Chao-Hua Chuang

Chinese herbal medicine use in Taiwan during pregnancy and the postpartum period: A population-based cohort study

BACKGROUND Using Chinese herbal medicines during pregnancy and postpartum is common in the Chinese community. OBJECTIVE The purpose of this current study is to explore the use of Chinese herbal medicines by women during pregnancy and postpartum in Taiwan. DESIGN It is an on-going prospective longitudinal study design. SETTING AND PARTICIPANTS We used multistage stratified systematic sampling to recruit 24,200 pairs, postpartum women and newborns, from the Taiwan national birth register in 2005. Subjects underwent a home interview 6 months after their deliveries between June 2005 and July 2006. A structured questionnaire was successfully administered to 87.8% of the sampled population. RESULTS At least one Chinese herbal medicine was used by 33.6% and 87.7% of the interviewed subjects during pregnancy and the postpartum period, respectively. An-Tai-Yin, Pearl powder, and Huanglian were the most commonly used during pregnancy, while Shen-Hua-Tang and Suz-Wu-Tang were the most commonly used by postpartum women. Pregnant women aged 20-34, with high education, threatened abortion, chronic disease, and primipara appeared to use more Chinese herbal medicines than others in the sample. Postpartum women with high education, primipara, normal spontaneous delivery, and breastfeeding were found to use more Chinese herbal medicines; but women with pregnancy-related illness used less. CONCLUSIONS Chinese herbal medicines are frequently used by women during pregnancy and the postpartum period in Taiwan and those with high education and primipara used more such herbs. Due to limited safety information on these herbs, we would advise caution regarding their use either during pregnancy or postpartum breastfeeding period. Moreover, it is important for nurses/midwifes enquiring about such habits, and providing the adequate education to women during prenatal and postpartum care to prevent potential side effects.

Herbal medicines used during the first trimester and major congenital malformations : An analysis of data from a pregnancy cohort study

AbstractBackground: Major congenital malformations place a considerable burden on the affected child, the family and society. Any kind of medicine used during pregnancy might have a harmful impact; therefore, such practice has raised concerns. The objective of the current study was to explore the relationship between the use of herbal medicines by pregnant women during the first trimester of pregnancy and the risk of major congenital malformation in their live born infants. Methods: This was a cross-sectional analysis of data from a prospective pregnancy cohort, which was established between 1984 and 1987. To assemble the cohort, pregnant women of ≥26 weeks of gestation who came to the Taipei Municipal Maternal and Child Hospital in Taiwan for prenatal care were enrolled in the study and interviewed using a structured questionnaire. Detailed information, including herbal medicine use during different periods of pregnancy, was obtained during the interview. Past medical history, current obstetric data and details on conventional medicines used during pregnancy were abstracted from medical records. Data on birth weight, gestational duration and characteristics of live born infants were gathered from the Taiwan national birth register. Congenital malformation information was obtained from multiple sources: the newborn examination record (1984–7); the national death register (1984–2003); and Taiwan National Health Insurance data (1996–2000). Multiple logistic regression was used to estimate the odds ratio [OR] of major congenital malformation by herbal medicines used during the first trimester. Results: A total of 14 551 live births were analysed. After adjustment for confounding factors, taking huanglian during the first trimester of pregnancy was found to be associated with increased risk of congenital malformations of the nervous system (adjusted OR 8.62, 95% CI 2.54, 29.24). An-Tai-Yin was associated with an increased risk of congenital malformations of the musculoskeletal and connective tissues (adjusted OR 1.61, 95% CI 1.10, 2.36) and the eye (adjusted OR 7.30, 95% CI 1.47, 36.18). Conclusion: We found evidence for a possible link between the use of specific herbal medicines during the first trimester of pregnancy and increased risks of specific groups of congenital malformations. We could not investigate whether the adverse effects were related to direct toxicity from the herbal medicines, or were from misuse, contamination or uncontrolled confounding. Nonetheless, we would advise caution regarding use of herbal medicines during pregnancy, and we suggest that further investigation of these findings is warranted.

Maternal psychosocial factors around delivery on development of 2-year-old children: A prospective cohort study.

Aim:  To explore whether maternal psychosocial factors around delivery are related to development of 2‐year‐old children.

Herbal medicines during pregnancy and childhood cancers: an analysis of data from a pregnancy cohort study

To the Editor Pregnant women using herbs is common in Taiwan and mainland China, but relatively little is known about the safety of taking herbal medicines during pregnancy. Our previous study showed a possible link between the use of specific herbal medicines during the first trimester of pregnancy and an increased risk of specific congenital malformations. Thus, this analysis was conducted to explore the relationship between herbal

Prevalence and related factors of Chinese herbal medicine use in pregnant women of Taipei, 1985-1987

Objectives: The use of herbal medicines during pregnancy is becoming fashionable. The purpose of this study is to explore the prevalence and related factors of pregnant women using Chinese herbal medicines in Taipei. Methods: During 1985-87, a total of 10,756 pregnant women with 26 or more weeks of gestation who came to the Taipei Municipal Maternal and Child Hospital for prenatal care, were interviewed by trained interviewers using structured questionnaires to obtain detailed information. Multiple logistic regressions were used to estimate odds ratios of the dichotomous outcomes such as Chinese herbal medicines, medicines and supplements during different time periods. Results: The use of at least one herbal medicine was 6.9% before pregnancy and 42.3% during pregnancy. Before pregnancy, women used significantly more Chinese herbal medicines associated with lower family incomes, primipara, gynecological diseases, and irregular cycles of menstruation. During pregnancy, pregnant women with characteristics of lower education, a non-professional job, previous spontaneous or induced abortion or stillbirth, and women carried HBsAg virus tended to use Chinese herbal medicines. Conclusions: This mid-1980s survey showed that Chinese herbal medicines were frequently used before and during pregnancy in Taipei women, especially among those with low socio-economic levels. It deserves future studies to clarify their potential health effects on fetuses and enquire about such habits during prenatal care.

Maternal psychosocial factors around delivery, and the behavior of 2-year-old children

Background:  The objectives of the present study were to explore whether maternal psychosocial factors, mental health and work stress around delivery, are related to the behavior of 2‐year‐old children.