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Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Research

Is oral consumption of dates (Phoenix dactylifera L. fruit) in the peripartum period effective and safe integrative care to facilitate childbirth and improve perinatal outcomes: a comprehensive revised systematic review and dose-response meta-analysis

Authors: Zahra Salajegheh, Morteza Nasiri, Mohammad Imanipour, Mina Zamanifard, Omid Sadeghi, Mohammad Ghasemi Dehcheshmeh, Masoomeh Asadi

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

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Abstract

Background

Recent reviews have reported inconclusive results regarding the usefulness of consuming dates (Phoenix dactylifera L. fruit) in the peripartum period. Hence, this updated systematic review with meta-analysis sought to investigate the efficacy and safety of this integrated intervention in facilitating childbirth and improving perinatal outcomes.

Methods

Eight data sources were searched comprehensively from their inception until April 30, 2023. Parallel-group randomized and non-randomized controlled trials published in any language were included if conducted during peripartum (i.e., third trimester of pregnancy, late pregnancy, labor, or postpartum) to assess standard care plus oral consumption of dates versus standard care alone or combined with other alternative interventions. The Cochrane Collaboration’s Risk of Bias (RoB) assessment tools and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were employed to evaluate the potential RoB and the overall quality of the evidence, respectively. Sufficient data were pooled by a random-effect approach utilizing Stata software.

Results

Of 2,460 records in the initial search, 48 studies reported in 55 publications were included. Data were insufficient for meta-analysis regarding fetal, neonatal, or infant outcomes; nonetheless, most outcomes were not substantially different between dates consumer and standard care groups. However, meta-analyses revealed that dates consumption in late pregnancy significantly shortened the length of gestation and labor, except for the second labor stage; declined the need for labor induction; accelerated spontaneity of delivery; raised cervical dilatation (CD) upon admission, Bishop score, and frequency of spontaneous vaginal delivery. The dates intake in labor also significantly reduced labor duration, except for the third labor stage, and increased CD two hours post-intervention. Moreover, the intervention during postpartum significantly boosted the breast milk quantity and reduced post-delivery hemorrhage. Likewise, dates supplementation in the third trimester of pregnancy significantly increased maternal hemoglobin levels. The overall evidence quality was also unacceptable, and RoB was high in most studies. Furthermore, the intervention’s safety was recorded only in four trials.

Conclusion

More well-designed investigations are required to robustly support consuming dates during peripartum as effective and safe integrated care.

