Exploring the effect of traditional medicine ingestion in the peri-pqrtum period on maternal and foetal outcomes: a prospective cohort study

Tochie J1, Dohbit J2, Mbia Koudo M2, Foumane P3

Research Type

Clinical

Abstract Category

Prevention and Public Health

Abstract 811
Non Discussion Abstract
Scientific Non Discussion Abstract Session 37
Prospective Study Prevention Outcomes Research Methods Imaging Pharmacology
1.Ubiversity of Yaounde I, 2.University of Yaounde I, 3.University of Yaoundé 1
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Abstract

Hypothesis / aims of study
Hypothesis:Traditional medicine (TM) is the sum of all knowledge, skills and practices that are based on the theories, beliefs and experiences of health preservation, specific to different cultures, whether explainable or not, which are used in health preservation, as well as in the prevention, diagnosis, improvement or treatment of physical or mental illness [1]. In TM, drugs of the traditional pharmacopoeia, called "herbal medicines" are used. As high as 80% of pregnant African women in Africa and the diaspora use TM to treat pregnancy related symptoms [2]. Peripartum ingestion of traditional medicine may be deleterious for the preganant mother and newborn.  
Aim : we sought to determine the effects of traditional medicine ingestions during the
peri-partum period on the maternal and foetal outcomes.
Study design, materials and methods
we carried out a prospective cohort study was conducted from January to April 2016 in two referral maternity departments of a sub-Sahara African country in central Africa. We consecutively enrolled all consenting paturients with gestational age above 28 weeks. We divided them into two groups; exposed and unexposed. The exposure studied was ingestion of traditional medicine within 72 hours prior to delivery. Variables studied were socio-demographic characteristics, type and frequency of traditional medicine ingested and details of labour.
Results
We enrolled a total of 603 paturients of whom 147 in the exposed group and
456 in the non-exposed group. The most frequently used traditional medicine were honey and
Triumfetta pentandra A. Ingestion of traditional medicine in the peri-paritum period was associated with intra-partum vaginal bleeding, dystocic labour, tachysystole and uterine atony. No adverse neonatal outcome was observed.
Interpretation of results
Overall, we found that about one parturient out of every four uses traditional medicine during labour. Some socio-demographic characteristics such as liberal union and tertiary level of education predispose pregnant women to traditional medicine ingestion during labour. Traditional medicine oral intake during the peri-partum period was associated with vaginal bleeding prior to consultation, tachysytole, dystocic delivery and uterine atony. The findings from the current study should be interpreted within the context of its limitations. These include the inability of 12.3% parturients to precisely identity what type of traditional medicine was taken prior to delivery or during labour. Furthermore, traditional medicine oral intake during labour had no effect on foetal outcome perharbs due to the fact that the study was grossly underpowered to detect any significant differences in foetal outcomes such as stillbirth, hypoxia-ischemia, cerebral palsy, that are extremely rare events. Also, as the study population was drawn from only two referral maternities of sub-Sahara African, preventing the generalizability of the findings herein. However, based on a large sample (n=603) of well followed-up parturients, we have used robust statistical methods to contribute data of on the current scarcity of evidence on the maternal and foetal outcomes of peri-partum traditional medicine use in the tropics. These findings findings could help guide the direction of future research into the safety and potential benefits of peripartum traditional medicine use, as well as serving as a preliminary reference for counselling pregnant women and obstetricians
Concluding message
The findings of the present study could help guide the direction of future research into the safety and potential benefits of peri-partum traditional medicine use, as well as serving as a preliminary reference for counselling.
References
  1. World Health Organization: Factsheet 134: traditional medicine. 2013, Geneva: WorldHealth Organization. http://www.who.int/mediacentre/factsheets/2003/fs134/en/.
  2. Shewamene Z, Dune T, and Smith CA. The use of traditional medicine in maternity care among African women in Africa and the diaspora: a systematic review. BMC Complementary and Alternative Medicine 2017;17:382.
Disclosures
Funding none Clinical Trial No Subjects Human Ethics Committee The study was approved by the Institutional Review Board of the Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon under the ethical clearance No 192/CIERSH/DM/2016. Administrative authorizations were equally obtained from the administration of both hospitals involved prior to the beginning of the study. Wrtten consent to participate was obtained from all participants prior to their enrolment into the study. Helsinki Yes Informed Consent Yes