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First Study on Safety of Echinacea During Pregnancy

The first controlled prospective study of its kind suggests that consumption of echinacea (Echinacea purpurea [L.] Moench, and E. angustifolia D.C., Asteraceae) during pregnancy is not associated with an increased risk of birth defects (Gallo et al., 2000). The study involved 412 pregnant Canadian women who contacted the Motherisk Program (a teratogen information service in Toronto) between 1996 and 1998 with concerns about the safety of consuming echinacea during pregnancy. Two hundred and six of the women had taken echinacea during pregnancy; the other 206 (the control group) had called Motherisk to ask about the safety of echinacea, but subsequently decided not to take it. The women in the control group were matched to the echinacea group by age, alcohol and cigarette use, and disease (i.e., upper respiratory tract infections during pregnancy). One hundred and twelve of the women in the echinacea group (54 percent) reported taking the herb in the first trimester of pregnancy, and 17 (8 percent) used echinacea throughout their pregnancies.

Results revealed no significant differences between the two groups in the rate of major or minor birth defects, nor were there any differences in pregnancy outcome, delivery method, maternal weight gain, gestational age, infant birth weight, or fetal distress. In the echinacea group, 6 major and 6 minor malformations occurred; of these, there were 4 major and 2 minor malformations in babies of women who took echinacea during the first trimester, the most important period in terms of initial fetal development. By comparison, the researchers observed 7 major and 7 minor malformations in control group infants. There were 13 spontaneous abortions in the echinacea group, compared with 7 in the control group; the researchers did not address the significance of this finding. They concluded, "The first prospective study suggests that gestational use of echinacea during organogenesis is not associated with an increased risk for major malformations." Approximately 60 percent of the women who took echinacea during pregnancy had consulted a health care provider before taking the herb, and 48 percent of the providers consulted (who included physicians, pharmacists, complementary health practitioners, and midwives) felt that echinacea posed no significant safety concerns. The dosages of echinacea capsules or tablets used by the women varied from 250 to 1,000 mg a day; tincture dosages varied from 5 to 30 drops a day. About 81 percent of the participants reported that echinacea was effective in improving their upper respiratory tract symptoms.

- Evelyn Leigh, Herb Research Foundation [Gallo M, Sarkar M, Au W, Pietrzak K, Comas B, Smith M, Jaeger TV, Einarson A, Koren G. Pregnancy outcome following gestational exposure to echinacea. Arch Intern Med 2000; 160: 3141-3143.]

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