2020 Nutrients

Ginger has been effective in a majority of studies, including those that examined the alleviation of nausea and vomiting of pregnancy, digestive function, improvement in the expression level of markers for colorectal cancer risk, and anti-inflammatory functions.

Ginger is a natural spice that is used in diverse regions to add a pungent flavor to food. Furthermore, ginger has been used as an herbal medicine for common health problems. This systematic review is the first study that has exclusively collected RCTs regarding the efficiency of ginger in several human health conditions. The clinical effects of ginger have been introduced as six subsections: nausea and vomiting, gastrointestinal function, pain, inflammation, metabolic syndromes, and other symptoms. Reportedly, ginger has been effective in a majority of studies, including those that examined the alleviation of nausea and vomiting of pregnancy, digestive function, improvement in the expression level of markers for colorectal cancer risk, and anti-inflammatory functions. Several other functions have also been regarded as beneficial in trials, with some confronting results. However, a few drawbacks regarding the quality of the trials, inconsistent evaluation systems or parameters, and the generally small size of the studies need to be noted. Therefore, systematically designed research with detailed descriptions of methodology and a sufficient pool of participants is necessary for future clinical trials to address the functional characteristics of ginger.

Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials Anh NH, Kim SJ, Long NP, Min JE, Yoon YC, Lee EG, Kim M, Kim TJ, Yang YY, Son EY, Yoon SJ, Diem NC, Kim HM, Kwon SW.

2020 BioMed Research International

Endometriosis and Adenomyosis can have impact on miscarriage risk in pregnancy.

The study analyzed 39 publications involving 697,984 women to assess the impact of endometriosis (EMS) and adenomyosis (AD) on miscarriage risk. Women with EMS showed increased miscarriage risk in spontaneous conception (SC), but similar risk in assisted reproductive technology (ART) compared to tubal infertility. AD was associated with higher miscarriage risk in ART. Sensitivity analyses supported these conclusions. EMS staging did not significantly alter miscarriage risk. Early-stage EMS showed higher early abortion risk. No significant associations were found between EMS and low birthweight, placental abruption, intrauterine growth restriction, or preeclampsia. EMS correlated with higher odds of antepartum hemorrhage, postpartum hemorrhage, preterm birth, placenta praevia, and stillbirth. SUP and DIE were linked to increased miscarriage risk, while OMA showed no significant association. The findings suggest the need for closer monitoring and follow-up for pregnant women with EMS or AD, particularly in early pregnancy. Standardized recording of EMS types, stages, and miscarriage timing is recommended for future studies.

Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis Yangxue Huang, Xianhong Zhao, Yiyuan Chen, Jie Wang, Weilin Zheng, Lixing Cao

2020 Complementary Therapies in Medicine

Clinical trials categorize botanical parts of date palm as being most effective in eight different areas such as obstetrics, oncology, and endocrinology.

In the study, a comprehensive review was conducted on all types of clinical trials (including randomized, pilot, quasi-experimental, cross-over, and non-randomized) assessing the clinical impacts of date palm for the period between 2000 to August 2019. These trials were sourced from both English and Persian language papers. The methodological quality of these trials was scrutinized based on the risk of bias assessment laid out by the Cochrane handbook of systematic reviews and subsequently, results were reported via the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

The study saw twenty-six research works fitting the criteria set for inclusion. These studies spanned across eight categories based on the varied botanical derivatives of the date palm. These categories consisted of fields like obstetrics, gynecology, oncology, dermatology, hematology, gastroenterology, endocrinology, metabolism, and infertility. However, there were concerns raised regarding existing biases in trial conduction, with about 80% of the studies indicating performance and detection bias, roughly half indicating selection bias, and about 20% indicating attrition and reporting bias. Regardless, these clinical trials provide useful insights into the possible health benefits of various date palm components.

Clinical effects of date palm (Phoenix dactylifera L.): A systematic review on clinical trials Bagherzadeh karimi A, Elmi A, Zargaran A, Mirghafourvand M, Fazljou SMB, araj-Khodaei M, Baghervand Navid R

2019 Women and Birth

Aromatherapy significantly reduces labor pain and duration without impacting emergency caesarean section, membrane rupture, and the onset of spontaneous labor.

Researchers undertook a meta-analysis of randomized controlled trials for determining the efficacy of aromatherapy in mitigating labor pain and reducing its duration. Various academic and scientific databases such as PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Clinicaltrials.gov were employed to find relevant trials. A total of 17 trials involving low-risk laboring women were identified and included in the meta-analysis.

