Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation.
BACKGROUND
There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbal medicines used in pregnancy and lactation. This is one article in a series that systematically reviews the evidence for commonly used herbs during pregnancy and lactation.


OBJECTIVE
To systematically review the literature for evidence on the use, safety, and pharmacology of ginkgo focusing on issues pertaining to pregnancy and lactation.


METHODS
We searched 7 electronic databases and compiled data according to the grade of evidence found.


RESULTS
There is some very weak scientific evidence from animal and in vitro studies that ginkgo leaf has antiplatelet activity, which may be of concern during labour as ginkgo use could prolong bleeding time. Low-level evidence based on expert opinion shows that ginkgo leaf may be an emmenagogue and have hormonal properties. The safety of ginkgo leaf during lactation is unknown. Patients and clinicians should be aware of past reports of ginkgo products being adulterated with colchicine.


CONCLUSIONS
Ginkgo should be used with caution during pregnancy, particularly around labour where its anti-platelet properties could prolong bleeding time. During lactation the safety of ginkgo leaf is unknown and should be avoided until high quality human studies are conducted to prove its safety.
Dugoua
Jean-Jacques
JJ
Department of Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Canada. jeanjacques.dugoua@utoronto.ca
Mills
Edward
E
Perri
Daniel
D
Koren
Gideon
G
D000818:Animals; D005260:Female; D020441:Ginkgo biloba; D041743:Herb-Drug Interactions; D006801:Humans; D007774:Lactation; D007928:Lethal Dose 50; D018515:Plant Leaves; D028321:Plant Preparations / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use / Q000633:toxicity; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use / Q000633:toxicity; D006473:Postpartum Hemorrhage / Q000139:chemically induced; D011247:Pregnancy; D018570:Risk Assessment; D012639:Seeds
D028321:Plant Preparations; D010975:Platelet Aggregation Inhibitors