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eCAM Advance Access published online on May 7, 2008
eCAM, doi:10.1093/ecam/nen031
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© 2008 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Use, Attitudes and Knowledge of Complementary and Alternative Drugs (CADs) Among Pregnant Women: a Preliminary Survey in Tuscany

Francesco Lapi1,2, Alfredo Vannacci1,2, Martina Moschini1,2, Fabrizio Cipollini3, Maria Morsuillo1,2, Eugenia Gallo1,2, Grazia Banchelli1,2, Enrica Cecchi1,2,4, Marina Di Pirro1,2, Maria Grazia Giovannini2, Maria Teresa Cariglia2, Luigi Gori5, Fabio Firenzuoli5 and Alessandro Mugelli1,2

1Tuscan Regional Centre of Pharmacovigilance, 2Department of Preclinical and Clinical Pharmacology, Florence, 3Department of Statistical Science, University of Florence, 4Department of Emergency Medicine, ASL 4 Hospital, Prato and 5Centre of Natural Medicine, ASL 11 Hospital, Empoli, Italy

To explore pregnant women's use, attitudes, knowledge and beliefs of complementary and alternative drugs (CADs) defined as products manufactured from herbs or with a natural origin. A preliminary survey was conducted among 172 pregnant women in their third trimester of pregnancy, consecutively recruited in two obstetrical settings; 15 women were randomly selected to compute a test-to-retest analysis. Response rate was 87.2%. Test-to-retest analysis showed a questionnaire's reproducibility exceeding a K-value of 0.7 for all items. Mean age was 32.4 ± 0.4 years; most women were nulliparae (62.7%). The majority of subjects (68%) declared to have used one or more CADs during their lifetime; 48% of pregnant women reported taking at least one CAD previously and during the current pregnancy. Women's habitual use of CADs meant they were at higher risk of taking CADs also during pregnancy (adjusted odds ratio = 10.8; 95% confidence interval: 4.7–25.0). Moreover, 59.1% of the subjects were unable to correctly identify the type of CADs they were using. The majority of women resorted to gynecologists as the primary information source for CADs during pregnancy, while they mainly referred to herbalists when not pregnant. Habitual use of CADs seems to be a strong predictor for their ingestion also during pregnancy; in addition most subjects were unable to correctly identify the products they were taking. In the light of the scanty data concerning the safety of CADs during pregnancy, these preliminary results confirm the need to investigate thoroughly the situation of pregnant women and CADs consumption.

Keywords: CAM – herbal products – natural origin – pregnancy

For reprints and all correspondence: Francesco Lapi, Tuscan Regional Centre of Pharmacovigilance, Department of Pharmacology, University of Florence, Viale G. Pieraccini n°6 50139, Florence, Italy. Tel: +390554271255; Fax: +390554271255; E-mail: francesco.lapi{at}unifi.it

Received December 6, 2007; accepted April 4, 2008


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