McLay James S, Izzati Naila, Pallivalapila Abdul R, Shetty Ashalatha, Pande Binita, Rore Craig, Al Hail Moza, Stewart Derek
The Division of Applied Health Sciences, The University of Aberdeen, Aberdeen, UK.
Pharmacy Department, Women's Hospital-HMC, Doha, Qatar.
BMC Complement Altern Med. 2017 Dec 19;17(1):543. doi: 10.1186/s12906-017-2052-1.
Pregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance.
A cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland. Outcome measures included; Prescription medicines use excluding vitamins and potential HDIs assessed using Natural Medicines Comprehensive Database.
The survey was completed by 889 respondents (73% response rate). 45.3% (403) reported the use of at least one prescription medicine, excluding vitamins. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1-12). A total of 91 different prescription medicines were reported by respondents using HNPs. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1-12). Thirty-four herb-drug interactions were identified in 23 (12.7%) women with the potential to increase the risk of postpartum haemorrhage, alter maternal haemodynamics, and enhance maternal/fetal CNS depression. Almost all were rated as moderate (93.9%), one as a potentially major (ginger and nifedipine) and only one minor (ondansetron and chamomile).
Almost half of pregnant women in this study were prescribed medicines excluding vitamins and minerals and almost half of these used HNPs. Potential moderate to severe HDIs were identified in an eighth of the study cohort. Healthcare professionals should be aware that the concurrent use of HNPs and prescription medicines during pregnancy is common and carries potential risks.
孕妇在自行服用草药天然产品以治疗主要与妊娠相关的病症时，通常会被开具药物。本研究的目的是评估孕妇中草药与药物相互作用（HDI）的可能性，并探索可能的草药与药物相互作用及其潜在的临床意义。
对苏格兰东北部孕早期或产后即刻的女性进行横断面调查。观察指标包括：不包括维生素的处方药使用情况，以及使用天然药物综合数据库评估潜在的HDI。
889名受访者完成了调查（应答率为73%）。45.3%（403人）报告使用了至少一种不包括维生素的处方药。在服用处方药的人群中，44.9%（181人）还报告同时使用了至少一种草药天然产品（范围为1至12种）。使用草药天然产品的受访者共报告了91种不同的处方药。在服用处方药的人群中，44.9%（181人）还报告同时使用了至少一种草药天然产品（范围为1至12种）。在23名（12.7%）女性中识别出34种草药与药物相互作用，这些相互作用有可能增加产后出血风险、改变母体血流动力学并增强母体/胎儿中枢神经系统抑制。几乎所有相互作用被评为中度（93.9%），一种为潜在重大相互作用（生姜与硝苯地平），只有一种为轻度相互作用（昂丹司琼与洋甘菊）。
本研究中近一半孕妇被开具了不包括维生素和矿物质的药物，其中近一半使用了草药天然产品。在八分之一的研究队列中识别出了潜在的中度至重度HDI。医疗保健专业人员应意识到，孕期同时使用草药天然产品和处方药很常见且存在潜在风险。
