Safety of Japanese herbal Kampo medicines for the treatment of depression during pregnancy

Nobuaki Michihata*, Daisuke Shigemi, Hayato Yamana, Hiroki Matsui, Taisuke Jo, Hideo Yasunaga

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To clarify the fetal safety of herbal Kampo medicines, including Hange-koboku-to, Koso-san, Nyoshin-san, Yokukansan, Yokukansan-kachinpi-hange, Saiko-keishikankyo-to, Keishi-karyukotu-borei-to, and Kanbaku-taisou-to, when administered to pregnant women with depression using a large healthcare administrative database. Methods: We extracted data from the JMDC Claims Database (2005–2018) for this retrospective cohort study of pregnant women aged 19 years or older admitted to obstetric clinics or hospitals for delivery. Participants were classified into four groups: those without depression, those diagnosed with depression without medication, those given Kampo medicines for depression, and those given western medicines for depression. Neonatal outcomes (congenital anomalies, low birth weight, and preterm birth) were considered as the safety outcome measures. Results: We identified 179 707 eligible mothers. The adverse outcomes did not differ significantly between participants receiving Kampo medicine and those not diagnosed with depression during pregnancy. The proportion of low-birth-weight neonates did not differ significantly between the Kampo medicine and non-depression groups (adjusted odds ratio [aOR] 1.28; 95% confidence interval [CI] 0.86–1.91), but was significantly higher in the unmedicated depression group (aOR 1.31; 95% CI 1.07–1.61) and western medicine group (aOR 1.47; 95% CI 1.18–1.83). Conclusion: Kampo medicines are safe for treating depression during pregnancy without increasing the incidence of congenital anomalies, low birth weight, or preterm birth.

Original languageEnglish
JournalInternational Journal of Gynecology and Obstetrics
Publication statusAccepted/In press - 2022


  • Congenital anomaly
  • Depression during pregnancy
  • Hange-koboku-to
  • Japanese herbal Kampo medicine
  • Kanbaku-taisou-to
  • Yokukansan
  • Yokukansan-kachinpi-hange

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


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