Trial registration

PROSPERO Registration No: CRD42023399626
Appendix
Available only for authorised users
Literature
12.
go back to reference Gohari H, Rahmani R, Rahmani Bilandi R. Effect of evening primrose on cervical ripening: a systematic review study (Persian). J Mazandaran Univ Med Sci. 2020;30(191):155–65. Gohari H, Rahmani R, Rahmani Bilandi R. Effect of evening primrose on cervical ripening: a systematic review study (Persian). J Mazandaran Univ Med Sci. 2020;30(191):155–65.
17.
go back to reference Abdi F, Torabi A, Ahangar Khorasani A, Atarodi Kashani Z, Takfallah R. Effect of date on delivery stages and pregnancy outcomes from the medical, holy Quran and hadiths point of view (Persian). Quran Med. 2022;7(3):57–69. Abdi F, Torabi A, Ahangar Khorasani A, Atarodi Kashani Z, Takfallah R. Effect of date on delivery stages and pregnancy outcomes from the medical, holy Quran and hadiths point of view (Persian). Quran Med. 2022;7(3):57–69.
21.
go back to reference Al-Snafi A, Thuwaini M. Phoenix dactylifera: Traditional uses, chemical constituents, nutritional benefit and therapeutic effects. Tradit Med Res. 2023;8(4):20.CrossRef Al-Snafi A, Thuwaini M. Phoenix dactylifera: Traditional uses, chemical constituents, nutritional benefit and therapeutic effects. Tradit Med Res. 2023;8(4):20.CrossRef
22.
go back to reference Namazi Zadegan S, Ghayour-Mobarhan M, Hasheminejad SO, Shamsoddin Dayani M. [Effects of eating frankincense, dates and quince during pregnancy and lactation on the mood, mental and behavioral health of children according to the Quran, Hadith and Medical Sciences (Persian)]. Iran J Obstet Gynecol Infertil. 2018;20(11):93–105. https://doi.org/10.22038/ijogi.2018.10232.CrossRef Namazi Zadegan S, Ghayour-Mobarhan M, Hasheminejad SO, Shamsoddin Dayani M. [Effects of eating frankincense, dates and quince during pregnancy and lactation on the mood, mental and behavioral health of children according to the Quran, Hadith and Medical Sciences (Persian)]. Iran J Obstet Gynecol Infertil. 2018;20(11):93–105. https://​doi.​org/​10.​22038/​ijogi.​2018.​10232.CrossRef
23.
go back to reference Shaikh ML, Patel MF, Chaudhry AR, Mulla G, Chaudhry RA. Effect of consumption of date fruit in late pregnancy-A review in Islamic and scientific perspective. Adv J AYUSH Res. 2020;1(1):28–32. Shaikh ML, Patel MF, Chaudhry AR, Mulla G, Chaudhry RA. Effect of consumption of date fruit in late pregnancy-A review in Islamic and scientific perspective. Adv J AYUSH Res. 2020;1(1):28–32.
24.
go back to reference Hosseini Karnamy SH, Asghari Velujayi AA. Evaluation of the effects of date palm on childbirth based on the scientific interpretation of verses 26–23 of Surah Maryam (As) in the holy Quran (Persian). Relig Health. 2016;3(2):29–40. Hosseini Karnamy SH, Asghari Velujayi AA. Evaluation of the effects of date palm on childbirth based on the scientific interpretation of verses 26–23 of Surah Maryam (As) in the holy Quran (Persian). Relig Health. 2016;3(2):29–40.
25.
go back to reference Saryono M, Rahmawati E. Effects of dates fruit (Phoenix dactylifera L.) in the female reproductive process. Int J Recent Adv Multidiscip Res. 2016;3(7):1630–3. Saryono M, Rahmawati E. Effects of dates fruit (Phoenix dactylifera L.) in the female reproductive process. Int J Recent Adv Multidiscip Res. 2016;3(7):1630–3.
26.
go back to reference Mahomoodally MF, Khadaroo SK, Hosenally M, Zengin G, Rebezov M, Ali Shariati M, et al. Nutritional, medicinal and functional properties of different parts of the date palm and its fruit (Phoenix dactylifera L.) - A systematic review. Crit Rev Food Sci Nutr. 2023:Online ahead of print. https://doi.org/10.1080/10408398.2023.2191285. Mahomoodally MF, Khadaroo SK, Hosenally M, Zengin G, Rebezov M, Ali Shariati M, et al. Nutritional, medicinal and functional properties of different parts of the date palm and its fruit (Phoenix dactylifera L.) - A systematic review. Crit Rev Food Sci Nutr. 2023:Online ahead of print. https://​doi.​org/​10.​1080/​10408398.​2023.​2191285.
32.
go back to reference Azizah G, Mappaware NA, Pramono SD, Hamsah M, Karsa NS. Comparative analysis of the childbirth process in mothers (inpartu) who consuming and those who do not consuming Ajwa dates (Phoenix dactylifera L) (Indonesian). Fakumi Med J. 2023;3(2):98–105. Azizah G, Mappaware NA, Pramono SD, Hamsah M, Karsa NS. Comparative analysis of the childbirth process in mothers (inpartu) who consuming and those who do not consuming Ajwa dates (Phoenix dactylifera L) (Indonesian). Fakumi Med J. 2023;3(2):98–105.
