Risk of Fetal Abnormalities after Intake of Herbal Medicinal Products and Western Pharmaceutical Products in Pregnancy

Abstract

Objectives: To identify the risk of fetal abnormalities after intake of herbal medicinal products (HMPs) in pregnancy.
Methods: A retrospective review of our database (from January 1995 to December 2001) and a prospective study (from January 2002 to June 2006) were conducted in a teaching hospital to identify the pattern of HMP and western pharmaceutical product (WPP) usage and corresponding fetal outcomes. All women with a history of intake of HMP and / or WPP were referred to our prenatal diagnostic clinic for assessment and counselling. Paediatricians assessed all babies after delivery.
Results: Of 1351 women studied, 206 had taken HMPs and 1145 had taken WPPs during their index pregnancies. More women were nulliparous among those who had taken WPPs than those who had taken HMPs (63% vs 55%) [p=0.04]. There were no significant differences in the marital status, family incomes, and educational levels between the HMP and WPP groups. The number of drugs taken in the WPP (2.5) group was significantly greater than that in the HMP (1.5) group. Common reasons for intake of HMPs were flu-like symptoms, to promote health, for menstrual problems, gastrointestinal problems, and pain relief. Seven women took HMPs and 99 took WPPs for weight reduction. The number of sonographic fetal abnormalities in the HMP and WPP groups were 3 (1.5%) and 22 (1.9%), respectively. This difference was not significant. Also there were no significant differences between the two groups in the rates of silent miscarriage, and termination of pregnancy for anxiety. One woman in the HMP group and 14 women in the WPP group requested termination of pregnancy.
Conclusion: After the intake of the HMPs or WPPs taken by our patient cohort, the risk of fetal abnormalities was not higher than that of the general unexposed population. There was also no demonstrable increase in the risk of fetal growth restriction or silent miscarriage in either group.