Observations from the meta-analysis revealed that aromatherapy effectively alleviated labor pain during the transition phase and reduced the periods of active phase and third stage labor. Additionally, a trend of decreasing duration was noticed during the second stage. Notably, aromatherapy did not have any marked effects on emergency caesarean sections, membrane ruptures, or the initiation of spontaneous labor, indicating its general safety for expectant mothers. However, the diversity of outcomes across different trials was noted.

Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials Chen SF, Wang CH, Chan PT, Chiang HW, Hu TM, Tam KW, Loh EW

2018 Acupuncture in Medicine

Acupuncture appears to be effective for postpartum depression with respect to certain outcomes.

Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group. Moreover, acupuncture significantly increased oestradiol levels compared with the control group. Regarding the Hamilton Rating Scale for Depression (HAMD) and Edinburgh Postnatal Depression Scale (EPDS) scores, no difference was found between the two groups.

Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis Li S, Zhong W, Peng W, Jiang G

2018 British Journal of Midwifery

Acupuncture in postpartum depression was at least as effective as fluoxetine hydrochloride, supporting the notion that acupuncture may be a safe and effective option.

Of the 1592 studies reviewed, three met the inclusion criteria for quantitative analysis. Two studies reported no significant differences between acupuncture and fluoxetine for depression, while the third reported significant improvements.

Acupuncture versus antidepressants in the management of postpartum depression: A systematic review Akari Komori, David Arthur, Samara Radford, Hsiewe Ying Tan, Li Zheng, Mira An, Rika Umeda, and Zhen Zheng

2018 Foods

Ginger emerges as a safe and effective treatment for nausea and vomiting in early pregnancy.

Nausea and vomiting of pregnancy (NVP) affect 7 in 10 pregnant women, significantly impacting their quality of life. Concerns about the safety of traditional antiemetic drugs have led to the consideration of natural options like ginger, which has shown favorable risk/benefit ratios and strong evidence. Ginger supplements with 0.5 to 2 g of root per day can effectively alleviate NVP. However, ensuring ginger quality is crucial, especially in monitoring methyleugenol concentration for potential toxicity. The variability in gingerol composition among supplements underscores the importance of stringent quality control measures. Studies have not found significant reproductive or developmental risks associated with ginger use during pregnancy, but medical supervision and case-specific evaluation are essential. Further research on ginger's effect on platelet aggregation in pregnant women is recommended.

How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy? Stanisiere J, Mousset PY, Lafay S

2018 Nursing and Midwifery Studies

Inhalation aromatherapy with Boswellia Carterii essential oil can significantly reduce labor pain intensity in nulliparous women.

In this randomized controlled trial, 126 nulliparous women were split into two groups — an aromatherapy group and a placebo group. A piece of gauze was soaked with Boswellia Carterii essential oil diluted in normal saline for the aromatherapy group and was attached to the collar of each woman in this group. This intervention was repeated at 30-minute intervals up to a cervical dilation of 10 centimeters. The placebo group intervention mirrored those of the aromatherapy group but used only normal saline on the gauze. The intensity of labor pain was assessed before the intervention and at certain cervical dilation stages using a numeric pain rating scale.

The results revealed that the aromatherapy group experienced significantly less labor pain compared to the placebo group at all tracked stages of cervical dilation. It was found that Boswellia Carterii essential oil can indeed mitigate labor pain when used in inhalation aromatherapy. No significant differences were observed concerning the 1 and 5 minute Apgar scores across both groups.

The effects of inhalation aromatherapy with Boswellia carterii essential oil on the intensity of labor pain among nulliparous women Esmaelzadeh-Saeieh S, Rahimzadeh M, Khosravi-Dehaghi N, Torkashvand S

2016 BMC Complementary Medicine and Therapies

Acupoint stimulation shows promise in alleviating nausea and vomiting in pregnancy.

This review assesses acupoint stimulation techniques for treating nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG). Of 29 studies, 20 were included in quantitative analyses. Acupressure, acupuncture, auricular acupressure, and moxibustion were examined. While acupressure showed a 41% reduction in symptom severity, acupuncture had double the effect of control groups, and moxibustion improved symptoms by 65%. Continuous outcome measures did not show significant relief. Adverse events were minimal. The study calls for more rigorous trials, emphasizing the need for blinding and standardizing treatment protocols for conclusive results on acupoint stimulation's efficacy in NVP and HG.

