Prevalence and Factors Influencing the Use of Herbal Medicines During Pregnancy in Libya: A Cross-Sectional Study

Authors

  • Hajer M. Arjaibi Department of Pharmacognosy, Faculty of Pharmacy, University of Zawia, Libya Author
  • Hussam Alwafi Department of Family and Community Medicine, Faculty of Medicine, University of Zawia, Libya Author
  • Najat Benyusef Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, University of Zawia, Libya Author
  • Olfat N. Alqatish Faculty of Pharmacy, University of Zawia, Libya Author
  • Aisha M. Albhlool Faculty of Pharmacy, University of Zawia, Libya Author

DOI:

https://doi.org/10.54361/LJMR.19.2.18

Keywords:

Herbal Medicine, Libya, Pregnancy, Knowledge, Attitude, Practice

Abstract

Background:: Herbal medicines (HM) are commonly used during pregnancy worldwide, but safety concerns exist due to limited regulation and evidence. This study assesses the prevalence, knowledge, attitudes, and practices of HM use among pregnant women in Libya. Materials and Methods: A cross-sectional survey was conducted between March and June 2025, sampling 500 women across various regions in Libya. Participants completed a questionnaire evaluating their demographic characteristics, HM usage, and perceptions of safety and efficacy during pregnancy. Results: The results revealed that 50.8% of participants had used HM during pregnancy, with the third trimester being the most common period for use (44.6%). Cultural beliefs, perceived safety, and accessibility were key factors influencing the use of HM, with 77.8% relying on family or friends for advice. Alarmingly, 68.4% of women did not consult healthcare providers about their use of HM. Despite a general awareness of the side effects (88.6%), there was considerable uncertainty about the relative safety of HM compared to conventional medicine, with 26.2% of respondents unsure. The study showed that education level significantly influenced practices, with higher levels of education associated with less frequent use of HM during pregnancy (p <0.05).  The number of children, previous pregnancies, and history of abortion have a significant effect on the increased use of HM (p <0.05). Conclusion: The study emphasizes the importance of improving patient education and provider engagement in the use of HM during pregnancy to reduce risks and promote safety. It also calls for regulatory frameworks to monitor HM use and prevent adverse outcomes, especially in vulnerable groups like pregnant women.

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References

1. Ekor M. The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Front Neurol. 2014;4 JAN. doi:10.3389/fphar.2013.00177

2. Mohammed A, Amsalu B, Hailu M, et al. Indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care at public health facilities in Dire Dawa, Ethiopia: a cross-sectional study. BMJ Open. 2024;14(6). doi:10.1136/bmjopen-2023-079719

3. Moreira D de L, Teixeira SS, Monteiro MHD, De-Oliveira ACAX, Paumgartten FJR. Traditional use and safety of herbal medicines. Revista Brasileira de Farmacognosia. 2014;24(2):248-257. doi:10.1016/j.bjp.2014.03.006

4. WHO Traditional Medicine Strategy. 2014-2023. World Health Organization; 2013. Accessed February 4, 2025. https://www.who.int/publications/i/item/9789241506096

5. Wu CH, Wang CC, Tsai MT, Huang WT, Kennedy J. Trend and pattern of herb and supplement use in the United States: Results from the 2002, 2007, and 2012 national health interview surveys. Evidence-based Complementary and Alternative Medicine. 2014;2014. doi:10.1155/2014/872320

6. Bent S. Herbal medicine in the United States: Review of efficacy, safety, and regulation - Grand Rounds at University of California, San Francisco Medical Center. J Gen Intern Med. 2008;23(6):854-859. doi:10.1007/s11606-008-0632-y

7. Rashrash M, Schommer JC, Brown LM. Prevalence and Predictors of Herbal Medicine Use Among Adults in the United States. J Patient Exp. 2017;4(3):108-113. doi:10.1177/2374373517706612

8. von Conrady DM, Bonney A. 7. Patterns of complementary and alternative medicine use and health literacy in general practice patients in urban and regional Australia. Aust Fam Physician. 2017;46(5):315-320.

