Department of Global Health and Development, Hanyang University, Seoul, Korea.
Institute of Health Services Management, Hanyang University, Seoul, Korea.
BMJ Glob Health. 2024 Mar 5;9(3):e013412. doi: 10.1136/bmjgh-2023-013412.
Lack of transparent communication between patients and physicians regarding the use of herbal medicine (HM) presents a major public health challenge, as inappropriate HM use poses health risks. Considering the widespread use of HM and the risk of adverse events, it is crucial for pregnant women to openly discuss their HM use with healthcare providers. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of pregnant women's HM use and disclosure to healthcare providers and to examine the relationship between HM disclosure and various maternal and child health (MCH) measures.
A systematic search of five databases was conducted for cross-sectional studies on HM use during pregnancy published from 2000 to 2023. Data extraction followed a standardised approach, and Stata V.16.0 was used for data analysis. Also, Spearman's correlation coefficient was calculated to examine the association between use and disclosure of HM and various MCH indicators.
This review included 111 studies across 51 countries on the use of HM among pregnant women. Our findings showed that 34.4% of women used HM during pregnancy, driven by the perception that HM is presumably safer and more natural than conventional medical therapies. However, only 27.9% of the HM users disclosed their use to healthcare providers because they considered HM as harmless and were not prompted by the healthcare providers to discuss their self-care practices. Furthermore, a significant correlation was observed between HM disclosure and improved MCH outcomes.
Inadequate communication between pregnant women and physicians on HM use highlights a deficiency in the quality of care that may be associated with unfavourable maternal outcomes. Thus, physician engagement in effective and unbiased communication about HM during antenatal care, along with evidence-based guidance on HM use, can help mitigate the potential risks associated with inappropriate HM use.
患者和医生之间缺乏关于草药（HM）使用的透明沟通，这是一个主要的公共卫生挑战，因为不当使用 HM 会带来健康风险。考虑到 HM 的广泛使用和不良事件的风险，孕妇与医疗保健提供者公开讨论其 HM 使用情况至关重要。因此，本系统评价和荟萃分析旨在估计孕妇 HM 使用和向医疗保健提供者披露的综合流行率，并研究 HM 披露与各种母婴健康（MCH）指标之间的关系。
对 2000 年至 2023 年期间发表的关于怀孕期间 HM 使用的横断面研究进行了五项数据库的系统搜索。数据提取采用标准化方法，使用 Stata V.16.0 进行数据分析。此外，还计算了斯皮尔曼相关系数，以检验 HM 使用和披露与各种 MCH 指标之间的关联。
本综述包括来自 51 个国家的 111 项关于孕妇使用 HM 的研究。我们的研究结果表明，34.4%的孕妇在怀孕期间使用 HM，这是因为她们认为 HM 比传统的医疗疗法更安全、更自然。然而，只有 27.9%的 HM 用户向医疗保健提供者披露了他们的使用情况，因为他们认为 HM 无害，并且没有被医疗保健提供者提示讨论他们的自我保健实践。此外，HM 披露与改善 MCH 结果之间存在显著相关性。
孕妇和医生之间关于 HM 使用的沟通不足突显了护理质量的缺陷，这可能与不良的产妇结局有关。因此，医生在产前保健期间就 HM 进行有效和无偏见的沟通，并提供基于证据的 HM 使用指南，可以帮助减轻不当使用 HM 带来的潜在风险。
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