Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria; Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY.
Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY.
Am J Obstet Gynecol. 2018 Apr;218(4):401.e1-401.e11. doi: 10.1016/j.ajog.2017.08.016. Epub 2017 Aug 30.
Placentophagy or placentophagia, the postpartum ingestion of the placenta, is widespread among mammals; however, no contemporary human culture incorporates eating placenta postpartum as part of its traditions. At present, there is an increasing interest in placentophagy among postpartum women, especially in the United States. The placenta can be eaten raw, cooked, roasted, dehydrated, or encapsulated or through smoothies and tinctures. The most frequently used preparation appears to be placenta encapsulation after steaming and dehydration. Numerous companies offer to prepare the placenta for consumption, although the evidence for positive effects of human placentophagy is anecdotal and limited to self-reported surveys. Without any scientific evidence, individuals promoting placentophagy, especially in the form of placenta encapsulation, claim that it is associated with certain physical and psychosocial benefits. We found that there is no scientific evidence of any clinical benefit of placentophagy among humans, and no placental nutrients and hormones are retained in sufficient amounts after placenta encapsulation to be potentially helpful to the mother postpartum. In contrast to the belief of clinical benefits associated with human placentophagy, the Centers for Disease Control and Prevention recently issued a warning due to a case in which a newborn infant developed recurrent neonatal group B Streptococcus sepsis after the mother ingested contaminated placenta capsules containing Streptococcus agalactiae. The Centers for Disease Control and Prevention recommended that the intake of placenta capsules should be avoided owing to inadequate eradication of infectious pathogens during the encapsulation process. Therefore, in response to a woman who expresses an interest in placentophagy, physicians should inform her about the reported risks and the absence of clinical benefits associated with the ingestion. In addition, clinicians should inquire regarding a history of placenta ingestion in cases of postpartum maternal or neonatal infections such as group B Streptococcus sepsis. In conclusion, there is no professional responsibility on clinicians to offer placentophagy to pregnant women. Moreover, because placentophagy is potentially harmful with no documented benefit, counseling women should be directive: physicians should discourage this practice. Health care organizations should develop clear clinical guidelines to implement a scientific and professional approach to human placentophagy.
胎食,即产后食用胎盘,在哺乳动物中广泛存在;然而,当代没有任何一种人类文化将产后食用胎盘纳入其传统。目前,越来越多的产后女性对胎食感兴趣,尤其是在美国。胎盘可以生吃、煮食、烤制、脱水、装胶囊或通过奶昔和酊剂食用。最常用的方法似乎是蒸干脱水后装胶囊。虽然人类胎食有益的证据只是传闻,且仅限于自我报告的调查,但有许多公司提供胎盘食用服务。一些宣传胎食的个人,特别是以胎盘胶囊形式宣传胎食的个人声称,胎食与某些身体和心理社会益处有关,但没有任何科学证据支持这种说法。我们发现,人类胎食没有任何临床益处,而且胎盘胶囊并不能保留足够数量的胎盘营养物质和激素,对产后母亲可能有帮助。与人们认为胎食对人类有临床益处的观点相反,由于一名新生儿在母亲食用含有无乳链球菌的受污染胎盘胶囊后反复发生新生儿 B 组链球菌败血症,美国疾病控制与预防中心最近发出了警告。美国疾病控制与预防中心建议避免摄入胎盘胶囊,因为在胶囊制作过程中无法完全消除感染性病原体。因此,对于表达对胎食感兴趣的女性,医生应告知其相关风险,以及食用胎盘没有临床益处。此外,在出现产后母亲或新生儿感染(如 B 组链球菌败血症)的情况下,医生应询问是否有胎盘食用史。总之,医生没有专业责任为孕妇提供胎食。此外,由于胎食可能有害而无确凿益处,因此对孕妇的咨询应该是指导性质的:医生应劝阻这种做法。医疗机构应制定明确的临床指南,对人类胎食采取科学专业的方法。