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Human Maternal Placentophagy: Possible Benefit and Potential Risks

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Human Maternal Placentophagy: Possible Benefit and Potential Risks GebFra Science | Review Placenta – Worth Trying? Human Maternal Placentophagy: Possible Benefit and Potential Risks Mutterkuchen – mal versuchen? Humane maternale Plazentophagie: möglicher Nutzen und potenzielle Risiken Authors Sophia K. Johnson 1,JanaPastuschek1, Jürgen Rödel2, Udo R. Markert 1, Tanja Groten 1 Affiliations 1 Plazenta-Labor, Klinik für Geburtsmedizin, Universitäts- Deutsche Version unter: klinikum Jena, Jena, Germany https://doi.org/10.1055/a-0674-6275 2 Institut für klinische Mikrobiologie, Universitätsklinikum Jena, Jena, Germany ABSTRACT The use of placenta preparations as an individual puerperal Key words remedy can be traced back to historical, traditional practices placenta, puerperium, postpartum, parturition, in Western and Asian medicine. To evaluate the ingestion of placentophagy processed placenta as a puerperal remedy, the potential risks (trace elements, microorganisms) and possible benefit (hor- Schlüsselwörter mones in the placental tissue) of such a practice are discussed Plazenta, Wochenbett, postpartal, Entbindung, in this article based on a literature review. Placentophagy ZUSAMMENFASSUNG received 24.4.2018 revised 7.8.2018 Die Einnahme der eigenen Plazenta durch die Mutter als indi- accepted 9.8.2018 viduelles Heilmittel im Wochenbett ist zurückzuführen auf historische, traditionelle Anwendungen in abendländischer Bibliography und asiatischer komplementärer Medizin. In dieser Über- DOI https://doi.org/10.1055/a-0674-6275 sichtsarbeit wurden mittels Literaturrecherche sowohl die Geburtsh Frauenheilk 2018; 78: 846–852 © Georg Thieme möglichen Risiken (Spurenelemente, Mikroorganismen) als Verlag KG Stuttgart · New York | ISSN 0016‑5751 auch möglicher Nutzen (Hormone im Plazentagewebe) er- fasst, um die Einnahme der verarbeiteten Plazenta als Heilmit- Correspondence tel im Wochenbett zu bewerten. PDDr.med.habil.TanjaGroten Geschäftsführende Oberärztin, Klinik für Geburtsmedizin, Haus E Am Klinikum 1, 07747 Jena, Germany [email protected] Introduction on placentophagy founded upon scientific data have yet to be produced. Originating in the USA, a trend has been observed among moth- ers in industrialized nations towards consuming their own, pro- Definition cessed placenta as a puerperal remedy. There has been little sys- tematic investigation into the associated benefit and potential Maternal human placentophagy describes the practice of ingest- risks, however. Obstetricians and pediatricians are faced with an ing oneʼs own placenta post partum [1], which is done in different increasing demand from patients, but general recommendations ways: either a piece of raw placenta is consumed immediately 846 Johnson SK et al. Placenta – Worth … Geburtsh Frauenheilk 2018; 78: 846–852 Possible risks Potential benefit Potentially toxic trace ele- Raw Postpartum depression: using ments below the toxicity placental hormones to prevent threshold (Cd, As, Hg, Pb) e.g. postpartum hormone with- Potentially pathogenic smoothies drawal bacteria (Escherichia coli, Lactation: increased milk Staphylococcus aureus) production and associated transmission Reduced bleeding/accelerated of infections from mother recovery:effectofoxytocin to child ontheuterus(contraction) Questionable accumulation Improved mood and sub- of drugs (anaesthetics, anti- jectivelymoreenergyduring biotics from Caesarean section) the postpartum period Traditional Chinese medicine Classic use (TCM) Capsules of Capsules steamed/ of raw, dried dried placenta placenta ▶ Fig. 1 Options for placenta processing and ingestion and potential risk and possible benefits of placentophagy. after parturition, or the tissue is heated, dried and then pulver- velops) and trophoblast (from which the fetal membranes and fe- ized. Placenta encapsulation, whereby the placenta is processed tal elements of the placenta develop). The embryonic pole of the into capsules, is a common practice in the Anglo-American world. blastocyst is connected to the endometrium of the uterus during It entails the filling of placental tissue as a dried powder into gela- implantation and completely penetrates the maternal connective tin capsules for everyday consumption [2] (▶ Fig. 1). tissue, where there is a plentiful supply of blood. The placenta be- Placenta capsules have to be destinguished from placental gins to develop once the endometrium starts exerting metabolic auto-nosodes produced in pharmacies according to the specifica- and secretory activity in response to the presence of the blasto- tions of the homeopathic pharmacopoeia. cyst. The syncytiotrophoblast develops from the outer layer of the blastocyst and is the basis for development of the placenta. A Methodology close