Safety Issues of Phytomedicines in Pregnancy and Paediatrics

In this review we discuss some aspects of herbal use among pregnant women and children, since exposure to phytomedicines is frequent in these subjects, often on a self-treatment basis. From an analysis of the literature some interesting aspects emerge: (1) herbal consumption during pregnancy ranges from 7 to 45%, depending on the geographical area; (2) the use of herbal products during pregnancy could be due to pre-existing conditions, to symptoms/problems related to the new physiological state (nausea, vomiting, etc.), to prevent miscarriage or to prepare for childbirth; (3) the important aspect of safe use should take into account that some plants are contraindicated (oxytocic and uterine-stimulating herbs, teratogenicity, effect on neonatal birth weight), may affect concurrent conditions such as gestational diabetes and pre-eclampsia and may be dangerous for the newborn (some case reports of adverse reactions are reported); (4) herbal use in children is relatively common and on the rise; (5) few data exist about the clinical evidence for effectiveness; (6) most herbal products have not been subjected to rigorous clinical trials in children and a number of case reports are available in the literature reporting side effects due to herbal consumption by newborns (through lactation), infants and children. Based on information summarized in this review, the use of herbs during pregnancy and in children remains inadequately studied as regards both efficacy and safety. However, data reported show that herbal products are not free of risk and suggest that their use should be contraindicated in pregnancy and a cautious behaviour adopted in children.