Safety classification of herbal medicines used among pregnant women in Asian countries: a systematic review

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Abstract

Background

High prevalence of herbal medicines used in pregnancy and the lack of information on their safety is a public concern. Despite this, no significant research has been done regarding potential adverse effects of using herbal medicines during pregnancy, especially among developing Asian countries.

Methods

Cross-sectional studies were searched up to year 2016 on PubMed/Medline and EMBASE, the data were extracted and quality of studies was assessed using the quality appraisal tool. The findings are reported in accordance to the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Classification on safety of identified herbal medicines was done based on current scientific literature.

Results

This study included eight cross-sectional studies (2729 participants) from seven different Asian countries, of which 1283 (47.01%) women used one or more herbal medicines during pregnancy. Peppermint (22.8%), aniseed (14.7%), olibanum (12.9%), flixweed seed (12.2%) and ginger (11.5%) were the most frequently used herbal medicines. Out of the 33 identified herbal medicines, 13 were classified as safe to use, five as use with caution, eight were potentially harmful to use in pregnancy and information on seven herbal medicines was not available in the current literature.

Conclusions

Several herbal medicines identified in this review were classified to be potentially harmful or the information regarding safety in pregnancy was missing. It is recommended that contraindicated herbal medicines should be avoided and other herbals should be taken under supervision of a qualified health care practitioner. The classification regarding safety of herbal medicines in pregnancy can be utilized to create awareness on prevention of adverse effects.

Electronic supplementary material

The online version of this article (10.1186/s12906-017-1995-6) contains supplementary material, which is available to authorized users.

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Most cited references 40

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The politics of publication.

Peter A. Lawrence (2003)

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Herbal medicine use in pregnancy: results of a multinational study

Deborah A. Kennedy, Angela Lupattelli, Gideon Koren … (2013)

Background The use of complementary and alternative medicines (CAM) is growing in the general population. Herbal medicines are used in all countries of the world and are included in the top CAM therapies used. Methods A multinational study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North and South America and Australia. In this study, the primary aim was to determine the prevalence of herbal medicine use in pregnancy and factors related to such use across participating countries and regions. The secondary aim was to investigate who recommended the use of herbal medication in pregnancy. Results There were 9,459 women from 23 countries participating in the study. Of these, 28.9% reported the use of herbal medicines in pregnancy. Most herbal medicines were used for pregnancy-related health ailments such as cold and nausea. Ginger, cranberry, valerian and raspberry were the most commonly used herbs in pregnancy. The highest reported rate of herbal use medicines was in Russia (69%). Women from Eastern Europe (51.8%) and Australia (43.8%) were twice as likely to use an herbal medicine versus other regions. Women using herbal medicines were characteristically having their first child, non-smokers, using folic acid and consuming some alcohol in pregnancy. Also, women who were currently students and women with an education other than a high school degree were more likely to use herbal medicines than other women. Although 1 out of 5 women stated that a physician had recommended the herbal use, most women used herbal medicine in pregnancy on their own initiative. Conclusions In this multinational study herbal medicine use in pregnancy was high although there were distinct differences in the herbs and users of herbal medicines across regions. Most commonly the women self-medicated with herbal medicine to treat pregnancy-related health ailments. More knowledge regarding the efficacy and safety of herbal medicines in pregnancy is warranted.

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Use of herbal drugs in pregnancy: a survey among 400 Norwegian women.

Hedvig Nordeng, Gro C Havnen (2004)

To investigate the use of herbal drugs by pregnant women. We interviewed 400 postpartum women at Ullevål University Hospital in Oslo, Norway about the use of herbal drugs, within 3 days after giving birth by using a structured questionnaire in the period from February to June 2001. We found that 36% of the pregnant women had used herbal drugs during pregnancy with an average of 1.7 products per woman. The proportion of women using herbal drugs increased throughout the first, second and third pregnancy trimester. The most commonly used herbs were echinacea, iron-rich herbs, ginger, chamomile and cranberry. Among the women having used herbal drugs in pregnancy, 39% had used herbal drugs that were considered possibly harmful or herbs where information about safety in pregnancy was missing. Herbal galactagogues had been used by 43% of the women who had breastfed a prior child during their breast-feeding period. Use of herbal drugs in pregnancy had most commonly been recommended by family or friends. The widespread use of herbal drugs during pregnancy indicates an increased need for documentation about the safety of herbal drugs in pregnancy. To meet the needs of pregnant women, it is necessary for health care personnel to have knowledge about herbal drugs during pregnancy. Copyright 2004 John Wiley & Sons, Ltd.

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Author and article information

Contributors

Mansoor Ahmed: mansoormahar@hanyang.ac.kr

Jung Hye Hwang: hwangjh@hanyang.ac.kr

Soojeung Choi: energyplus@hanyang.ac.kr

Dongwoon Han:

ORCID: http://orcid.org/0000-0003-0206-8976

+82-2-2220-0666 , dwhan@hanyang.ac.kr

Journal

Journal ID (nlm-ta): BMC Complement Altern Med

Journal ID (iso-abbrev): BMC Complement Altern Med

Title: BMC Complementary and Alternative Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6882

Publication date (Electronic): 14 November 2017

Publication date PMC-release: 14 November 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 489

Affiliations

[1 ]ISNI 0000 0001 1364 9317, GRID grid.49606.3d, Department of Global Health and Development & Department of Preventive Medicine, , Hanyang University, College of Medicine, ; 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea

[2 ]Institute of Health Services Management, Seoul, South Korea

[3 ]ISNI 0000 0001 1364 9317, GRID grid.49606.3d, Department of Obstetrics and Gynecology, , Hanyang University, ; Seoul, South Korea

Author information

Dongwoon Han http://orcid.org/0000-0003-0206-8976

Article

Publisher ID: 1995

DOI: 10.1186/s12906-017-1995-6

PMC ID: 5686907

PubMed ID: 29137614

SO-VID: 121733f8-6787-4c08-bd8f-0d08e4a4b766

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 20 April 2017

Date accepted : 7 November 2017

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ScienceOpen disciplines: Complementary & Alternative medicine

Keywords: pregnancy,herbal medicines,adverse effects,safety,asian countries

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ScienceOpen disciplines: Complementary & Alternative medicine

Keywords: pregnancy, herbal medicines, adverse effects, safety, asian countries

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Safety classification of herbal medicines used among pregnant women in Asian countries: a systematic review

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Abstract

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Herbal Medicines Journal (Herb Med J)

Most cited references 40

The politics of publication.

Herbal medicine use in pregnancy: results of a multinational study

Use of herbal drugs in pregnancy: a survey among 400 Norwegian women.

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Cited by 32

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