Nursing & Care

Abstract

Azadirachta indica A. juss: Safety and Efficacy during Pregnancy and Lactation

Nkechi Enwerem, Samson Amos.

Background: In Nigeria decoctions and aqueous extract of Azadirachta indica A. juss (AI), are commonly used in the treatment of malaria. Some women have been observed consuming aqueous extract of AI during pregnancy and lactation because of the folkloric belief that it is potentially harmless.

Objectives: There is a paucity of data on the effects of consumption of AI during pregnancy and lactation. Its use by women during lactation and pregnancy, calls for an in-depth understanding of its efficacy and potential for harm during pregnancy and lactation.

Methodology: AHMED, CINAHL, Cochrane CENTRAL, Cochrane Library, Medline, Internet journals, Natural Medicines comprehensive database, and Natural standard were reviewed from inception to 2017 for information on Azadirachta indica A. juss , as it relates to its use on “pregnancy”, “lactation”, and “breastfeeding”. The Latin and common name of Azadirachta indica A. juss (AI), were also used as keywords in the search. Data were compiled based on the grade and evidence found.

Results: There were no evidence based scientific data to support the use of Azadirachta indica A. juss during pregnancy and lactation. However, there is invitro evidence that pregnancy termination was observed in rodents and primates given neem extract at early post-implantation stage. No residual permanent effect and fertility was regained following treatment in subsequent cycles. In lactating rats AI at concentrations of 400 mg/kg and 600 mg/kg significantly increased in a dose dependent manner the packed cell volume (PCV), red blood cell (RBC), and a decrease in blood glucose level. AI has the potential to interact with some prescription medications such as antidiabetic drugs.

Conclusions: A more rigorous and well controlled- clinical research is needed before this plant can be used during pregnancy and lactation. It is important for consumers and clinicians to know that AI can lower blood sugar level. This is particularly important in the developing tropical countries where AI is used for the management of malaria. It is equally important for male and female in their reproductive stage to know that AI has some effect on fertility.