Pregnancy support- Vitamin Deficiencies

Ginger - updated: 03 November 2008

A randomized comparison of ginger and dimenhydrinate in the treatment of nausea and vomiting in pregnancy

J Med Assoc Thai. 2007 Sep;90(9):1703-9

Pongrojpaw D, Somprasit C, Chanthasenanont A.

OBJECTIVE: To study the efficacy of ginger and dimenhydrinate in the treatment of nausea and vomiting in pregnancy. STUDY DESIGN: Double blind randomized controlled trial. SETTING: Department of Obstetrics and Gynecology, Thammasat Hospital, Faculty of Medicine, Thammasat University. MATERIAL AND METHOD: Between January 2005 and December 2005, 170 pregnant women who attended at antenatal clinic Thammasat University Hospital with the symptoms of nausea and vomiting in pregnancy were randomly allocated into group A (n = 85) and group B (n = 85). The patients in group A received one capsule of ginger twice daily (one capsule contained 0.5 gm of ginger powder) while the patients in group B received the identical capsule of 50 mg dimenhydrinate twice daily. The visual analogue nausea scores (VANS) and vomiting times were evaluated at day 0-7 of the treatment. RESULTS: There was no significant difference in the visual analogue nausea scores (VANS) between group A and group B in day 1-7 of the treatment. The vomiting episodes of group A were greater than group B during the first and second day of the treatment with statistically significant difference. No difference in vomiting episodes during the day 3-7 of treatment was found in both groups. There was a statistically significant difference in the side effect of drowsiness after treatment in group B greater (77.64%) than group A (5.88%) (p < 0.01). CONCLUSION: From the presented data, ginger is as effective as dimenhydrinate in the treatment of nausea and vomiting during pregnancy and has fewer side effects.

Publication Types:

• placebo controlled

Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial

J Med Assoc Thai. 2007 Jan;90(1):15-20

Chittumma P, Kaewkiattikun K, Wiriyasiriwach B.

OBJECTIVE: To compare the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in pregnancy. DESIGN: Randomized double-blind controlled trial. SETTING: Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital. MATERIAL AND METHOD: One hundred and twenty-six pregnant women, with a gestational age of < or = 16 weeks who had nausea and vomiting, required anti-emetics, had no medical complication, and were not hospitalized. Pregnant women were randomly allocated to receive either 650 mg of ginger or 25 mg of vitamin B6. They were given three times per day for 4 days. The degree of nausea and vomiting were assessed by three physical symptoms of Rhode's score (episodes of nausea, duration of nausea and number of vomits). These were recorded 24 hours before treatment for baseline and each subsequent day of treatment. Difference of baseline and post-treatment nausea vomiting scores were calculated for both groups during 4 days of treatment. RESULTS: One hundred and twenty-three women returned to follow-up. Ginger and vitamin B6 significantly reduced nausea and vomiting scores from 8.7 +/- 2.2 to 5.4 +/- 2.0 and 8.3 +/- 2.5 to 5.7 +/- 2.3 respectively, (p < 0.05). The mean score change after treatment with ginger was greater than with vitamin B6 (3.3 +/- 1.5 versus 2.6 +/- 1.3), (p < 0.05). There were some minor side effects in both groups 25.4% and 23.8% (p = 0.795) respectively, such as sedation, heartburn, arrhythmia. CONCLUSION: Both ginger and vitamin B6 were effective for treatment of nausea and vomiting in pregnancy. Moreover, ginger was more effective than vitamin B6. Side effects from ginger were reported to be minor and did not need any treatment.

Publication Types:

• randomised controlled trial

A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy

Obstet Gynecol. 2004 Apr;103(4):639-45

Smith C, Crowther C, Willson K, Hotham N, McMillian V.

OBJECTIVES: To estimate whether the use of ginger to treat nausea or vomiting in pregnancy is equivalent to pyridoxine hydrochloride (vitamin B6). METHODS: A randomized, controlled equivalence trial involving 291 women less than 16 weeks pregnant was undertaken at a teaching hospital in Australia. Women took 1.05 g of ginger or 75 mg of vitamin B6 daily for 3 weeks. Differences from baseline in nausea and vomiting scores were estimated for both groups at days 7, 14, and 21. RESULTS: Ginger was equivalent to vitamin B6 in reducing nausea (mean difference 0.2, 90% confidence interval [CI] -0.3, 0.8), retching (mean difference 0.3; 90% CI -0.0, 0.6) and vomiting (mean difference 0.5; 90% CI 0.0, 0.9), averaged over time, with no evidence of different effects at the 3 time points. CONCLUSION: For women looking for relief from their nausea, dry retching, and vomiting, the use of ginger in early pregnancy will reduce their symptoms to an equivalent extent as vitamin B6.

Publication Types:

• randomised controlled trial

Effect of a ginger extract on pregnancy-induced nausea: a randomised controlled trial

Aust N Z J Obstet Gynaecol. 2003 Apr;43(2):139-44

Willetts KE, Ekangaki A, Eden JA.

