Lee Amy, Minhas Ravinder, Matsuda Noriko, Lam Michael, Ito Shinya
Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
J Clin Psychiatry. 2003 Aug;64(8):966-8. doi: 10.4088/jcp.v64n0818.
We examined the safety of St. John's wort to nursing mothers and their infants.
A prospective, observational, cohort study was conducted. Thirty-three breastfeeding women receiving St. John's wort (Group 1) who contacted our teratogen/toxicant counseling service regarding the safety of St. John's wort during breastfeeding were followed up between May 1999 and April 2001. These women were compared with 101 disease-matched (Group 2) and 33 age- and parity-matched nondisease controls (Group 3). Information collected included maternal and neonatal demographics, breastfeeding duration, use of St. John's wort, maternal and infant adverse events, infant weight over the first year of life, and whether or not the mother experienced a decrease in lactation.
There were no statistically significant differences found in maternal or infant demographics or maternal adverse events. Whereas only 1 infant each in Groups 2 and 3 was reported to be colicky, there were 2 cases of "colic," 2 of "drowsiness," and 1 of "lethargy" in Group 1 (p <.01; Group 1 vs. Group 2, p <.01; Group 1 vs. Group 3, p =.20). Although 3 of these women in Group 1 consulted their doctor, specific medical treatment was not required. No significant difference was observed in the frequency of maternal report of decreased milk production among the groups, nor was a difference found in infant weight over the first year of life.
These results provide a framework for the management of breastfeeding women receiving St. John's wort.
我们研究了圣约翰草对哺乳期母亲及其婴儿的安全性。
进行了一项前瞻性观察队列研究。1999年5月至2001年4月期间，对33名服用圣约翰草的哺乳期妇女（第1组）进行了随访，这些妇女就哺乳期服用圣约翰草的安全性联系了我们的致畸物/毒物咨询服务。将这些妇女与101名疾病匹配的妇女（第2组）和33名年龄及产次匹配的无疾病对照妇女（第3组）进行比较。收集的信息包括母亲和新生儿的人口统计学数据、母乳喂养持续时间、圣约翰草的使用情况、母婴不良事件、婴儿出生后第一年的体重，以及母亲是否出现泌乳减少。
在母亲或婴儿的人口统计学数据或母亲不良事件方面未发现统计学上的显著差异。第2组和第3组各只有1名婴儿被报告有腹绞痛，而第1组有2例“腹绞痛”、2例“嗜睡”和1例“昏睡”（p<.01；第1组与第2组比较，p<.01；第1组与第3组比较，p =.20）。虽然第1组中有3名妇女咨询了医生，但不需要特殊治疗。各组之间母亲报告乳汁分泌减少的频率没有显著差异，婴儿出生后第一年的体重也没有差异。
这些结果为管理服用圣约翰草的哺乳期妇女提供了一个框架。
