is common worldwide due to physiological changes that lead to pregnancy related problems. OBJECTIVES The aims of this study were to measure the prevalence and predictors of herb use among a group of Palestinian pregnant women and the possible influence of herbal consumption on pregnancy outcomes. METHODS This study was a questionnaire-based cross sectional descriptive study. It was conducted in the maternity ward of a governmental hospital between March and May 2012, a random sample of women who gave birth during the study period were met and asked to answer a face to face questionnaire. RESULTS Out of 300 women, 120 women (40.0%) used herbs during pregnancy; most women preferred to use herbs because they thought herbs are safer than medications (82.5%), women based in their choices mainly on advice from family or doctors (36.7%, 33.0%, respectively), 65.8% of them told their doctors that they used herbs, 91.7% considered these therapies beneficial, and 99.2% reported no side effects. The most commonly used herbs were anise (Pimpinella anisum) (61.7%), chamomile (Matricaria recutita) (53.3%), sage (Salvia officinalis) (55%), mixture of herbs (33.3%), and thyme (Thymus vulgaris) (29.2%). Most women were using herbs on as needed bases. There were no statistically significant differences between users and non-users of herbs in all socio-demographic variables and pregnancy outcomes. CONCLUSIONS This study found that the use of herbs during pregnancy is very common among Palestinian women. Infrequent use of herbs during pregnancy seems to be safe and beneficial. To provide the best care to pregnant women who use herbal products, clinicians and pharmacist are recommended to stay up to date with herb use and their safety in pregnancy. Not all women tell their doctors about herbal products use, so the physicians are recommended to ask pregnant women about this to avoid any possible negative outcomes on the mother or the fetus.
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Affiliation(s)
- Rowa Al-Ramahi
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, PO Box: 7, Nablus, Palestine.
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Complementary and Alternative Medicines Use during Pregnancy: A Systematic Review of Pregnant Women and Healthcare Professional Views and Experiences. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:205639. [PMID: 24194778 PMCID: PMC3806151 DOI: 10.1155/2013/205639] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 06/12/2013] [Accepted: 08/21/2013] [Indexed: 12/12/2022]
Abstract
Aims. To undertake a systematic review of the recent (2008-2013) primary literature, describing views and experiences of CAM use during pregnancy by women and healthcare professionals. Method. Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Review Library and Allied, and Complementary Medicine Database were searched. Studies reporting systemic CAM products (homeopathic preparations, herbal medicines, Vitamins and minerals, homeopathy, and special diets) alone or in combination with other nonsystemic CAM modalities (e.g., acupuncture) were included. Results. Database searches retrieved 2,549 citations. Removal of duplicates followed by review of titles and abstracts yielded 32 relevant studies. Twenty-two reported the perspectives of women and their CAM use during pregnancy, while 10 focused on healthcare professionals. The majority of studies had significant flaws in study design and reporting, including a lack of appropriate definitions of CAM and associated modalities, absence of detailed checklists provided to participants, the use of convenience sampling, and a general lack of scientific robustness in terms of data validity and reliability. Conclusion. To permit generalisability of study findings, there is an urgent need to expand the evidence base assessing CAMs use during pregnancy using appropriately designed studies.
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Kim Sooi L, Lean Keng S. Herbal Medicines: Malaysian Women's Knowledge and Practice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:438139. [PMID: 24093047 PMCID: PMC3777224 DOI: 10.1155/2013/438139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/22/2013] [Accepted: 07/25/2013] [Indexed: 11/17/2022]
Abstract
This is a cross-sectional, descriptive study among Malay women admitted in the antenatal and postnatal ward to determine the prevalence and use of herbal medicines during pregnancy and elemental analysis in the most popular herbs. A total of 460 women were surveyed. Herbal medicine use during pregnancy was 34.3%, while 73% utilized herbal medicines during labor, because of a belief that it may shorten and ease labor. The most commonly used herbal medicines in pregnancy were Anastatica hierochuntica L. (60.1%) followed by coconut oil (35.4%). The majority of women (89.2%) used only one type of herbal medicines and took one capsule/glass (38%) per day. Herbal medicines use by pregnant women is largely unsupervised (81%), with most women getting information from their parents (60.7%) and buying the products directly from traditional midwives (32.2%) and 77% agreed upon its efficacy and safety. From the 460 respondents, 89.8% women were in the low end of the herbs knowledge. There was a significant difference found between knowledge score and income (P < 0.05). Microdiffraction analysis revealed significant presence of carbon, oxygen, silica, calcium, magnesium, aluminium, potassium, zinc, and iron that were found in Anastatica hierochuntica L. and proved to have good benefits for pregnancy.
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Affiliation(s)
- Law Kim Sooi
- Advanced Medical & Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia
| | - Soon Lean Keng
- School of Health Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia
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Hall HG, Griffiths DL, McKenna LG. Keeping childbearing safe: Midwives' influence on women's use of complementary and alternative medicine. Int J Nurs Pract 2013; 19:437-43. [DOI: 10.1111/ijn.12089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Helen G Hall
- School of Nursing & Midwifery; Monash University, Peninsula Campus; Frankston; Victoria; Australia
| | - Debra L Griffiths
- School of Nursing & Midwifery; Monash University, Peninsula Campus; Frankston; Victoria; Australia
| | - Lisa G McKenna
- School of Nursing & Midwifery; Monash University, Clayton Campus; Clayton; Victoria; Australia
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Majaj L, Nassar M, De Allegri M. "It's not easy to acknowledge that I'm ill": a qualitative investigation into the health seeking behavior of rural Palestinian women. BMC Womens Health 2013; 13:26. [PMID: 23705933 PMCID: PMC3679862 DOI: 10.1186/1472-6874-13-26] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 04/05/2013] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND This qualitative study sets to fill a gap in knowledge by exploring the health seeking behaviour of rural women living in the occupied Palestinian territories (oPt). The existing literature on the oPt has so far focused on unravelling the country's epidemiological and health system profile, but has largely neglected the assessment of factors shaping people's decisions on health care use. METHODS Based on a conceptual framework rooted in the Anderson behavioural model, we conducted 30 semi-structured interviews with purposely selected women and seven key informant interviews in three purposely selected villages in Ramallah district. RESULTS Our findings indicate that women delay seeking professional care, use self-prescribed medications and home treatment, and do not use preventive and educational health services. Their health seeking behaviour is the result of the interplay of several factors: their gendered socio-cultural role; their health beliefs; financial affordability and geographical accessibility; their perceptions of the quality of care; and their perceived health needs. CONCLUSIONS Findings are discussed in the light of their policy implications, suggesting that adequate health policy planning ought to take into considerations socio-cultural dimensions beyond those directly pertinent to the health care system.
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Affiliation(s)
- Linda Majaj
- UNICEF Bethlehem, West Bank occupied Palestinian territory, Heidelberg, Germany
| | - Majed Nassar
- Medical Aid for Palestinians Ramallah West Bank occupied Palestinian territory, Bethlehem, West Bank
| | - Manuela De Allegri
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
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Gómez MF, Field CJ, Olstad DL, Loehr S, Ramage S, McCargar LJ. Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort. MATERNAL AND CHILD NUTRITION 2013; 11:497-510. [PMID: 23557540 DOI: 10.1111/mcn.12038] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women.
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Affiliation(s)
- Mariel Fajer Gómez
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine J Field
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sarah Loehr
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Stephanie Ramage
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Linda J McCargar
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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López E. A Review of CAM Internet Resources in Spanish. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2013. [DOI: 10.1080/15398285.2013.780958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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