TOX/2024/43 Annex A

Search methodology

1.    The following electronic databases were searched for relevant articles published between 2014 and 2024: LitFetch (which includes material from PubMed, Scopus, Ebsco (Food Science Source) and Springer), Google and Google Scholar. The searches were conducted on various dates between 13^th  May 2024 and 24^th May 2024.

2.    The search terms used included ‘echinacea’ AND: (‘pregnan*’ OR ‘maternal*’ OR ‘reproduction’ OR ‘gestation’ OR ‘lactation’ OR ‘preconception’ OR ‘development’ OR ‘tox*’ OR ‘safety’ OR ‘uses’ OR ‘consumption’ OR ‘indication’ OR ‘interaction’).

3.    The references from extracted papers were searched for citations not captured in the literature search. Only articles published in English were included, due to the linguistic abilities of the reviewer.

4.    The UKTIS was also asked for information on any enquiries relating to maternal echinacea use and any reports of adverse effects in pregnant women or their newborn infants received from 1983 to June 2024. This included information relating to the type, dosage, duration, and timing of echinacea taken and any pregnancy outcomes captured through follow-up.