9. Bent S. 3. Herbal medicine in the United States: Review of efficacy, safety, and regulation - Grand Rounds at University of California, San Francisco Medical Center. J Gen Intern Med. 2008;23(6):854-859. doi:10.1007/s11606-008-0632-y

10. Rasmussen SA. 16. Human teratogens update 2011: Can we ensure safety during pregnancy? Birth Defects Res A Clin Mol Teratol. 2012;94(3):123-128. doi:10.1002/bdra.22887

11. Mbarambara PM, Songa PB, Wansubi LM, Mututa PM, Minga BBK. 17. Self-mediccation among pregnant women. 2016;16(1):38-45.

12. Kennedy DA, Lupattelli A, Koren G, Nordeng H. 18. Herbal medicine use in pregnancy: Results of a multinational study. BMC Complement Altern Med. 2013;13. doi:10.1186/1472-6882-13-355

13. Mohamed M, El-Kashif L, Ebrahim El-Tahry S. 15. An Assessment of the Factors Influencing the Use of over-the-Counter Medication during the Second Trimester of Pregnancy, Egypt. International Journal of Nursing Science. 2018;8(6):99-107. doi: 10.5923/j.nursing.20180806.01

14. Mauliddiyah NL. 11. Medicinal Plants and Pharmaceutical Medicines Use in Pregnant and Lactating Women in Ethiopia.; 2021.

15. Malan DF, Neuba DF. 19. Medicinal Plants and Pregnancy African Journal of Reproductive Health. 2011;15(1):85.

16. Shewamene Z, Dune T, Smith CA. The use of traditional medicine in maternity care among African women in Africa and the diaspora: A systematic review. BMC Complement Altern Med. 2017;17(1). doi:10.1186/s12906-017-1886-x

17. John LJ, Shantakumari N. 22. Herbal medicines use during pregnancy: A review from the middle east. Oman Med J. 2015;30(4):229-236. doi:10.5001/omj.2015.48

18. E E. 26. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.

19. Barnes LAJ, Barclay L, McCaffery K, Aslani P. 27. Complementary medicine products used in pregnancy and lactation and an examination of the information sources accessed pertaining to maternal health literacy: A systematic review of qualitative studies. BMC Complement Altern Med. 2018;18(1):1-27. doi:10.1186/s12906-018-2283-9

20. Muñoz Balbontín Y, Stewart D, Shetty A, Fitton CA, McLay JS. 29. Herbal medicinal product use during pregnancy and the postnatal period: A systematic review. Obstetrics and Gynecology. 2019;133(5):920-932. doi:10.1097/AOG.0000000000003217

21. Nyeko R, Tumwesigye NM, Halage AA. 30. Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda. BMC Pregnancy Childbirth. 2016;16(1):1-12. doi:10.1186/s12884-016-1095-5

22. Alemdaroglu, N.C.; Dietz, U.; Wolffram, S.; Spahn-Langguth, H.; Langguth P. 31. Influence of green and black tea on folic acid pharmacokinetics in healthy volunteers: potential risk of diminished folic acid bioavailability. Biopharm Drug Dispos. 2008;29(6):335-348.

23. Wilkinson JM. 33. What do we know about herbal morning sickness treatments? A literature survey. : Midwifery. 16(3):224-228.

24. Marty AT. 34. PDR for Herbal Medicines. Vol 281.; 1999. doi:10.1001/jama.281.19.1853

25. Orief YI, Farghaly NF, Ibrahim MIA. 35. Use of herbal medicines among pregnant women attending family health centers in Alexandria. Middle East Fertil Soc J. 2014;19(1):42-50. doi: 10.1016/j.mefs.2012.02.007

26. Ekor M. 38. The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Front Neurol. 2014;4 JAN(January):1-10. doi:10.3389/fphar.2013.00177

27. Agiel N, Mericli F. 43. A survey on the aromatic plants of Libya. Indian Journal of Pharmaceutical Education and Research. 2017;51(3): S304-S308. doi:10.5530/ijper.51.3s.35

28. Feng Y, Lei JQ, Xu XW, Pan BR. 44. Composition and characteristics of Libyan flora. Arch Biol Sci. 2013;65(2):651-658. doi:10.2298/ABS1302651Y

29. Louhaichi M, Salkini AK, Estita HE, Belkhir S. 48. Initial assessment of medicinal plants across the Libyan mediterranean coast. Adv Environ Biol. 2011;5(2 SPEC. ISSUE):359-370.

