Ingestion of herbal medication during pregnancy and adverse perinatal outcomes

Background. Pregnant women in South Africa (SA) traditionally use herbal medicines even though the potential risk or benefit is not fully elucidated.  Objectives. To determine the prevalence of the use of herbal medicines in pregnant women in our setting, as well as explore the reasons for use.  Methods. This cross-sectional study was conducted at King Edward VIII Hospital, from 1 September 2014 to 31 December 2014. Women were interviewed using a structured questionnaire during the post-delivery period, irrespective of outcome. The questionnaires enquired about women’s demographic data, social and previous obstetric history and herbal medication use during current pregnancy.  Results. Two hundred and ninety-nine women were interviewed. The prevalence of herbal medication use was 33.7% ( n =101), mainly via the oral route. Fifty-eight (57.4%) of these women used herbal medication throughout their pregnancy. Reasons given for herbal ingestion included general well-being, or to make labour easier or come sooner. There was a high rate of caesarean delivery among pregnant women who used herbal medication compared with those who did not (79.2% v. 52.8%; p =0.001). One hundred and eighteen women had meconium-stained liquor; 59% of the herbal medication users compared with 29.6% of the non-users ( p <0.001) comprised this group.The perinatal mortality rate was also higher among users ( p <0.04). There were no maternal deaths.  Conclusion. Herbal medicine was used by a third of black South African pregnant women in this study and was associated with significant adverse obstetric and perinatal outcomes.