Echinacea, a supplement thought to stimulate the immune system, is one of the most popular herbal medicines on the North American market. It is used primarily for the prevention and treatment of upper respiratory tract infections; however, little data has been available to date on its safety in pregnant women.
In the study, published in the Nov. 13 issue of the Archives of Internal Medicine, researchers followed up about 200 women who had contacted the Motherisk Program regarding the use of echinacea during pregnancy. Motherisk provides information and guidance on the potential risks of drugs, disease, and other factors on the developing fetus or infant. Some of the women had taken the supplement knowingly while others used it because they were unaware they were pregnant.
The group was compared to another group of about 200 pregnant women who did not use echinacea.
The researchers compared the rates of live births, miscarriages, and major and minor birth defects between the two groups and found no statistical differences between them in terms of infant outcomes.
"The information is quite reassuring that echinacea as a product has not been shown to pose a risk for major malformations in pregnancy and specifically during the first trimester, which is obviously a very critical time," says study author Michael Gallo, BSc. "At this point, this is the one published report available."
Gallo, a toxicologist and coordinator of the Motherisk Program, tells WebMD that while many of these women were hesitant to use prescription or over-the-counter cold remedies during their pregnancy, they had no qualms about herbal supplements. But he cautions that "natural" does not necessarily mean "safe."
Echinacea also was recommended to these women by almost half of the doctors, naturopaths, and midwives they consulted, despite the fact that very little evidence of its safety exists, Gallo says.
"It's still really up to mum to decide how comfortable she feels with this level of information," Gallo says. "We cannot without question say [echinacea is] safe. What we're saying is, based on the published data and how this herb has been used historically over the last several years, we have not seen any reason to suggest that it's harmful."
Robert Caddick, MD, an obstetrician/gynecologist at Moncton Hospital in Moncton, New Brunswick, typically does not recommend the use of herbal supplements in pregnant patients. "Do I advise people to take herbs? Not particularly. The reason I don't is because we don't know a lot about them. Whether they do any good is a hard question."
"We in the profession cannot say that herbs and plants are not any good. All we can tell our patients is there's never been any financial incentive to study these things, and therefore we cannot advise them one way or the other," says Caddick, a co-author of Healthy Beginnings: Guidelines for Care During Pregnancy and Childbirth, a document put out by the Society of Obstetricians and Gynecologists of Canada in 1998.