Main Article Content
Cranberry, vaccinium macrocarpon, pregnancy, lactation, breastfeeding, systematic review
There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbs used during pregnancy and lactation. This is one article in a series that systematically reviews the evidence for herbs commonly used during pregnancy and lactation.
To systematically review the literature for evidence on the use, safety and pharmacology of cranberry, focusing on issues pertaining to pregnancy and lactation.
We searched 7 electronic databases and compiled data according to the grade of evidence found.
There is no direct evidence of safety or harm to the mother or fetus as a result of consuming cranberry during pregnancy. Indirectly, there is good scientific evidence that cranberry may be of minimal risk, where a survey of 400 pregnant women did not uncover any adverse events when cranberry was regularly consumed. In lactation, the safety or harm of cranberry is unknown.
Women experience urinary tract infections with greater frequency during pregnancy. Given the evidence to support the use of cranberry for urinary tract infections (UTIs) and its safety profile, cranberry supplementation as fruit or fruit juice may be a valuable therapeutic choice in the treatment of UTIs during pregnancy
2. Raz R, Chazan B, Dan M. Cranberry juice and urinary tract infection. Clin Infect Dis 2004;38(10):1413-9.
3. Lynch DM. Cranberry for prevention of urinary tract infections. Am Fam Physician 2004;70(11):2175-7.
4. Liu Y, et al. Role of cranberry juice on molecular- scale surface characteristics and adhesion behavior of Escherichia coli. Biotechnol Bioeng 2006;93(2):297-305.
5. D'Souza Z, D'Souza D. Urinary tract infection during pregnancy--dipstick urinalysis vs. culture and sensitivity. J Obstet Gynaecol 2004;24(1):22-4.
6. Sheikh MA, et al. Incidence of urinary tract infection during pregnancy. East Mediterr Health J 2000;6(2-3):265-71.
7. Cranberry and urinary tract infection. Drug Ther Bull 2005;43(3):17- 9.
8. Nordeng H, Havnen GC. Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiol Drug Saf 2004;13(6):371 -80.
9. Jellin JM, Batz F, Hitchens K. Natural medicines comprehensive database 3rd Edition. 2002, Stockton, CA: Therapeutic Research Faculty. 1530.
10. www.naturalstandard.com, Cranberry (Vaccinium macrocarpon) Natural Standard Monograph. 2003.
11. Jepson RG, Mihaljevic L, Craig J. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2004;(2):CD001321.
12. Shmuely H, et al. Susceptibility of Helicobacter pylori isolates to the antiadhesion activity of a high-molecular- weight constituent of cranberry. Diagn Microbiol Infect Dis 2004;50(4):231- 5.
13. Burger O, et al. A high molecular mass constituent of cranberry juice inhibits helicobacter pylori adhesion to human gastric mucus. FEMS Immunol Med Microbiol 2000;29(4):295-301
14. Weiss EL, et al. Inhibitory effect of a high- molecular- weight constituent of cranberry on adhesion of oral bacteria. Crit Rev Food Sci Nutr 2002;42(3 Suppl):285-92.
15. Koo H, et al. Influence of cranberry juice on glucan- mediated processes involved in Streptococcus mutans biofilm development. Caries Res 2006;40(1):20- 7.
16. Labrecque J, et al. Effects of a high-molecular- weight cranberry fraction on growth, iofilm formation and adherence of Porphyromonas gingivalis. J Antimicrob Chemother 2006;58(2):439-43.
17. Weiss EI, et al. Cranberry juice constituents affect influenza virus adhesion and infectivity. Antiviral Res 2005;66(1):9- 12.
18. Dwyer PL, O'Reilly M. Recurrent urinary tract infection in the female. Curr Opin Obstet Gynecol 2002;14(5):537-43.
19. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed. 1993, Binghamton, NY: Haworth Herbal Press.
20. Terris MK, Issa MM, Tacker JR. Dietary supplementation with cranberry concentrate tablets may increase the risk of nephrolithiasis. Urology 2001;57(1):26-9.
21. Bodel P, Cotran R, Kass E. Cranberry juice and the antibacterial action of hippuric acid. J Lab & Clin Med 1959;54(6):881- 8.
