The effect of perinatal misuse of medicinal plants by parturients on the survival of newborns in Morocco

The concept of perinatal misuse of medicinal plants among parturients is widespread and the association between these effects and the survival of newborns requires research. The objective of this study is to evaluate the performance of the neonatal unit at the service of pediatrics from the Laâyoune center based on the survival analysis of newborns aged 28 to 37 weeks. This is a retrospective analytical study carried out at the neonatal unit of the pediatric department of Laayoune of newborns (N: 243) hospitalized at the Regional Hospital Center of Mothers using medicinal plants perinatally. Proportional hazards regression, also called Cox regression model, was used to perform Kaplan-Meier (K-M) survival curve analysis. Results linked to maternal (age, parity, marital status, occupation, education, medical and toxicological history, gestational age) and neonatal characteristics (reference age at the neonatal center, sex, birth weight, birth size, duration of resuscitation) as well that the evaluation of maternal perinatal herbal toxicity by the severity score of intoxication, were studied. A cohort of 243 participants, including 158 boys and girls aged 85 from urban and rural areas, average age of one month ±7 days, hospitalized at the Lâayoune Regional Hospital Center from April 1, 2022 to May 1 2023 Neonatal mortality was significantly associated with the use mainly of Artemissa herba-alba Asso (OR=1.13 [1.01-1.45]), Rosmarinus officinalis L (OR=1.7 [1.43] - 2.14]) and Juniperus oxycedrus (OR=1.2 [.35-2.34]), for the survival analysis, the calculated log-rank estimate is (13.408), with the P value between zero and three decimal places (0.000); conclude that there is a statistically significant difference in survival times between the two treatments: antibiotic therapy, corticosteroid therapy and observation of newborns who received no treatment and were admitted to the pediatric department.

分娩产妇围产期滥用药用植物的现象普遍存在，此类用药行为与新生儿存活状况之间的关联仍有待进一步研究。本研究旨在基于28至37周龄新生儿的生存分析，评估拉永（Laâyoune）中心儿科下属新生儿科病房的诊疗效能。本研究为回顾性分析研究，研究对象为2022年4月1日至2023年5月1日期间，在拉永地区母亲区域医院中心新生儿科住院、且围产期使用过药用植物的新生儿（N=243）。研究采用比例风险回归模型（proportional hazards regression，亦称Cox回归模型）开展Kaplan-Meier（K-M）生存曲线分析。本次研究分析了产妇相关特征（年龄、孕产次、婚姻状况、职业、受教育程度、病史与毒物接触史、孕周）与新生儿特征（新生儿中心接收时的校正胎龄、性别、出生体重、出生身长、复苏时长），并通过中毒严重程度评分评估产妇围产期草药用药的毒性风险。本研究共纳入243名研究对象，其中男婴158名、女婴85名，来自城乡地区，研究对象平均住院时月龄为1个月±7天，收治时段为2022年4月1日至2023年5月1日。研究结果显示，新生儿死亡率与主要使用白艾蒿（Artemisia herba-alba Asso）、迷迭香（Rosmarinus officinalis L.）及洋圆柏（Juniperus oxycedrus）的用药行为显著相关，其比值比（OR）分别为1.13[95%置信区间：1.01-1.45]、1.7[95%置信区间：1.43-2.14]及1.2[95%置信区间：0.35-2.34]。生存分析的对数秩检验统计量为13.408，P值为0.000（保留三位小数）。分析结果表明，接受抗生素治疗、糖皮质激素治疗的新生儿组，与未接受任何治疗仅接受常规观察并收治于儿科病房的新生儿组相比，两组间的生存时间存在统计学显著性差异。