Are there any known risks with use of Eye Q or evening primrose oil during pregnancy and breast-fee

Fråga: Are there any known risks with use of Eye Q or evening primrose oil during pregnancy and breast-feeding?

This is a general question.

Sammanfattning: There is limited information concerning the use of evening primrose oil and Eye Q during pregnancy and breast-feeding. Both natural remedies contain different fatty acids, and are traditionally used by pregnant or breast-feeding women to shorten the length of labour, reduce the incidence of preterm delivery, and support the development of the fetal and infant brain. Based on available data, none of these two natural remedies seem to posses a risk for the fetus or breast-fed child. Neither are there any data supporting a definite benefit from these oils.

Svar: Evening primrose oil is a natural remedy that contains fatty acids, mainly linolenic acid and gamma-linolenic acid, from the seeds of the plant oenothera biennis. There are a wide variety of suggested indications, such as atopic eczema, mastalgia, rheumatoid arthritis, asthma, premenstrual syndrome and postviral fatigue syndrome (1,2).

Eye Q is a natural remedy containing the fatty acids docosahexaenoic acid, eicosapentaenoic acid from fish oil, gamma-linolenic acid from evening primrose oil and vitamin E. The amounts of the different fatty acids can vary. The product is supposed to improve brain and eye function (2,3).

The use of evening primrose oil during pregnancy and breast-feeding has been discussed previously in a Drugline document (4). It was concluded that data are scarse, but that there is no documented risk for a fetus exposed in utero. Evening primrose oil can increase the fat content and amount of essential fatty acids in the breast milk. It is not known whether this has any untoward effect on the breast-fed infant.

In a national survey from the United States, use of herbal preparations by nurses and midwives were viewed. It was seen that herbal preparations, among them evening primrose oil, was traditionally used by and recommended to pregnant women by midwives. Herbal preparations were mostly recommended for stimulating cervical ripening and labour (5). In a retrospective study of labour charts from 54 woman who self-medicated with evening primrose oil from pregnancy week 37 and onwards, there was no apparent benefit with respect to the incidence of adverse labour outcomes or overall length of labour, compared with 54 women not taking evening primrose oil (6).

The effect of fish-oil supplementation on pregnancy duration was studied in a randomised controlled trial. In the study, 553 healthy Danish women in week 30 of pregnancy were randomised to receive fish oil, olive oil or no supplementation. The pregnancy length was on average 4.0 (95% CI 1.5-6.4) days longer in the fish oil group, compared with the olive oil group (7). There is also one randomised, double-blind placebo controlled trial of fish oil supplementation in 233 high risk pregnancies. No benefits, with respect to pregnancy induced hypertension, birth weight or pregnancy duration, were abserved from fish oil, compared with placebo (8). Barnes J, Anderson LA, Phillipson JD. Herbal medicines. A guide for healthcare professionals. 2nd ed. London: The Pharmaceutical Press; 2002. p. 201-5.

Färnlöf Å, Tunon H. Naturläkemedel 2002/2003. Stockholm: Hälsokostrådets Förlag; 2002. p. 193-4, 213-4.
Eye q - en omega-3-olja med GLA. www.naturmedel.org (citerad 2005-02-14)
Drugline no 12958 (year 1996)

McFarlin BL, Gibson MH, O´Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44(3):205-16. Dove D, Johnson P. Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women. J Nurse Midwifery 1999;44(3):320-4. Olsen SF, Sorensen JD, Secher NJ et al. Randomised controlled trial of eeffect of fish-oil supplementation on pregnancy duration. Lancet 1992;339:1003-7. Onwude JL, Lilford RJ, Hjartardottir H, Staines A, Tuffnell D. A randomised double blind placebo controlled trial of fish oil in high risk pregnancy. Br J Obtet Gynaecol 1995;102(2):95-100.