34.
go back to reference Zaher EH, Khedr NFH, Fadel EA. Effect of eating date fruit on the progress of labor for parturient women. Int J Novel Res Healthc Nurs. 2021;8(3):188–96. Zaher EH, Khedr NFH, Fadel EA. Effect of eating date fruit on the progress of labor for parturient women. Int J Novel Res Healthc Nurs. 2021;8(3):188–96.
37.
go back to reference Jayanti ID. [Duration of first stage active phase of mother maternity who consume palm extract and sugar water (Indonesian)]. Oksitosin. 2014;1(1):13–7. Jayanti ID. [Duration of first stage active phase of mother maternity who consume palm extract and sugar water (Indonesian)]. Oksitosin. 2014;1(1):13–7.
38.
go back to reference Yadegari Z, Akbari SAA, Sheikhan Z, Nasiri M, Akhlaghi F. The effect of consumption of the date fruit on the amount and duration of the postpartum bleeding (Persian). Iran J Obstet Gynecol Infertil. 2016;18(181):20–7. Yadegari Z, Akbari SAA, Sheikhan Z, Nasiri M, Akhlaghi F. The effect of consumption of the date fruit on the amount and duration of the postpartum bleeding (Persian). Iran J Obstet Gynecol Infertil. 2016;18(181):20–7.
39.
go back to reference Kuswati K, Handayani R. Effect of dates consumption on bleeding, duration, and types of labor. J Midwifery. 2019;4(1):85–91.CrossRef Kuswati K, Handayani R. Effect of dates consumption on bleeding, duration, and types of labor. J Midwifery. 2019;4(1):85–91.CrossRef
47.
go back to reference Azizah N, Abdullah RPI, Wello EA. The effect of consumption Ajwa dates (Phoenix Dactylifera L.) on the duration of the first stage of labor. Green Med J. 2022;4(1):9–15.CrossRef Azizah N, Abdullah RPI, Wello EA. The effect of consumption Ajwa dates (Phoenix Dactylifera L.) on the duration of the first stage of labor. Green Med J. 2022;4(1):9–15.CrossRef
63.
go back to reference Fathi L, Amraei K, Yari F. The effect of date consumption on the progress of labor in nulliparous women (Persian). J Islam Iran Tradit Med. 2018;9(3):219–26. Fathi L, Amraei K, Yari F. The effect of date consumption on the progress of labor in nulliparous women (Persian). J Islam Iran Tradit Med. 2018;9(3):219–26.
65.
go back to reference Kariman N, Yousefy Jadidi M, Jam Bar Sang S, Rahbar N, Afrakhteh M, Lary H. [The effect of consumption date fruit on cervical ripening and delivery outcomes (Persian)]. Pajoohande. 2015;20(2):72–7. Kariman N, Yousefy Jadidi M, Jam Bar Sang S, Rahbar N, Afrakhteh M, Lary H. [The effect of consumption date fruit on cervical ripening and delivery outcomes (Persian)]. Pajoohande. 2015;20(2):72–7.
66.
go back to reference Yousefy Jadidi M, Jam Bar Sang SJB, Lari H. [The effect of date fruit consumption on spontaneous labor (Persian)]. J Pizhūhish dar dīn va salāmat (Research Relig Health). 2015;1(3):4–10. Yousefy Jadidi M, Jam Bar Sang SJB, Lari H. [The effect of date fruit consumption on spontaneous labor (Persian)]. J Pizhūhish dar dīn va salāmat (Research Relig Health). 2015;1(3):4–10.
78.
go back to reference Andriani R. The effect of giving date fruit at the end of pregnancy towards cervical ripening (Indonesian). Jurnal Delima Harapan. 2021;8(1):69–78.CrossRef Andriani R. The effect of giving date fruit at the end of pregnancy towards cervical ripening (Indonesian). Jurnal Delima Harapan. 2021;8(1):69–78.CrossRef
79.
go back to reference Astari RY, Dewi DY. Consumption of dates at the end of pregnancy to accelerate the first stage of labor (Indonesian). Wellness Health Mag. 2019;1(2):177–85. Astari RY, Dewi DY. Consumption of dates at the end of pregnancy to accelerate the first stage of labor (Indonesian). Wellness Health Mag. 2019;1(2):177–85.
81.
go back to reference Rahayu MA, Nugraheni G, Rahayu S. The effect of giving dried dates (tamr) starting at 37 w of pregnancy on the progress of childbirth in mothers giving birth at Maternity Hospital G Bekasi (Indonesian). HSG J. 2016;1(1):1–10. Rahayu MA, Nugraheni G, Rahayu S. The effect of giving dried dates (tamr) starting at 37 w of pregnancy on the progress of childbirth in mothers giving birth at Maternity Hospital G Bekasi (Indonesian). HSG J. 2016;1(1):1–10.
