Illamola Sílvia M, Amaeze Ogochukwu U, Krepkova Lubov V, Birnbaum Angela K, Karanam Ashwin, Job Kathleen M, Bortnikova Valentina V, Sherwin Catherine M T, Enioutina Elena Y
Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States.
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States.
Front Pharmacol. 2020 Jan 9;10:1483. doi: 10.3389/fphar.2019.01483. eCollection 2019.
About 80% of the consumers worldwide use herbal medicine (HMs) or other natural products. The percentage may vary significantly (7%-55%) among pregnant women, depending upon social status, ethnicity, and cultural traditions. This manuscript discusses the most common HMs used by pregnant women, and the potential interactions of HMs with conventional drugs in some medical conditions that occur during pregnancy (e.g., hypertension, asthma, epilepsy). It also includes an examination of the characteristics of pregnant HM consumers, the primary conditions for which HMs are taken, and a discussion related to the potential toxicity of HMs taken during pregnancy. Many cultures have used HMs in pregnancy to improve wellbeing of the mother and/or baby, or to help decrease nausea and vomiting, treat infection, ease gastrointestinal problems, prepare for labor, induce labor, or ease labor pains. One of the reasons why pregnant women use HMs is an assumption that HMs are safer than conventional medicine. However, for pregnant women with pre-existing conditions like epilepsy and asthma, supplementation of conventional treatment with HMs may further complicate their care. The use of HMs is frequently not reported to healthcare professionals. Providers are often not questioning HM use, despite little being known about the HM safety and HM-drug interactions during pregnancy. This lack of knowledge on potential toxicity and the ability to interact with conventional treatments may impact both mother and fetus. There is a need for education of women and their healthcare professionals to move away from the idea of HMs not being harmful. Healthcare professionals need to question women on whether they use any HMs or natural products during pregnancy, especially when conventional treatment is less efficient and/or adverse events have occurred as herbal-drug interactions could be the reason for these observations. Additionally, more preclinical and clinical studies are needed to evaluate HM efficacy and toxicity.
全球约80%的消费者使用草药或其他天然产品。孕妇中的这一比例可能因社会地位、种族和文化传统而有显著差异（7%-55%）。本文讨论了孕妇最常用的草药，以及在孕期出现的某些病症（如高血压、哮喘、癫痫）中，草药与传统药物之间的潜在相互作用。它还包括对使用草药的孕妇特征、服用草药的主要病症的研究，以及对孕期服用草药潜在毒性的讨论。许多文化都在孕期使用草药来改善母亲和/或婴儿的健康状况，或帮助减轻恶心和呕吐、治疗感染、缓解胃肠道问题、为分娩做准备、引产或减轻分娩疼痛。孕妇使用草药的一个原因是认为草药比传统药物更安全。然而，对于患有癫痫和哮喘等既往病症的孕妇，用草药补充传统治疗可能会使她们的护理更加复杂。草药的使用情况往往未向医护人员报告。尽管对孕期草药安全性和草药与药物的相互作用知之甚少，但医护人员通常不会询问患者是否使用草药。这种对潜在毒性以及与传统治疗相互作用能力的缺乏了解，可能会对母亲和胎儿都产生影响。有必要对女性及其医护人员进行教育，使他们摒弃草药无害的观念。医护人员需要询问女性在孕期是否使用任何草药或天然产品，尤其是在传统治疗效果不佳和/或出现不良事件时，因为草药与药物的相互作用可能是这些情况的原因。此外，还需要更多的临床前和临床研究来评估草药的疗效和毒性。
