The Use of Herbal Medicines in Pregnancy: A Cross-sectional Analytic Study

Document Type : Original Article

Authors

1 Department of Obstertics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria

2 Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria

Abstract

Background and aim: The use of complementary and alternative medicine is increasing worldwide; Some of the medications, including native herbs, are taken just before conception and in all trimesters and may be risky to the conceptus. The extent and the factors affecting usage vary and have not been adequately studied. The study aimed to determine the prevalence and factors associated with Herbal medicine use among pregnant and recently pregnant women.
Materials and methods: Magnitude of use of Herbal medication, the sociodemographic, other associated factors and, the various types of the medications used were evaluated. It was a cross-sectional study. An unvalidated semi-structured, interviewer-assisted questionnaire was used to obtain information. Consenting current or recently pregnant women attending public tertiary and private specialist hospitals were included in the study, while unconscious, severely sick women were excluded; 120 responded and were consecutively recruited. Stata version13 statistical software was used for data analysis. The prevalence, type of Herbal medicines used, associated factors, and pregnancy outcomes were measured. A two-sided (5% significance level) test of significance at a 95% confidence level was adopted. The study duration was three months, from October to December 2020.
Results: The rate of usage of Herbal medication in the index pregnancy was 22.5%; bitter leaf was the highest 6 (22.2%), followed by Herbal concoctions (agbo) and moringa- 18.5% and 11.1%, respectively. Malaria in pregnancy was the commonest indication (18.5%). Usage was lower amongst high parity patients; use is the same across sociodemographic strata. Family and friends were the primary sources of information (40.7%).
Conclusion: The use of natural or Herbal products in pregnancy was relatively common in the study. The medications were used mainly for the presumed diagnosis of malaria. Therefore, there is a need for health personnel to be actively involved in the education of pregnant women, especially in the early trimester and lower parity, about Herbal drug use and the inherent dangers.

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[1] Qi Z. Who traditional medicine strategy. 2014-2023. Geneva: World Health Organization. 2013.
[2] Tilburt JC, Kaptchuk TJ. Herbal medicine research and global health: an ethical analysis. Bulletin of the World Health Organization. 2008;86:594-9. doi:10.2471/BLT.07.042820.
[3] World Health Organization (WHO). Herbal medicine research and global health: an ethical analysis. WHO. World Health Organization; 2011.
[4] Laelago T. Herbal medicine use during pregnancy: benefits and untoward effects. Herbal medicine. 2018.
[5] John LJ, Shantakumari N. Herbal medicines use during pregnancy: a review from the Middle East. Oman medical journal. 2015;30(4):229-236. doi: 10.5001/omj.2015.48.
[6] Mothupi MC. Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: a cross-sectional survey. BMC complementary and alternative medicine. 2014;14(1):1-8. https://doi.org/10.1186/1472-6882-14-432.
[7]  Jaradat N, Adawi D. Use of herbal medicines during pregnancy in a group of Palestinian women. Journal of ethnopharmacology. 2013;150(1):79-84. https://doi.org/10.1016/j.jep.2013.07.041.
[8] Adane F, Seyoum G, Alamneh YM, Abie W, Desta M, Sisay B. Herbal medicine use and predictors among pregnant women attending antenatal care in Ethiopia: a systematic review and meta-analysis. BMC pregnancy and childbirth. 2020;20(1):1-1. https://doi.org/10.1186/s12884-020-2856-8.
[9] Ologe MO, Aboyeji AP, Ijaiya MA, Adesina KT, Adewara AA, Olarinoye JK. Herbal use among pregnant mothers in Ilorin, Kwra State, Nigeria. Journal of Obstetrics and Gynaecology. 2008;28(7):720-1. https://doi.org/10.1080/01443610802461912.
[10] Fakeye TO, Adisa R, Musa IE. Attitude and use of herbal medicines among pregnant women in Nigeria. BMC Complementary and alternative medicine. 2009;9(1):1-7. https://doi.org/10.1186/1472-6882-9-53.
[11] Duru CB, Uwakwe KA, Chinomnso NC, Mbachi II, Diwe KC, Agunwa CC, et al. Socio-demographic determinants of herbal medicine use in pregnancy among Nigerian women attending clinics in a tertiary Hospital in Imo State, south-east, Nigeria. Am J Med Stud. 2016;4(1):1-0. DOI:10.12691/ajms-4-1-1.
[12] Laelago T, Yohannes T, Lemango F. Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: facility based cross sectional study. Archives of Public Health. 2016;74(1):1-8. https://doi.org/10.1186/s13690-016-0118-z.
[13] Balbontín YM, Stewart D, Shetty A, Fitton CA, McLay JS. Herbal medicinal product use during pregnancy and the postnatal period: a systematic review. Obstetrics and gynecology. 2019;133(5):920-932. doi: 10.1097/AOG.0000000000003217.
[14] Forster DA, Denning A, Wills G, Bolger M, McCarthy E. Herbal medicine use during pregnancy in a group of Australian women. BMC pregnancy and childbirth. 2006;6(1):1-9. https://doi.org/10.1186/1471-2393-6-21.
[15] Tamuno I, Omole-Ohonsi A, Fadare J. Use of herbal medicine among pregnant women attending a tertiary hospital in Northern Nigeria. The Internet Journal of Gynecology and Obstetrics. 2011;15(2).
[16] Tabatabaee M. Use of herbal medicine among pregnant women referring to Valiasr Hospital in Kazeroon, Fars, South of Iran. J Med Plants. 2011;10(37):96–108.
[17] Bayisa B, Tatiparthi R, Mulisa E. Use of herbal medicine among pregnant women on antenatal care at Nekemte Hospital, Western Ethiopia. Jundishapur journal of natural pharmaceutical products. 2014;9(4): e17368.
[18] Nyeko R, Tumwesigye NM, Halage AA. Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda. BMC pregnancy and childbirth. 2016;16(1):1-2. https://doi.org/10.1186/s12884-016-1095-5.
[19] Kennedy DA, Lupattelli A, Koren G, Nordeng H. Herbal medicine use in pregnancy: results of a multinational study. BMC complementary and alternative medicine. 2013;13(1):1-0. https://doi.org/10.1186/1472-6882-13-355.
[20] Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. European journal of clinical pharmacology. 2013;69(2):269-77. https://doi.org/10.1007/s00228-012-1331-5.
[21] Kekana LS, Sebitloane MH. Ingestion of herbal medication during pregnancy and adverse perinatal outcomes. South African Journal of Obstetrics and Gynaecology. 2020;26(2):71-5. https://doi.org/10.7196/SAJOG.2020.v26i2.1615.
[22] Mekuria AB, Erku DA, Gebresillassie BM, Birru EM, Tizazu B, Ahmedin A. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study. BMC complementary and alternative medicine. 2017;17(1):1-7. https://doi.org/10.1186/s12906-017-1608-4.