82.
go back to reference Suroso S, Paryono P. [The effect of consumption of dates juice at the end of pregnancy on the progress of the first stage of labor and the amount of bleeding during delivery in primiparas in the Working Area of the South Klaten Health Center (Indonesian)]. Interest. 2016;5(1):41–5. Suroso S, Paryono P. [The effect of consumption of dates juice at the end of pregnancy on the progress of the first stage of labor and the amount of bleeding during delivery in primiparas in the Working Area of the South Klaten Health Center (Indonesian)]. Interest. 2016;5(1):41–5.
83.
go back to reference Firdausi N, Mukhlis H. The effect of giving Sukkari dates to maternity mothers on the duration of labor (Indonesian). Wellness Health Mag. 2021;3(2):117–24. Firdausi N, Mukhlis H. The effect of giving Sukkari dates to maternity mothers on the duration of labor (Indonesian). Wellness Health Mag. 2021;3(2):117–24.
90.
go back to reference Prianti AT, Eryanti R. The effectiveness of provision of dates juice on the smooth production of breast milk for post-partum mothers at Rskdia Siti Fatimah Makassar (Indonesian). Jurnal Antara Kebidanan. 2020;3(1):11–20. Prianti AT, Eryanti R. The effectiveness of provision of dates juice on the smooth production of breast milk for post-partum mothers at Rskdia Siti Fatimah Makassar (Indonesian). Jurnal Antara Kebidanan. 2020;3(1):11–20.
91.
go back to reference Aminah S, Purwaningsih W. Differences in the effectiveness of giving dates and Katuk leaves on the flow of breast milk in breastfeeding mothers aged 0–40 days in Kediri City (Indonesian). J Public Heal Res Community Heal Dev. 2019;3(1):37–43.CrossRef Aminah S, Purwaningsih W. Differences in the effectiveness of giving dates and Katuk leaves on the flow of breast milk in breastfeeding mothers aged 0–40 days in Kediri City (Indonesian). J Public Heal Res Community Heal Dev. 2019;3(1):37–43.CrossRef
93.
go back to reference Sakka A, Salama M, Salama K. The effect of fenugreek herbal tea and palm dates on breast milk production and infant weight. J Pediatr Sci. 2014;6:e202. Sakka A, Salama M, Salama K. The effect of fenugreek herbal tea and palm dates on breast milk production and infant weight. J Pediatr Sci. 2014;6:e202.
94.
go back to reference Mojahed S, Aflatunian A, Khadem N, Dehghani Firouzabadi R, Karimi Zarchi M. An investigation into effectiveness of date (Rutab) on postpartum hemorrhage (Persian). J Shahid Sadoughi Univ Med Sci. 2012;20(2):159–66. Mojahed S, Aflatunian A, Khadem N, Dehghani Firouzabadi R, Karimi Zarchi M. An investigation into effectiveness of date (Rutab) on postpartum hemorrhage (Persian). J Shahid Sadoughi Univ Med Sci. 2012;20(2):159–66.
95.
go back to reference Khadem N, Sharaphy A, Latifnejad R, Hammod N, Ibrahimzadeh S. Comparing the efficacy of dates and oxytocin in the management of postpartum hemorrhage. Shiraz E-Med J. 2007;8(2):e93686. Khadem N, Sharaphy A, Latifnejad R, Hammod N, Ibrahimzadeh S. Comparing the efficacy of dates and oxytocin in the management of postpartum hemorrhage. Shiraz E-Med J. 2007;8(2):e93686.
96.
go back to reference Al-Mssallem MQ, Alqurashi RM, Al-Khayri JM. Bioactive compounds of date palm (Phoenix dactylifera L.). In: Murthy HN, Bapat VA, editors. Bioactive compounds in underutilized fruits and nuts. Cham: Springer International Publishing; 2020. p. 91–105. Al-Mssallem MQ, Alqurashi RM, Al-Khayri JM. Bioactive compounds of date palm (Phoenix dactylifera L.). In: Murthy HN, Bapat VA, editors. Bioactive compounds in underutilized fruits and nuts. Cham: Springer International Publishing; 2020. p. 91–105.
99.
go back to reference Indah Nurdin SS, Umar S. The effect of giving dates extract (Phoenix Dectylifera) on maternity mothers on the progress of childbirth. J Community Health Provision. 2021;1(2):29–32.CrossRef Indah Nurdin SS, Umar S. The effect of giving dates extract (Phoenix Dectylifera) on maternity mothers on the progress of childbirth. J Community Health Provision. 2021;1(2):29–32.CrossRef
100.
go back to reference Widiastuti T. Literature study of the effect of giving dates extract on the progress of active phase I labor in primipara mothers (Indonesian). Jurnal Keperawatan Karya Bhakti. 2021;7(1):99–107.CrossRef Widiastuti T. Literature study of the effect of giving dates extract on the progress of active phase I labor in primipara mothers (Indonesian). Jurnal Keperawatan Karya Bhakti. 2021;7(1):99–107.CrossRef
