Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil

Abstract

Background: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately.Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in São Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0.Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers.Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women’s HM use, ultimately promoting safer and more effective healthcare practices.

Patient–physician communication on herbal medicine use during pregnancy: a systematic review and meta-analysis

“…8 However, certain self-care modalities, such as herbal medicine (HM), contain bioactive compounds that can pose risks to both the mother and the fetus if misused. [9][10][11][12][13][14][15] While safety and efficacy data exist for some HM, many others lack conclusive evidence and, in some cases, rely on anecdotal evidence and information from mass media and other digital platforms. 9 16-18 Specifically, the abundance of information available online blurs the line between lay and expert knowledge, making it challenging for individuals to discern accurate information.…”

Effectiveness and Safety of Using Warm Lime Water in Pregnant Women

“…According to research conducted in various countries, approximately 50-80% of pregnant women experience emesis gravidarum during the first trimester of pregnancy [1][2][3]. The severity of symptoms can vary from mild to severe.…”

“…One alternative therapy derived from natural remedies is the consumption of warm lime water. Warm lime water is claimed to have antiemetic properties and can alleviate symptoms of nausea and vomiting in pregnant women [1][2][3]. Some proponents of warm lime water usage state that the citric acid content in limes can help stabilize the digestive system and relieve nausea.…”