Consumption of indigenous medicines by pregnant women in North India for selecting sex of the foetus: what can it lead to?
BACKGROUND
Sex ratio is an important indicator of development. Despite all the measures undertaken for improvement, it remains an issue of concern in India, with Haryana having a very low sex ratio in the country. Studies have been conducted indicating that consumption of indigenous drugs used for sex selection (SSD) could be strongly associated with adverse effects on the foetal development, including congenital malformations. Some samples of SSDs were collected from parts of North India and analysed in a standard laboratory for its components.


METHODS
Thirty SSDs used by the local community were procured from various sources in north India through a rigorous process of collection. These were subjected to laboratory tests to investigate the presence of phytoestrogen and testosterone. Following sample extraction, thin layer chromatography and high performance liquid chromatography were carried out for analysing phytoestrogen content.


RESULTS
SSDs were available in various forms such as powder, tablets, mostly from faith healers. Around 87% of the samples collected from sources like doctors, quacks and faith healers were to be taken by the pregnant women after conception; 63% drugs were strongly positive for phytoestrogens (genistein, daidzein, formononetin) and 20% drugs were positive for testosterone. The average dose of the components as calculated after analyses was as follows: daidzein--14.1 mg/g sample, genistein--8.6 mg/g sample, formononetin--5 mg/g sample.


CONCLUSIONS
These SSDs could be potentially detrimental to the growth and development of the foetus. This is likely to have implications on the health of the community. In view of the results obtained in our study, we strongly attest the importance in curbing this harmful practice by banning the supply of the drugs as well as by advocating behavioural changes in the community.
Indian Institute of Public Health-Delhi (IIPH-D), Public Health Foundation of India (PHFI), New Delhi, India. sutapa.bneogi@iiphd.org.
Sutapa Bandyopadhyay
SB
Neogi
Indian Institute of Public Health-Delhi (IIPH-D), Public Health Foundation of India (PHFI), New Delhi, India. preeti.negandhi@iiphd.org.
Preeti H
PH
Negandhi
Thapar University, Patiala, India. ganguliabhijit@rediffmail.com.
Abhijit
A
Ganguli
Indian Institute of Public Health-Delhi (IIPH-D), Public Health Foundation of India (PHFI), New Delhi, India. sapna.chopra@iiphd.org.
Sapna
S
Chopra
Government of Haryana, Chandigarh, India. sandhunavraj123@gmail.com.
Navraj
N
Sandhu
National Health Mission, Panchkula, Haryana, India. ravikantg@gmail.com.
Ravi Kant
RK
Gupta
Indian Institute of Public Health-Delhi (IIPH-D), Public Health Foundation of India (PHFI), New Delhi, India. Sanjay.zodpey@phfi.org.
Sanjay
S
Zodpey
Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India. amarminhas56@rediffmail.com.
Amarjeet
A
Singh
Rashtriya Bal Suraksha Karyakram, Government of India, New Delhi, India. drarunsingh61@gmail.com.
Arun
A
Singh
National Health Mission, Panchkula, Haryana, India. rguptaias@gmail.com.
Rakesh
R
Gupta
D005260:Female; D047109:Fetal Development / Q000187:drug effects*; D006801:Humans; D007194:India; D008519:Medicine, Traditional / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D048789:Phytoestrogens / Q000009:adverse effects / Q000032:analysis; D008517:Phytotherapy / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D011247:Pregnancy; D012743:Sex Preselection / Q000379:methods* / Q000523:psychology; D013739:Testosterone / Q000009:adverse effects / Q000032:analysis
D048789:Phytoestrogens; D013739:Testosterone