101.
go back to reference Siti C, Widayani W. The effect of date fruit on labor progress (Indonesian). Jurnal Kesehatan Siliwangi. 2022;2(3):762–70. Siti C, Widayani W. The effect of date fruit on labor progress (Indonesian). Jurnal Kesehatan Siliwangi. 2022;2(3):762–70.
102.
go back to reference Nasiri M, Zonoori S, Yarahmadi F, Arsanjani Shirazi M, Shekofteh Z, Sadegh O. Review on the effects of palm date consumption on safe labor: An Islamic recommendation (Persian). Clin Exc. 2017;6(1):55–65. Nasiri M, Zonoori S, Yarahmadi F, Arsanjani Shirazi M, Shekofteh Z, Sadegh O. Review on the effects of palm date consumption on safe labor: An Islamic recommendation (Persian). Clin Exc. 2017;6(1):55–65.
103.
go back to reference Rasooli T, Nasiri M, Kargarzadeh Aliabadi Z, Rajabi MR, Feizi S, Torkaman M, et al. Rosa Damascena mill for treating adults’ anxiety, depression, and stress: a systematic review and dose-response meta-analysis of randomized controlled trials. Phytother Res. 2021;35(12):6585–606. https://doi.org/10.1002/ptr.7243. Rasooli T, Nasiri M, Kargarzadeh Aliabadi Z, Rajabi MR, Feizi S, Torkaman M, et al. Rosa Damascena mill for treating adults’ anxiety, depression, and stress: a systematic review and dose-response meta-analysis of randomized controlled trials. Phytother Res. 2021;35(12):6585–606. https://​doi.​org/​10.​1002/​ptr.​7243.
104.
go back to reference Jannah SR, Widyawati MN, editors. Comparing effectiveness of palm dates and oxytocin massage in stimulating breastmilk production of postpartum mother. Proceedings of the International Conference on Applied Science and Health; 2017; Thailand. Jannah SR, Widyawati MN, editors. Comparing effectiveness of palm dates and oxytocin massage in stimulating breastmilk production of postpartum mother. Proceedings of the International Conference on Applied Science and Health; 2017; Thailand.
107.
go back to reference Rahmawati A, Wulandari RCL, Arisanti AZ, Nurrokhmah A. The effect of date juice and honey on increasing hemoglobin in pregnant women with anemia. Int J Islamic Complement Med. 2022;3(2):57–64.CrossRef Rahmawati A, Wulandari RCL, Arisanti AZ, Nurrokhmah A. The effect of date juice and honey on increasing hemoglobin in pregnant women with anemia. Int J Islamic Complement Med. 2022;3(2):57–64.CrossRef
110.
go back to reference Rock W, Rosenblat M, Borochov-Neori H, Volkova N, Judeinstein S, Elias M, et al. Effects of date (Phoenix dactylifera L., Medjool or Hallawi Variety) consumption by healthy subjects on serum glucose and lipid levels and on serum oxidative status: a pilot study. J Agric Food Chem. 2009;57(17):8010–7. https://doi.org/10.1021/jf901559a.CrossRefPubMed Rock W, Rosenblat M, Borochov-Neori H, Volkova N, Judeinstein S, Elias M, et al. Effects of date (Phoenix dactylifera L., Medjool or Hallawi Variety) consumption by healthy subjects on serum glucose and lipid levels and on serum oxidative status: a pilot study. J Agric Food Chem. 2009;57(17):8010–7. https://​doi.​org/​10.​1021/​jf901559a.CrossRefPubMed
111.
go back to reference Alalwan TA, Perna S, Mandeel QA, Abdulhadi A, Alsayyad AS, D’Antona G, et al. Effects of daily low-dose date consumption on glycemic control, lipid profile, and quality of life in adults with pre- and type 2 diabetes: a randomized controlled trial. Nutrients. 2020;12(1):217. https://doi.org/10.3390/nu12010217. Alalwan TA, Perna S, Mandeel QA, Abdulhadi A, Alsayyad AS, D’Antona G, et al. Effects of daily low-dose date consumption on glycemic control, lipid profile, and quality of life in adults with pre- and type 2 diabetes: a randomized controlled trial. Nutrients. 2020;12(1):217. https://​doi.​org/​10.​3390/​nu12010217.
Metadata
Title
Is oral consumption of dates (Phoenix dactylifera L. fruit) in the peripartum period effective and safe integrative care to facilitate childbirth and improve perinatal outcomes: a comprehensive revised systematic review and dose-response meta-analysis
Authors
Zahra Salajegheh
Morteza Nasiri
Mohammad Imanipour
Mina Zamanifard
Omid Sadeghi
Mohammad Ghasemi Dehcheshmeh
Masoomeh Asadi
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-023-06196-y

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