Effect of acustimulation on nausea and vomiting and on hyperemesis in pregnancy: a systematic review of Western and Chinese literature Van den Heuvel, E., Goossens, M., Vanderhaegen, H. et al.

2016 Obstetrics & Gynecology

Raspberry leaf consumption may decrease insulin requirements in pregnant women with gestational diabetes mellitus.

In the methodology of this case study, a 38-year-old pregnant woman, who was diagnosed with gestational diabetes mellitus, consumed raspberry leaf tea at 32 weeks of gestation. After the ingestion of the tea, she experienced hypoglycemia that required lowering her insulin dosage. This temporal relationship was verified by her ceasing and readopting the herb. Throughout the study, there were reassuring fetal surveillance and growth, resulting in a cesarean delivery at 39 weeks. The newborn didn't have hypoglycemia or any other complications and the placental biopsy showed standard outcomes.

In the discussion of the results, it was observed that raspberry leaf tea might have properties that can affect glycemic control in gestational diabetes mellitus patients. After consumption of the tea, the subject experienced hypoglycemia which necessitated a decrease in her insulin dose. Also, the re-consumption of the herb confirmed its hypoglycemic effects. Importantly, the baby was not affected by hypoglycemia or any other complications, indicating that raspberry leaf tea may be a practical alternative for managing gestational diabetes mellitus. However, it was recommended that pregnant women with such condition should be cautious about the use of the herb and monitor their glucose levels more frequently.

Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus Cheang KI, Nguyen TT, Karjane NW, Salley KES

2014 Journal of Advanced Nursing

Acupuncture showed both clinically important changes and statistically significant results for management of low back and/or pelvic pain (LBPP) in pregnancy.

Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low.

A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy Close C, Sinclair M, Liddle SD, Madden E, McCullough JE, Hughes C.

2014 Nutrition Journal

Ginger could be considered a harmless and possibly effective alternative option for women suffering from nausea and vomiting during pregnancy.

This review suggests potential benefits of ginger in reducing nausea symptoms in pregnancy (bearing in mind the limited number of studies, variable outcome reporting and low quality of evidence). Ginger did not significantly affect vomiting episodes, nor pose a risk for side-effects or adverse events during pregnancy. Based on evidence from this systematic review, ginger could be considered a harmless and possibly effective alternative option for women suffering from nausea and vomiting during pregnancy.

A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting Viljoen, E., Visser, J., Koen, N. et al.

2014 Acupuncture in Medicine

Acupuncture during pregnancy appears to be associated with few adverse events when correctly applied.

Of 105 included studies, detailed adverse events (AE) were reported only in 25 studies represented by 27 articles (25.7%). AEs evaluated as certain, probable or possible in the causality assessment were all mild/moderate in severity, with needling pain being the most frequent. Severe AEs or deaths were few and all considered unlikely to have been caused by acupuncture. Total AE incidence was 1.9%, and the incidence of AEs evaluated as certainly, probably or possibly causally related to acupuncture was 1.3%.

The Safety of Acupuncture during Pregnancy: A Systematic Review Park J, Sohn Y, White AR, Lee H.

2013 Medical Acupuncture

There is high-level evidence to support the use of acupuncture for treating major depressive disorder in pregnancy.

Six articles used the desired inclusion and exclusion criteria. The quality of research varied heavily. Five studies were properly randomized. Three were double-blinded. Three used individualized acupuncture. Four studies were of at least reasonable quality. One was of marginal quality, and one was of poor quality. There was a significant difference between acupuncture and at least one control in all six trials.

Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review Sniezek DP, Siddiqui IJ.

2013 Medical Acupuncture

Acupuncture's efficacy in treating gynecologic and obstetric disorders

This comprehensive review evaluates acupuncture's efficacy and safety in treating gynecologic and obstetric disorders. Examining systematic reviews and randomized controlled trials, the study addresses conditions like pregnancy-related pelvic and low-back pain, labor pain, primary dysmenorrhea, and menopausal symptoms. The results are inconclusive, with some evidence supporting acupuncture's potential in reducing pelvic and back pain during pregnancy and alleviating climacteric vasomotor symptoms. However, more rigorous research is necessary for definitive conclusions. Adverse effects were minimal. The review emphasizes the need for well-designed studies to enhance the precision and reliability of findings regarding acupuncture's therapeutic benefits in these disorders.

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview Selva Olid A, Martinez Zapata MJ, Sola I, Stojanovic Z, Uriona Tuma SM, Bonfill Cosp X.