22. Garcia-Calatayud S, Larreina Cordoba JJ, Lozano De La Torre MJ. [Severe cranberry juice poisoning]. An Esp Pediatr 2002;56:72-3.
23. Johns Cupp M, ed. Toxicology and Clinical Pharmacology of Herbal Products. 2000, Humana Press: Totowa, New Jersey.
24. Anonymous. Cranberry, in Lawrence review of natural products. 1994 Facts and Comparisons: St. Louis, MO.
25. Sobota AE. Inhibition of bacterial adherence by cranberry juice: potential use for the treatment of urinary tract infections. J Urol 1984;131:1013-6.
26. Ahuja S, Kaack B, Roberts J. Loss of fimbrial adhesion with the addition of Vaccinum macrocarpon to the growth medium of P- fimbriated Escherichia coli. J Urol 1998;159:559-62.
27. Avorn J. The effect Of Cranberry Juice on the presence of bacteria and white blood cells in the urine of elderly women. What is the role of bacterial adhesion? Adv Exp Med Biol 1996;408:185-6.
28. Fleet JC. New support for a folk remedy: Cranberry juice reduces bacteriuria and pyuria in elderly women. Nutr Rev 1994;52:168- 70
29. Kinney AB, Blount M. Effect of cranberry juice on urinary pH. Nurs Res 1979;28:287-90.
30. Lee YL, et al. Does cranberry juice have antibacterial activity? JAMA 2000;283:1691.
31. Ofek I, et al. Anti-Escherichia coli adhesin activity of cranberry and blueberry juices. N Engl J Med 1991;324:1599.
32. Foo LY, et al. The structure of cranberry proanthocyanidins which inhibit adherence of uropathogenic P-fimbriated Escherichia coli in vitro. Phytochemistry 2000;54:173-81.
33. Habash MB, et al. The effect of water, ascorbic acid, and cranberry derived supplementation on human urine and uropathogen adhesion to silicone rubber. Can J Microbiol 1999;45:691 -4.
34. Harkins K. What's the use of cranberry juice? Age and Ageing 2000;29:9-12.
35. Howell AB, et al. Inhibition of the Adherence of P-Fimbriated Escherichia coli to Uroepithelial -Cell Surfaces by Proanthocyanidin Extracts from Cranberries (letter). N Engl J Med 1998;339:1085-6.
36. Schmidt DR, Sobota AE. An examination of the anti- adherence activity of cranberry juice on urinary and nonurinary bacterial isolates. Microbios 1988 ;55:173 -81.
37. Di Martino P, et al. Reduction of Escherichia coli adherence to uroepithelial bladder cells after consumption of cranberry juice: a double -blind randomized placebo-controlled cross-over trial. World J Urol 2006;24(1):21-7.
38. Lowe FC, Fagelman E. Cranberry juice and urinary tract infections: what is the evidence? Urology 2001;57:407-13.
39. Konowalchuk J, Speirs JI. Antiviral effect of commercial juices and beverages. Appl Environ Microbiol 1978;35(6):1219-20.
40. Pedersen CB, et al. Effects of blueberry and cranberry juice consumption on the plasma antioxidant capacity of healthy female volunteers. Eur J Clin Nutr 2000;54:405-8.
41. Bomser J, et al. In vitro anticancer activity of fruit extracts from Vaccinium species. Planta Med 1996;62:212-6.
42. Anonymous. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8.
43. Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.
44. Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003;327(7429):1454.
45. Greenblatt DJ, et al. Interaction of flurbiprofen with cranberry juice, grape juice, teafluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79(1):125-33.
46. Uesawa Y, Mohri K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-72.
47. Grenier J, et al. Pomelo juice, but not cranberry juice, affects the pharmacokinetics of cyclosporine , and in humans. Clin Pharmacol Ther 2006;79(3):255-62.
48. McAleer SJ, Loughlin KR. Nephrolithiasis and pregnancy. Curr Opin Urol 2004;14(2):123- 7.
49. Drago JR, Rohner TJ, Jr., Chez RA. Management of urinary calculi in pregnancy. Urology 1982;20(6):578 -81