Prevalence, predictors and pregnancy outcomes of unprescribed and herbal medicine use in Ibadan, Nigeria

Abstract

Background Unprescribed and herbal medicines use among pregnant women is a public health concern in low and middle-income countries because of the potential teratogenic effects, insufficient safety and weak drug regulatory systems. Unprescribed and herbal medicines are common among pregnant women in Nigeria, and only a few researchers have documented the prevalence and the risk factors. However, evidence on the associated pregnancy outcomes is still lacking. We assessed the prevalence, predictors and pregnancy outcomes of unprescribed and herbal medicines use among pregnant women in Ibadan, Nigeria. Methods This study was a component of the Ibadan Pregnancy Cohort Study, a prospective cohort study, among pregnant women in Ibadan, Nigeria, who were enrolled at ≤ 20 weeks gestation at their first antenatal visit and followed up till delivery. In all, 571 women participated in the maternal drug use assessment during the third trimester using a pretested interviewer-administered questionnaire. The primary outcomes were unprescribed and herbal medicines use and pregnancy outcomes, secondary outcomes, were abstracted from medical records. The predictors assessed included sociodemographic, obstetric, antenatal care utilization, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to evaluate the predictors and relative risk for the pregnancy outcomes of unprescribed and herbal medicines at 5% significance. Results The prevalence of unprescribed and herbal medicine use was 31.9% and 21.7%, respectively. On bivariate analysis, the significant predictors of unprescribed medicine (which were protective) were tertiary education, increasing income, adequate antenatal care (≥ 4 visits), and at least two doses of sulfadoxine-pyrimethamine. However, high parity and having an antenatal admission increased the risk. However, after adjusting for confounders, the significant factors associated with unprescribed medicines were; tertiary education (AOR) = 0.23; 95% CI: (0.06 – 0.95); p-value: 0.043] and obtaining at least two doses of sulfadoxine-pyrimethamine [AOR = 0.33; 95% CI: (0.29 – 3.60); p-value: 0.048]. For herbal medicines, the predictors were similar to unprescribed drugs. However, after adjusting for confounders, none was significant for herbal medicines. Unprescribed and herbal medicines were not significantly associated with pregnancy outcomes. Conclusions Unprescribed and herbal medicines use were common among pregnant women in Ibadan, Nigeria, particularly among women with low economic status and those with poor utilization of antenatal care services. These significant predictors can be targeted for public health intervention. Specifically, health education that discourages the use of unprescribed and herbal medications to pregnant women during antenatal care.

Metals and metalloid in medicinal plants: occurrence and risk assessment to human health

“…The estimated CR of the elements in all the six plants in the present study exceeded this range, hence there are potential risks of carcinogenic events through consumption of these medicinal plants. These findings are particularly unexpected since As, Cd, Ni, and Pb have been reported as carcinogens [21,[25][26][27][28].…”

“…They have also been able to cause oxidative stress in humans [46]. As has reportedly resulted in endocrine disruption, immune dysfunction, and disruption of cellular metabolism in humans [27,28]. Ni is carcinogenic and causes damage to important body organs such as the lungs, stomach, and kidneys [26].…”

“…The contamination of medicinal herbs with toxic elements has been linked to various human anthropogenic activities, which release the toxic chemical elements (including toxic metals and metalloids) into the environment and are subsequently uptake by the plants from the soil [24]. The literature is rich on the adverse effects of toxic chemical elements on humans such as carcinogenicity, immunotoxicity, oxidative stress, organ damage, and competition with essential elements such as Zn and Gu, thus limiting their bioavailability [25][26][27][28].…”

The Use of Non-Prescribed Medicines in Infants from Birth to Six Months in Rural Areas of Polokwane Municipality—Limpopo Province, South Africa

“…Given that non-prescribed medications are administered without consulting medical professionals, they may have severe side effects on children, compromising infant health, causing delay in growth and development, and likely causing mortality [9][10][11][12]. However, the inclusion of non-prescribed medicine may not affect exclusive breastfeeding; depending on the type of medicine, quantity, and method of administration, administering nonprescribed medicine to infants presents a risk due to the lack of guidance from certified health professionals.…”