Malaria remedies containing dry pawpaw leaf unsafe in pregnancy ― Experts

Pregnancy and malaria are common to the rainy season. So, it is not unlikely that pregnant women would resort to using malaria herbal preparations to prevent or treat malaria.

It is strongly assumed that since ‘Agbo-Iba’, a multi-herbal preparation is natural, they are safe. But using herbal medicines during pregnancy is a significant concern. Many specifically taken for symptoms appearing during pregnancy, including malaria, have potential harm for unborn baby safety.

Now, experts’ assessment of pawpaw leaf, a common condiment of many ‘Agbo-Iba’ indicates that in pregnancy, it can cause miscarriage.

A common multi-herbal combination (Agbo-Iba) for treating malaria is the mixture of pawpaw leaves, lemongrass, Anacardium occidentale (cashew) leaves and neem (dongoyaro) leaves.

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Its toxicity test in animals under laboratory conditions suggested that it contains some chemical substances that are bad for the womb. And care should be taken in its use during pregnancy.

Researchers in the 2019 study in the Asian Research Journal of Gynaecology and Obstetrics had investigated if pawpaw leaves have the propensity to induce miscarriage during pregnancy.

It included Dr Augustine Airaodion at the Federal University of Technology Owerri in collaboration with John Ekenjoku; Emmanuel O Ogbuagu; Victor N. Okoroukwu and Uloaku Ogbuagu.

They found that all doses of pawpaw leaf extract administered significantly induced contractions of the wombs of these test animals. This contraction increases as the dosage increases.

In fact, the effect of pawpaw leaf extract on the womb of the pregnant rat was higher at all doses when compared with oxytocin, a standard drug used to stimulate labour process in pregnant women.

Thirty each of fertile male and female Wistar rats were taken for this study. After the pregnancy test, the rats were grouped into four.

The first group (Group A) was treated with normal saline, other groups (B, C, D) were treated with undiluted leaf extract of pawpaw leaves for 24, 48 and 72 hours respectively. The animals were then observed daily if they littered.

Also, at the expiration of the exercise, their wombs were checked for any possible side effects of the pawpaw extract.

The leaf extract of pawpaw leaf was safe in rats at the tested oral doses (500–2000 mg/kg). Deaths were not recorded within the study period. But the leaf extract caused dose-dependent multiple contractions of the pregnant rat’s womb.

Also, 20 per cent of animals treated with pawpaw leaf extract for 24 hours did no litter which suggestive that miscarriage has occurred. In the animals treated for 48 hours, only 60 per cent littered which is also suggestive that miscarriage has occurred in the remaining 40 per cent that did not litter.

In the group treated with pawpaw leaf extract for 72 hours, 80 per cent of the animals did not litter. All the pregnant rats administered pawpaw leaf extract appeared physically healthy throughout this study. Also, all animals in the control group littered which is an indication that no abortion occurred.

The researchers declared: “Thus, it is recommended that care should be taken in the use of pawpaw leaves during pregnancy and its use in folklore medicine during pregnancy should be discouraged.

“However, the results observed in this study does not automatically translate to the same effect in humans, therefore, its effect on pregnant women can be further confirmed.”

Nonetheless, they suggested that pawpaw leaf extract may contain chemical substances capable of inducing womb contractions in the process of giving birth and as such could be used to facilitate labour process or as an abortifacient.

Herbal medicine use during pregnancy is common across regions and countries. Many women used herbal medicines during the first trimester.

Multinational studies conducted in different countries showed that 28.9 per cent of pregnant women used herbal medicines during pregnancy.

The most commonly consumed herbal medicines during pregnancy include; ginger, garlic, peppermint, eucalyptus, palm kernel oil, bitter kola and neem (Azadirachta indica).

Higher doses of ginger can cause thinning of blood, stomach discomfort and heartburn just as using garlic during pregnancy may aggravate heartburn.

Other untoward effects of using herbal medicine in pregnancy include premature labour, miscarriage, increase blood flow, abortion and allergic reactions.

Caution should be taken in using medicinal plants during the period of pregnancy. Physicians, nurses and other healthcare practitioners should take into consideration of the risk involved in using herbs during pregnancy and should also, educate their patients on the dangers associated with the use of such remedies.

NIGERIAN TRIBUNE