WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- The use of herbal medicinal products during pregnancy and the postnatal period is associated with increased risk of adverse events, according to a review published online April 9 in Obstetrics & Gynecology.
Yolanda Muñoz Balbontín, M.D., from Aberdeen University in the United Kingdom, and colleagues conducted a systematic review to examine the incidence and nature of adverse events associated with herbal medicinal products among pregnant and postnatal women. A total of 74 articles were included for data extraction and synthesis.
The researchers found that in 19 of the included studies, adverse drug reactions, congenital malformations, fetal growth retardation, or herb-drug interactions were the primary study objective. Overall, 47 herbal medicinal products and 1,067,071 women were included in the review. There were correlations for use of almond oil with preterm birth (odds ratio, 2.09), oral raspberry leaf with cesarean delivery (adjusted odds ratio, 3.47), and heavy licorice use with early preterm birth (adjusted odds ratio, 3.07). There were correlations for use of the African herbal medicine mwanaphepo with maternal morbidity (adjusted odds ratio, 1.28) and neonatal death or morbidity (adjusted odds ratio, 1.22).
"Considering the 30 years of evidence of possible harm presented, we conclude herbal medicinal products should not [be] recommended during pregnancy until robust evidence of safety is available," the authors write.