Abstract
About 80% of the consumers worldwide use herbal medicine (HMs) or other natural products. The percentage may vary significantly (7%–55%) among pregnant women, depending upon social status, ethnicity, and cultural traditions. This manuscript discusses the most common HMs used by pregnant women, and the potential interactions of HMs with conventional drugs in some medical conditions that occur during pregnancy (e.g., hypertension, asthma, epilepsy). It also includes an examination of the characteristics of pregnant HM consumers, the primary conditions for which HMs are taken, and a discussion related to the potential toxicity of HMs taken during pregnancy. Many cultures have used HMs in pregnancy to improve wellbeing of the mother and/or baby, or to help decrease nausea and vomiting, treat infection, ease gastrointestinal problems, prepare for labor, induce labor, or ease labor pains. One of the reasons why pregnant women use HMs is an assumption that HMs are safer than conventional medicine. However, for pregnant women with pre-existing conditions like epilepsy and asthma, supplementation of conventional treatment with HMs may further complicate their care. The use of HMs is frequently not reported to healthcare professionals. Providers are often not questioning HM use, despite little being known about the HM safety and HM-drug interactions during pregnancy. This lack of knowledge on potential toxicity and the ability to interact with conventional treatments may impact both mother and fetus. There is a need for education of women and their healthcare professionals to move away from the idea of HMs not being harmful. Healthcare professionals need to question women on whether they use any HMs or natural products during pregnancy, especially when conventional treatment is less efficient and/or adverse events have occurred as herbal-drug interactions could be the reason for these observations. Additionally, more preclinical and clinical studies are needed to evaluate HM efficacy and toxicity.
Highlights
herbal medicines (HMs) have the potential to interact with the antiepileptic drugs (AEDs) therapy leading to reduced efficacy and increased complications during pregnancy increases the risk to both mother and fetus
As outlined in this review, the problem has become the introduction of HMs or other natural products similtaneously with conventional drugs during pregnancy and our lack of knowledge of potential herbal-drug interactions, which can impact fetus or mother
There are many known benefits associated with HMs that can help during or after pregnancy such as increasing milk production, decreasing nausea, easing labor pains, relief of morning sickness, or decreasing flatulence
Summary
The main purpose of this scoping review is to inform healthcare professionals regarding HMs commonly used by pregnant women and potential interactions of these HMs with conventional drugs used for the treatment of some preexisting medical conditions or those that occur during pregnancy (e.g., hypertension, asthma, epilepsy). It has been reported that use of antiepileptic drugs (AEDs) by pregnant women may be associated with an increase in adverse outcomes such as miscarriage, antepartum, and post-partum hemorrhages (Viale et al, 2015). This manuscript includes an examination of the characteristics of pregnant HM consumers, the primary conditions for which HMs are taken, and a discussion related to the potential toxicity of HMs taken during pregnancy
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