OBJECTIVE: To investigate the effect of a ginger extract (EV.EXT35) on the symptoms of morning sickness. DESIGN: Double-blind randomised placebo-controlled trial. SETTING: A tertiary metropolitan teaching hospital, March 1999-November 1999. PARTICIPANTS: The participants included 120 women less than 20 weeks pregnant, who had experienced morning sickness daily for at least a week and had had no relief of symptoms through dietary changes. INTERVENTION: Random allocation of 125 mg ginger extract (EV.EXT35; equivalent to 1.5 g of dried ginger) or placebo given four times per day for 4 days. MAIN OUTCOME MEASURES: Nausea, vomiting and retching as measured by the Rhodes Index of Nausea, Vomiting and Retching. RESULTS: The nausea experience score was significantly less for the ginger extract group relative to the placebo group after the first day of treatment and this difference was present for each treatment day. Retching was also reduced by the ginger extract although to a lesser extent. No significant effect was observed on vomiting. Follow-up of the pregnancies revealed normal ranges of birthweight, gestational age, Apgar scores and frequencies of congenital abnormalities when the study group infants were compared to the general population of infants born at the Royal Hospital for Women for the year 1999-2000. CONCLUSION: Ginger can be considered as a useful treatment option for women suffering from morning sickness.

Publication Types:

• randomised controlled trial

A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy

J Med Assoc Thai. 2003 Sep;86(9):846-53

Sripramote M, Lekhyananda N.

OBJECTIVE: To compare the efficacy of ginger to vitamin B6 in the treatment of nausea and vomiting of pregnancy. STUDY DESIGN: A randomized double-blind controlled trial. SETTING: The Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital. SUBJECTS: Women with nausea and vomiting of pregnancy at or before 16 weeks of gestation, who attended the antenatal care clinic. The subjects requested anti-emetics, had no medical complications, non-hospitalized and were able to attend a one week follow-up visit. From November, 1999 to November 2000, 138 women participated and gave consent for the study. METHOD: The subjects were randomly allocated into two groups to take either 500 mg of ginger orally or an identical 10 mg of vitamin B6 one capsule three times daily for three days. Subjects graded the severity of their nausea using visual analogue scales before treatment and recorded the number of vomiting episodes in the previous 24 hours and again during three consecutive days of treatment. MAIN OUTCOME MEASURES: The change of nausea scores and the number of vomiting episodes during three days of treatment. RESULTS: The 64 subjects in each group remained in the study. The demographic data were comparable in both groups. The ginger and vitamin B6 significantly reduced the nausea scores from 5.0 (SD, 1.99) to 3.6 (SD, 2.48) and 5.3 (SD, 2.08) to 3.3 (SD, 2.07) respectively, with p < 0.001. The mean score change after treatment with ginger was 1.4 (2.21), less than with vitamin B6, which was 2.0 (2.19) but with no statistically significant difference (95% CI -1.4 to 0.2, p = 0.136). The ginger and vitamin B6 also significantly reduced the number of vomiting episodes from 1.9 (2.06) to 1.2 (1.75) and 1.7 (1.81) to 1.2 (1.50) respectively, with p < 0.01. The mean number change after treatment with ginger was 0.7 (2.18), more than with vitamin B6, which was 0.5 (1.44) but with no statistically significant difference, (p = 0.498). There were some minor side effects in both groups such as sedation (26.6% vs 32.8%, p = 0.439), and heartburn (9.4% vs 6.3%, p = 0.510), a non-significant difference. CONCLUSION: The nausea score and the number of vomiting episodes were significantly reduced following ginger and vitamin B6 therapy. Comparing the efficacy, there was no significant difference between ginger and vitamin B6 for the treatment of nausea and vomiting during pregnancy

Publication Types:

• randomised controlled trial

Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting.

Obstet Gynecol. 2005 Apr;105(4):849-56

Borrelli F, Capasso R, Aviello G, Pittler MH, Izzo AA.

OBJECTIVE: Conventional antiemetics are burdened with the potential of teratogenic effects during the critical embryogenic period of pregnancy. Thus, a safe and effective medication would be a welcome addition to the therapeutic repertoire. This systematic review was aimed at assessing the evidence for or against the efficacy and safety of ginger (Zingiber officinale) therapy for nausea and vomiting during pregnancy. DATA SOURCES: Systematic literature searches were conducted in 3 computerized databases (MEDLINE, EMBASE, and Cochrane Library), and the reference lists of all papers located were checked for further relevant publications. METHODS OF STUDY SELECTION: For the evaluation of efficacy, only double-blind, randomized controlled trials (RCTs) were included. All retrieved clinical data, including uncontrolled trials, case reports, observational studies, and RCTs, were included in the review of safety. TABULATION, INTEGRATION, AND RESULTS: Six double-blind RCTs with a total of 675 participants and a prospective observational cohort study (n = 187) met all inclusion criteria. The methodological quality of 4 of 5 RCTs was high. Four of the 6 RCTs (n = 246) showed superiority of ginger over placebo; the other 2 RCTs (n = 429) indicated that ginger was as effective as the reference drug (vitamin B6) in relieving the severity of nausea and vomiting episodes. The observational study retrieved and RCTs (including follow-up periods) showed the absence of significant side effects or adverse effects on pregnancy outcomes. There were no spontaneous or case reports of adverse events during ginger treatment in pregnancy. CONCLUSION: Ginger may be an effective treatment for nausea and vomiting in pregnancy. However, more observational studies, with a larger sample size, are needed to confirm the encouraging preliminary data on ginger safety. LEVEL OF EVIDENCE: I.

Publication Types:

• Review

Publication Types:

• Review