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Safety of ginger use in pregnancy: results from a large population-based cohort study

  • Pharmacoepidemiology and Prescription
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Abstract

Purpose

The objective of the study was to examine the safety of ginger use during pregnancy on congenital malformations and selected pregnancy outcomes.

Methods

The Norwegian Mother and Child Cohort study, a large population-based cohort, provided the data used in this study. Our study population consisted of 68,522 women. Data on ginger use and socio-demographic factors were retrieved from three self-administered questionnaires completed by the women during weeks 17 and 30 of the pregnancy and when their child was 6 months old. Data on pregnancy outcomes were provided by the Medical Birth Registry of Norway.

Results

Among the 68,522 women in the study, 1,020 (1.5 %) women reported using ginger during pregnancy. The use of ginger during pregnancy was not associated with any increased risk of congenital malformations. No increased risk for stillbirth/perinatal death, preterm birth, low birth weight, or low Apgar score was detected for the women exposed to ginger during pregnancy compared to women who had not been exposed.

Conclusion

Use of ginger during pregnancy does not seem to increase the risk of congenital malformations, stillbirth/perinatal death, preterm birth, low birth weight, or low Apgar score. This finding is clinically important for health care professionals giving advice to pregnant women with NPV.

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References

  1. Blumenthal M, Goldberg A, Brinkmann J (Eds.) (2000) Herbal Medicine. Expanded Comission E Monographs. Integrative Medicine, Newton

  2. Natural medicines comprehensive database (2012) Ginger monograph. Natural medicines comprehensive database. http://naturaldatabase.therapeuticresearch.com/home.aspx?cs=&s=ND. Accessed 16 March 2012

  3. Lumb AB (1993) Mechanism of antiemetic effect of ginger. Anaesth 48:1118

    Article  CAS  Google Scholar 

  4. Pertz HH, Lehmann J, Roth-Ehrang R, Elz S (2011) Effects of Ginger Constituents on the Gastrointestinal Tract: role of Cholinergic M(3) and Serotonergic 5-HT(3) and 5-HT(4) Receptors. Planta Med 77:973–978. doi:10.1055/s-0030-1270747

    Article  PubMed  CAS  Google Scholar 

  5. Adams J, Lui CW, Sibbritt D, Broom A, Wardle J, Homer C, Beck S (2009) Women's use of complementary and alternative medicine during pregnancy: a critical review of the literature. Birth 36:237–245. doi:10.1111/j.1523-536X.2009.00328.x

    Article  PubMed  Google Scholar 

  6. Forster DA, Denning A, Wills G, Bolger M, McCarthy E (2006) Herbal medicine use during pregnancy in a group of Australian women. BMC Pregnancy Childbirth 6:21. doi:10.1186/1471-2393-6-21

    Article  PubMed  Google Scholar 

  7. Holst L, Wright D, Haavik S, Nordeng H (2009) The use and the user of herbal remedies during pregnancy. J Altern Complement Med 15:787–792. doi:10.1089/acm.2008.0467

    Article  PubMed  Google Scholar 

  8. Nordeng H, Havnen GC (2005) Impact of socio-demographic factors, knowledge and attitude on the use of herbal drugs in pregnancy. Acta Obstet Gynecol Scand 84:26–33. doi:10.1111/j.0001-6349.2005.00648.x

    PubMed  Google Scholar 

  9. Nordeng H, Bayne K, Havnen GC, Paulsen BS (2011) Use of herbal drugs during pregnancy among 600 Norwegian women in relation to concurrent use of conventional drugs and pregnancy outcome. Complement Ther Clin Pract 17:147–151. doi:10.1016/j.ctcp. 2010.09.002

    Article  PubMed  Google Scholar 

  10. Matthews A, Dowswell T, Haas DM, Doyle M, O'Mathuna DP (2010) Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 9:CD007575. doi:10.1002/14651858.CD007575.pub2

    PubMed  Google Scholar 

  11. Mazzotta P, Stewart DE, Koren G, Magee LA (2001) Factors associated with elective termination of pregnancy among Canadian and American women with nausea and vomiting of pregnancy. J Psychosom Obstet Gynaecol 22:7–12

    Article  PubMed  CAS  Google Scholar 

  12. Vutyavanich T, Kraisarin T, Ruangsri R (2001) Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 97:577–582. doi:10.1016/S0029-7844(00)01228-X

    Article  PubMed  CAS  Google Scholar 

  13. Keating A, Chez RA (2002) Ginger syrup as an antiemetic in early pregnancy. Altern Ther Health Med 8:89–91

    PubMed  Google Scholar 

  14. Sripramote M, Lekhyananda N (2003) A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc Thai 86:846–853

    PubMed  Google Scholar 

  15. Smith C, Crowther C, Willson K, Hotham N, McMillian V (2004) A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 103:639–645. doi:10.1097/01.AOG.0000118307.19798.ec

