March of Dimes Warns of Dangers of Herbs in Pregnancy

By Suzanne Rostler
Reuters Health
Washington Post

Tuesday, December 12, 2000; 5:52 PM

NEW YORK—Many of the herbal supplements available in health food stores and pharmacies can pose serious health hazards to pregnant women, scientists warn.

Speaking at a symposium here on Tuesday, sponsored by the March of Dimes, researchers stressed that many of these herbs, taken in pill or tea forms for pregnancy-related conditions such as morning sickness and leg swelling, can cause miscarriage, cleft lip and cyclopia--a birth defect in which a baby is born with only one eye.

And a dearth of scientific research and lack of regulatory oversight has led to conflicting advice and confusion over what doses, if any, are safe, and whether products are pure or contain unlisted ingredients that may be harmful.

"It's never possible to know for sure that it's pure and doesn't contain other things that you don't want it to contain," said Dr. Michael Greene, an associate professor at Harvard Medical School in Boston, Massachusetts.

He said that as many as 40 percent of women use some type of "natural" product during their pregnancy and up to 20 percent of women use these products throughout their pregnancy. But natural does not mean the product is necessarily safe or does not contain a potentially harmful ingredient.

The herb digitalis, used to stimulate the heart, can be lethal in high doses. Likewise, the herb hellebore, used to relieve vomiting and cramps, can cause miscarriage, cleft lip and cyclopia. Tragacanth, a "natural" laxative, can cause miscarriage, Greene said.

But many women--pregnant or not--fail to tell their doctor that they are taking these products, said Dee L. Quinn, a genetic counselor in the department of obstetrics and gynecology at the University of Arizona College of Medicine. She said some women believe natural products are healthy while others withhold the information out of fear that their doctor will disapprove. In some instances, doctors simply do not think to ask whether a woman is taking any dietary supplements.

"We really don't know the magnitude of use, particularly in pregnant women," Quinn said.

She added that some drugs, such as those taken for depression, can have behavioral effects of the developing fetus that may not be apparent for many years.

The March of Dimes recommends that all women of childbearing age consume 400 micrograms of folic acid daily to lower their risk of neural tube defects, such as spina bifida, in which the spinal cord does not completely close, and anencephaly, an absence of brain and spinal cord. It is recommended that women take a daily supplement before they plan to become pregnant, since half of all pregnancies are unplanned, Quinn noted.

The flu vaccine is also recommended for all pregnant women except those who are allergic to eggs. Acetaminophen (Tylenol) can also be taken safely by pregnant women.

However, the March of Dimes recommends that women who are pregnant avoid all dietary supplements, prescription and over-the-counter medications unless recommended by their doctor.