hypericum and Premature-Birth

Hypericum perforatum (HP; also known as St. John's Wort) is one of the most commonly used herbal therapies in the management of depressive illness. The aim of this study was to evaluate the potential side effects of HP during pregnancy on pregnancy outcome. Using data from the Danish National Birth Cohort (DNBC), we investigated outcomes among 38 HP exposed pregnancies compared to a group of 90,128 women. Associations between HP use and gestational age, preterm birth, birth weight, malformations and Apgar scores were investigated. Preterm birth did not differ across the groups. While the prevalence of malformations in the HP exposed group was slightly higher (8.1%) than observed in the control groups (3.3%; p=0.13), this was based on only three cases and was not of any specific pattern.

Topics: Abnormalities, Drug-Induced; Adult; Antidepressive Agents; Databases, Factual; Denmark; Female; Humans; Hypericum; Phytotherapy; Plant Extracts; Plants, Medicinal; Pregnancy; Pregnancy Complications; Premature Birth; Prevalence; Risk Assessment; Risk Factors; Surveys and Questionnaires

St. John's Wort is a herbal therapy, shown to be effective in treating mild to moderate depression; a disease common in women in their childbearing years. With a significant proportion of unplanned pregnancies, exposure to St. John's Wort into pregnancy is expected to occur. The purpose of this study was to determine whether exposure to this agent in pregnancy is associated with major malformations. We prospectively collected and followed subjects taking St. John's Wort and compared them to a matched group of pregnant women taking other pharmacologic therapy for depression and a third group of healthy women, not exposed to any known teratogens. We obtained follow-up information on 54 St. John's Wort exposed pregnancies and 108 pregnancies in the two comparator groups. Our results indicated that the rates of major malformations were similar across the three groups, with 5%, 4% and 0% in the St. John's Wort, disease comparator, and health group, respectively (p=0.26), This was not different that the 3-5% risk expected in the general population. The live birth and prematurity rates were also not different among the three groups. Though further large scale studies are still needed, this first study on the effects of St. John's Wort in human pregnancy does provide some evidence of fetal safety.

Topics: Abnormalities, Drug-Induced; Adult; Antidepressive Agents; Birth Weight; Case-Control Studies; Consumer Product Safety; Depression; Female; Humans; Hypericum; Live Birth; Plant Preparations; Pregnancy; Pregnancy Complications; Premature Birth; Prospective Studies; Risk Assessment