    Article  PubMed  CAS  Google Scholar 

  16. Willetts KE, Ekangaki A, Eden JA (2003) Effect of a ginger extract on pregnancy-induced nausea: a randomised controlled trial. Aust N Z J Obstet Gynaecol 43:139–144

    Article  PubMed  Google Scholar 

  17. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U (1991) Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 38:19–24

    Article  PubMed  CAS  Google Scholar 

  18. Ensiyeh J, Sakineh MA (2008) Comparing ginger and vitamin B6 for the treatment of nausea and vomiting in pregnancy: a randomised controlled trial. Midwifery. doi: 10.1016/j.midw.2007.10.013

  19. Pongrojpaw D, Somprasit C, Chanthasenanont A (2007) A randomized comparison of ginger and dimenhydrinate in the treatment of nausea and vomiting in pregnancy. J Med Assoc Thai 90:1703–1709

    PubMed  Google Scholar 

  20. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B (2007) Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 90:15–20

    PubMed  Google Scholar 

  21. Ozgoli G, Goli M, Simbar M (2009) Effects of ginger capsules on pregnancy, nausea, and vomiting. J Altern Complement Med 15:243–246. doi:10.1089/acm.2008.0406

    Article  PubMed  Google Scholar 

  22. Goldstein L, Berkovitch M (2007) Antiemetics. In: Schaefer C, Peters P, Miller R (eds) Drugs during pregnancy and lactation, 2nd edn. Academic Press, London, pp 82–83

  23. Mills E, Dugoua JJ, Perri D, Koren G (2006) Herbal Medicines in Pregnancy and Lactation. An evidence-Based Approached. Taylor & Francis Group, London and New York

    Google Scholar 

  24. Briggs GG, Freeman RK, Yaffe SJ (2008) Drugs in Pregnancy and Lactation,8th edn. Lippinncott Williams & Wilkins, Philadelphia

    Google Scholar 

  25. Tiran D (2012) Ginger to reduce nausea and vomiting during pregnancy: Evidence of effectiveness is not the same as proof of safety. Complement Ther Clin Pract 18:22–25. doi:10.1016/j.ctcp. 2011.08.007

    Article  PubMed  Google Scholar 

  26. Westfall RE (2004) Use of anti-emetic herbs in pregnancy: women's choices, and the question of safety and efficacy. Complement Ther Nurs Midwifery 10:30–36. doi:10.1016/S1353-6117(03)00057-X

    Article  PubMed  Google Scholar 

  27. Srivastava KC (1984) Effects of Aqueous Extracts of Onion, Garlic and Ginger on Platelet-Aggregation and Metabolism of Arachidonic-Acid in the Blood Vascular System - Invitro Study. Prosta Leukotr Med 13:227–235

    Article  Google Scholar 

  28. Bordia A, Verma SK, Srivastava KC (1997) Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids 56:379–384

    Article  PubMed  CAS  Google Scholar 

  29. Jiang X, Williams KM, Liauw WS, Ammit AJ, Roufogalis BD, Duke CC, Day RO, McLachlan AJ (2005) Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 59:425–432. doi:10.1111/j.1365-2125.2005.02322.x

    Article  PubMed  CAS  Google Scholar 

  30. Srivastava KC (1989) Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukotrienes Essent Fatty Acids 35:183–185

    Article  CAS  Google Scholar 

  31. Backon J (1991) Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 42:163–164

    Article  PubMed  CAS  Google Scholar 

  32. Portnoi G, Chng LA, Karimi-Tabesh L, Koren G, Tan MP, Einarson A (2003) Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 189:1374–1377. doi:10.1067/S0002-9378(03)00649-5

    Article  PubMed  CAS  Google Scholar 

  33. Norwegian Institute of Public Health (2010) The Norwegian Mother and Child Cohort Study. Norwegian Institute of Public Health. http://www.fhi.no/eway/default.aspx?pid=238&trg=MainArea_5811&MainArea_5811=5903:0:15,4329:1:0:0:::0:0. Accessed 02 February 2012

  34. Magnus P, Irgens LM, Haug K, Nystad W, Skjaerven R, Stoltenberg C (2006) Cohort profile: the Norwegian Mother and Child Cohort Study (MoBa). Int J Epidemiol 35:1146–1150. doi:10.1093/ije/dyl170

    Article  PubMed  Google Scholar 

  35. Norwegian Institute of Public Health The Nowegian Mother and Child Cohort Study. Questionnaire 1. Norwegian Institute of Public Health. http://www.fhi.no/dokumenter/1f32a49514.pdf. Accessed 01 March 2012

  36. Norwegian Institute of Public Health The Nowegian Mother and Child Cohort Study. Questionnaire 3. Norwegian Institute of Public Health. http://www.fhi.no/dokumenter/7b6b32b0cd.pdf. Accessed 01 March 2012