30. Arjaibi HM, Sherlala RA, Alameer EM, Hussain AA. Herbal Medicine Use and Attitudes during the COVID-19 Crisis in Libya: Cross-Sectional Study. University of Zawia Journal of Medical Sciences. 2025;1(1):16-23. doi:10.26629/uzjms.2025.03

31. Ashur ST, Shah SA, Bosseri S, Shamsuddin K. 49. Use of traditional medicine among type 2 diabetic Libyans. Eastern Mediterranean Health Journal. 2017;23(5):375-382. doi:10.26719/2017.23.5.375

32. Arjaibi HM, Sherlala RA, Mansour MH, Osman SA. Community Pharmacists’ Knowledge, Attitudes, and Practices Regarding Herbal Medicine: A Cross-Sectional Study in Libya. Medical and Pharmaceutical Journal. 2024;3(4):172-187. doi:10.55940/medphar2024108

33. Worldometer. 57. Libya Demographics. Worldometer. 2020. Accessed May 12, 2024. https://www.worldometers.info/demographics/libya-demographics/

34. Worldometer. Libya Population- Country Meter. Worldometer. 2024. https://countrymeters.info/en/Libya

35. Almoayad F, Assiri IA, Almarshoud HF, Safhi AM, Altahan HM, Benajiba N. 1. Exploring the use of herbal treatments during pregnancy among Saudi women an application of the knowledge-attitude-practice model. Sultan Qaboos Univ Med J. 2021;21(4):591-597. doi:10.18295/squmj.4.2021.045

36. M. Mothupi. 24. Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: A cross-sectional survey. BMC Complement Altern Med. 2014;14(1):1-8. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L601312998%0Ahttp://dx.doi.org/10.1186/1472-6882-14-432

37. Forster DA, Denning A, Wills G, Bolger M, McCarthy E. 25. Herbal medicine use during pregnancy in a group of Australian women. BMC Pregnancy Childbirth. 2006;6. doi:10.1186/1471-2393-6-21

38. Fakeye TO, Adisa R, Musa IE. 50. Attitude and use of herbal medicines among pregnant women in Nigeria. BMC Complement Altern Med. 2009; 9:1-7. doi:10.1186/1472-6882-9-53

39. Belayneh YM, Yoseph T, Ahmed S. 56. A cross-sectional study of herbal medicine use and contributing factors among pregnant women on antenatal care follow-up at Dessie Referral Hospital, Northeast Ethiopia. BMC Complement Med Ther. 2022;22(1):1-8. doi:10.1186/s12906-022-03628-8

40. Calapai G. 60. European legislation on herbal medicines: A look into the future. Drug Saf. 2008;31(5):428-431. doi:10.2165/00002018-200831050-00009

41. Briggs DR. 61. The regulation of herbal medicines in Australia. Toxicology. 2002;181-2:565-570. doi:10.1016/s0300-483x (02)00483-3

42. Leung C, Marvin V, Ofili-Yebovi D. 63. Herbal medicines in pregnancy. Pharmaceutical Journal. 2022;309(7966):1-17. doi:10.1211/PJ.2022.1.157273

43. Frawley J, Adams J, Sibbritt D, Steel A, Broom A, Gallois C et al. 64. Prevalence and determinants of complementary and alternative medicine use during pregnancy: results from a multinational study. BMC Complement Altern Med. 2013; 13:335. doi: https://doi.org/10.1186/1472-6882-13-355

44. Al-Ghamdi S, Aldossari K, Al-Zahrani J, et al. 23. Prevalence, knowledge and attitudes toward herbal medication use by Saudi women in the central region during pregnancy, during labor and after delivery. BMC Complement Altern Med.

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Published

01-07-2025

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How to Cite

1.
Arjaibi H, Alwafi H, Benyusef N, Alqatish O, Albhlool A. Prevalence and Factors Influencing the Use of Herbal Medicines During Pregnancy in Libya: A Cross-Sectional Study. LJMR [Internet]. 2025 Jul. 1 [cited 2025 Jul. 31];19(2):144-6. Available from: https://ljmr.ly/index.php/ljmr/article/view/402

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