Use and safety of Korean herbal medicine during pregnancy: A Korean medicine literature review

IntroductionKorean herbal medicine (KHM) is widely used as a therapeutic modality during pregnancy in Korea. The purpose of this review is to identify use and adverse events (AEs) associated with KHM during pregnancy in Korean medicine literature.MethodsWe searched Pubmed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and five Korean databases to identify relevant studies published before January 2015. Studies were included regardless of their design if they reported original data and involved KHM for any conditions in pregnant women. For safety problems, we also excluded studies if there was no information about maternal and fetal outcomes.ResultsFifty-two studies were included in this review. The most frequently reported indication for KHM was hyperemesis gravidarum (26.3%). Anjeonicheon-tang and Atractylodes Rhizome White were the most commonly used in KHM prescriptions and as single herbs during pregnancy. Some studies reported mild or unassessable AEs like diarrhea, pruritis, and preterm birth. Severe AEs were all considered unlikely to have been caused by KHM.ConclusionsHyperemesis gravidarum and maintaining pregnancy accounted for more than two-thirds of clinical indications for KHM during pregnancy in Korean medicine literature. Few studies reported on mild AEs associated with KHM, but due to a lack of large prospective surveys, this finding is not conclusive. Prospective studies with a larger sample size are needed to confirm the safety of KHM during pregnancy.