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Barbara Lorson

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Barbara Lorson COMPARISON OF NEONATAL OUTCOMES IN MATERNAL USERS AND NON-USERS OF HERBAL SUPPLEMENTS A Thesis Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of The Ohio State University By Holly A Larson, B.S. ***** The Ohio State University 2008 Master‟s Examination Committee: Dr. Maureen Geraghty, Advisor Approved by Annette Haban Bartz ______________________________ Dr. Christopher A. Taylor Advisor Graduate Program in Allied Medical Professions COMPARISON OF NEONATAL OUTCOMES IN MATERNAL USERS AND NON-USERS OF HERBAL SUPPLEMENTS By Holly A. Larson, M.S. The Ohio State University, 2008 Dr. Maureen Geraghty, Advisor This pilot study was a retrospective chart review. The purposes of this study were to describe the prevalence herbal supplement use, to identify characteristics linked to increased herbal supplement use and, to identify adverse outcomes linked to herbal supplement use. Rate of use in the study sample of 2136 charts was 1.1% and identified 17 supplements. The most common supplements identified were teas. Characteristics of the neonates and controls were analyzed as appropriate and revealed no statistical significance. Characteristics of the mothers also revealed no statistical difference. There was a statistically significant difference between herbal users and herbal non-users and the trimester prenatal care began. Neonatal outcomes were statistically different on two measures. Further study is needed to be able to make recommendations regarding safety and efficacy of herbal supplements as well as to be able to better understand motives for choosing to use them. ii Dedicated to the Mama and the Daddy Bears iii ACKNOWLEDGMENTS I would like to express my heartfelt gratitude to my advisor, Dr. Maureen Geraghty. Her genuine interest in me and my learning experience is the backbone of my academic success at The Ohio State University. She set the bar high but provided the counsel and support to be victorious. Thank you. I wish to enthusiastically thank my research team at Nationwide Children‟s Hospital. Annette Haban-Bartz, Joyce Brezny, Nancy Ryan-Wenger, Robin Catlett and Darcy Harmon were all my teachers, coaches and team members. Thank you for your willingness to teach, your support and your many hours contributed to this project. Many thanks to Dr. Chris Taylor for his numerous “technology consults”, his aid and guidance in writing of chapter three and support throughout the entire process. Thank you to Mariel Viggers for countless hours of data entry assistance and moral support. Thanks to Anne Arlinghaus for helping edit and polish the entire document, even though she was in Nigeria. Finally, thank you to my friends and family for supporting me on this learning journey. Thank you for your strength and encouragement and for helping celebrate as this project comes to a close. Thank you. iv VITA August 17,1984 ..............................................Born – Cincinnati, Ohio 2006................................................................B.S. Dietetics, Ohio University 2006-2007 ......................................................Dietetic Internship The Ohio State University FIELD OF STUDY Major Field: Allied Medical Professions v TABLE OF CONTENTS Page Abstract ............................................................................................................................... ii Dedication .......................................................................................................................... iii Acknowledgments.............................................................................................................. iv Vita .......................................................................................................................................v List of Tables ..................................................................................................................... ix Chapters: 1. Introduction ........................................................................................................1 Background of the Problem .........................................................................1 Significance of the Problem .........................................................................2 Objectives ....................................................................................................3 Research Approach ......................................................................................4 Definition of Terms......................................................................................4 Abbreviations ...............................................................................................8 2. Review of Literature ..........................................................................................9 Herbal Supplement Use in the United States and Worldwide ...................11 Herbal supplement use in pregnancy .....................................................13 Patient Disclosure of Herbal Supplement Use ...........................................15 Increased disclosure in acute situation ..................................................16 Risks and Safety of Herbal Supplement Use .............................................21 Attitudes Regarding Risk ...........................................................................23 Sources of Information for Herbal Supplement Use ..................................23 Midwives...............................................................................................24 Healthcare practitioners and physicians ................................................25 Friends and family ................................................................................26 Health food store ..................................................................................26 Internet, self-education, television ........................................................27 Common Herbal Supplements Used During Pregnancy; use, safety .........30 Aloe .......................................................................................................30 Anise ....................................................................................................30 Black cohosh .........................................................................................31 vi Page Blessed thistle herb ...............................................................................31 Blue cohosh ...........................................................................................31 Castor ....................................................................................................32 Chamomile, German .............................................................................33 Coriander...............................................................................................33 Cranberry ..............................................................................................33 Echinacea ..............................................................................................34 Evening primrose oil .............................................................................35 Fennel ....................................................................................................35 Fenugreek ..............................................................................................35 Garlic.....................................................................................................36 Ginger ...................................................................................................36 Ginkgo biloba........................................................................................37 Ginseng, American ...............................................................................38 Ginseng, Panax .....................................................................................38 Ginseng, Siberian ..................................................................................39 Goldenseal.............................................................................................39 Green Tea ..............................................................................................40 Juniper ...................................................................................................41 Kava kava..............................................................................................42 Lemongrass ...........................................................................................42 Lemon verbena......................................................................................43 Marshmallow root .................................................................................43 Mother‟s Milk Tea ................................................................................44 Nettle (Stinging)....................................................................................44 Noni juice (morinda) .............................................................................45 Omega-3 fatty acids ..............................................................................46 Papaya ...................................................................................................46 Peppermint ............................................................................................46 Red Raspberry .......................................................................................47 Spearmint ..............................................................................................47
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