  37. Norwegian Institute of Public Health The Nowegian Mother and Child Cohort Study. Questionnaire 4. Norwegian Institute of Public Health. http://www.fhi.no/dokumenter/9ecca1c459.pdf. Accessed 01 March 2012

  38. Irgens LM (2000) The Medical Birth Registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand 79:435–439

    Article  PubMed  CAS  Google Scholar 

  39. Norwegian Institute of Public Health (2012) Medical Birth Registry of Norway. Norwegian Institute of Public Health. http://www.fhi.no/eway/default.aspx?pid=238&trg=MainArea_5811&MainArea_5811=5895:0:15,3320:1:0:0:::0:0&MainLeft_5895=5825:73560::1:5896:4:::0:0. Accessed 27 February 2012

  40. World Health Organization (2010) International statistical classification of disease and related health problems, 10th revision. World Health Organization. http://apps.who.int/classifications/icd10/browse/2010/en. Accessed 27 February 2012

  41. Norwegian Institute of Public Health (2011) Definisjonsrapporter for variabler i Medisinsk fødselsregister (in Norwegian) In English: Definition report for variables in the Medical Birth Registry of Norway. Norwegian Institute of Public Health. http://www.fhi.no/dokumenter/8105c63e8e.pdf. Accessed 01 March 2012

  42. Rothman KJ, Greenland S, Lash TL (2008) Modern Epidemiology, 3rd edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  43. DSS Research (2012) Researcher's Tool Kit. Statistical Power Calculator. Two Sample Tests Using Percentage Values. DSS Research. http://www.dssresearch.com/toolkit/spcalc/power_p2.asp. Accessed 29 February 2012

  44. Moussally K, Oraichi D, Berard A (2009) Herbal products use during pregnancy: prevalence and predictors. Pharmacoepidemiol Drug Saf 18:454–461. doi:10.1002/pds.1731

    Article  PubMed  Google Scholar 

  45. Refuerzo JS, Blackwell SC, Sokol RJ, Lajeunesse L, Firchau K, Kruger M, Sorokin Y (2005) Use of over-the-counter medications and herbal remedies in pregnancy. Am J Perinatol 22:321–324. doi:10.1055/s-2005-873235

    Article  PubMed  Google Scholar 

  46. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC (1998) Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA 280:1569–1575. doi:10.1001/jama.280.18.1569

    Article  PubMed  CAS  Google Scholar 

  47. Tindle HA, Davis RB, Phillips RS, Eisenberg DM (2005) Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med 11:42–49

    PubMed  Google Scholar 

  48. Hanssen B, Grimsgaard S, Launso L, Fonnebo V, Falkenberg T, Rasmussen NK (2005) Use of complementary and alternative medicine in the Scandinavian countries. Scand J Prim Health Care 23:57–62. doi:10.1080/02813430510018419

    Article  PubMed  Google Scholar 

  49. Melve KK, Lie RT, Skjaerven R, Van Der Hagen CB, Gradek GA, Jonsrud C, Braathen GJ, Irgens LM (2008) Registration of Down syndrome in the Medical Birth Registry of Norway: validity and time trends. Acta Obstet Gynecol Scand 87:824–830. doi:10.1080/00016340802217184

    Article  PubMed  Google Scholar 

  50. Kubon C, Sivertsen A, Vindenes HA, Abyholm F, Wilcox A, Lie RT (2007) Completeness of registration of oral clefts in a medical birth registry: a population-based study. Acta Obstet Gynecol Scand 86:1453–1457. doi:10.1080/08037050701645090

    Article  PubMed  Google Scholar 

  51. Nilsen RM, Vollset SE, Gjessing HK, Skjaerven R, Melve KK, Schreuder P, Alsaker ER, Haug K, Daltveit AK, Magnus P (2009) Self-selection and bias in a large prospective pregnancy cohort in Norway. Paediatr Perinat Epidemiol 23:597–608. doi:10.1111/j.1365-3016.2009.01062.x

    Article  PubMed  Google Scholar 

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Acknowledgments

The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, NIH/NIEHS (contract no NO-ES-75558), NIH/NINDS (grant no.1 UO1 NS 047537-01), and the Norwegian Research Council/FUGE (grant no. 151918/S10). We are grateful to all of the participants and their families for taking part in this study. We thank Gro C Havnen and Ingebjørg Sandøy Rødahl for their help identifying and classifying the herbal products.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Public Health and Primary Health Care and Centre of Pharmacy, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway

    Kristine Heitmann & Lone Holst

  2. Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway

    Hedvig Nordeng

  3. Division of Mental Health, Norwegian Institute of Public Heath, Bergen, Norway

    Hedvig Nordeng

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  1. Kristine Heitmann
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  2. Hedvig Nordeng
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  3. Lone Holst
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Correspondence to Kristine Heitmann.

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Heitmann, K., Nordeng, H. & Holst, L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 69, 269–277 (2013). https://doi.org/10.1007/s00228-012-1331-5

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