connection between the maternal and embryonal blood cir- culation facilitates the exchange of gases and metabolites by dif- A systematic search for literature was conducted in PubMed and fusion. This does not result in direct contact between the mater- the Web of Science Core Collection databases using the keywords nal and fetal blood – functions as a barrier, regulating the passage “placentophagy”, “placentophagia”, “human placentophagy”, of substances. “maternal placentophagy” and “placenta encapsulation”.En- The physiological role of the placenta during pregnancy is ex- glish-language studies focusing on human placentophagy pub- tremely complex: metabolism, excretion, respiration and immu- lished between 1918 and 2018, and animal studies relevant to nological processes such as hormone synthesis ensure and regu- clinical assessment, were included (▶ Table 1). In addition, a late the survival and growth of the fetus and the adaptation of selective review of gynaecological, anthropological and legal liter- the motherʼs body to pregnancy and childbirth. Hormones such ature was undertaken. as oxytocin, human placental lactogen, progesterone, oestrogens and neurohormones such as thyroid-stimulating hormone (TSH), The development of the placenta adrenocorticotropic hormone (ACTH) and corticotropin-releasing Fertilisation leads to the development of the blastocyst, which hormone (CRH), some of them are produced exponentially during consists of the embryoblast (cell mass from which the embryo de- pregnancy [3]. The hormonal activity of the fetoplacental unit at Johnson SK et al. Placenta – Worth … Geburtsh Frauenheilk 2018; 78: 846–852 847 GebFra Science | Review ▶ Table 1 Overview of selected publications on placentophagia and their results. Selection of publications on human maternal placentophagia Results Hammett 1917 [46]: The effect of the ingestion of desiccated The percentage of protein and lactose contained in breast milk increased after in- placenta on the variations in the composition of human milk during gestion of desiccated placenta. the first eleven days after parturition. Hammett 1918 [15]: The effect of the maternal ingestion of desic- Weight gain in infants breast-fed exclusively by mothers having ingested desic- cated placenta upon the rate of growth of breast-fed infants. cated placenta was faster than in the control group where placenta was not con- sumed. Soykova-Pachnerova 1954 [20]: Placenta as a Lactagogon. The hormones found in dehydrated placenta caused increased milk production in 86.2% of women (n = 181); placentophagy as a therapeutic option in hypogalactia. Selander 2013 [2]: Human maternal placentophagy: a survey of self- Women (n = 189) describe the following benefits after placentophagy: improved reported motivations and experiences associated with placenta postnatal mood, more energy, increased milk production, reduced bleeding and consumption. faster recovery. Gryder 2017 [19]: Effects of Human Maternal Placentophagy on Placentophagy neither positively nor negatively influences postpartum maternal Maternal Postpartum Iron Status: A Randomized, Double-Blind, iron status. Placenta capsules are not an adequate treatment for postpartum Placebo-Controlled Pilot Study. anaemia. Young 2017 [17]: Effects of placentophagy on maternal salivary The ingestion of steamed, dried placenta leads to minor yet significant changes in hormones: A pilot trial, part 1. the womenʼs hormone profiles. Young 2017 [18]: Placentophagyʼs effects on mood, bonding, and The ingestion of steamed, dried placenta does not significantly alter maternal fatigue: A pilot trial, part 2. mood, bonding or fatigue. Benyshek 2018 [21]: Placentophagy among women planning com- Almost one third of mothers from community birth ingest their placenta post munity births in the United States: Frequency, rationale, and associ- partum; in 73%, the reason to do so is avoidance of PPD. There is no evidence that ated neonatal outcomes. the neonate is at increased risk from maternal placentophagy. the end of pregnancy can be summarised as follows: The pro- grounds of cleanliness. In various cloven-hoofed animals of the duction of fetal cortisol stimulates placental CRH secretion. The horse family, placentophagia does not significantly alter the mor- elevated CRH concentration in the maternal blood stimulates the tality rate in the offspring. It is therefore assumed that further secretion of CRH, ACTH and cortisol. placentophagia has no influence on the avoidance of predators Progesterone, which around the time of parturition is synthes- [8]. ised in the placenta at a daily production rate of approximately The discussion of whether there is an evolutionary biological 300 mg [4], is used by the fetus as a precursor for producing glu- explanation for placentophagy in humans is inconclusive [7, 8]. cocorticoids and mineralocorticoids.
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