Translating Ethnomedicinal Knowledge Into Evidence-Based Assessment: Evaluating the Safety of Rhus coriaria L. (Sumac) During Pregnancy

Abstract

Rhus coriaria L. (sumac) is a traditional spice and medicinal plant widely used in Kurdish and Middle Eastern cultures. Its bioactive polyphenols—particularly gallic acid, quercetin derivatives, tannins, and anthocyanins—confer antioxidant, anti-inflammatory, and antimicrobial activities. Despite extensive ethnomedicinal use, data on its safety during pregnancy are scarce. Traditional sources caution against excessive intake due to possible uterine stimulation, while experimental evidence indicates hormonal modulation and cytotoxicity at high doses. A recent clinical trial demonstrated postpartum uterotonic and hemostatic actions, highlighting potential reproductive tissue effects. However, no controlled reproductive toxicology or teratogenicity studies exist. This review integrates phytochemical, pharmacological, and ethnomedicinal evidence to assess the reproductive safety of R. coriaria . Current evidence has not identified adverse outcomes associated with normal culinary consumption; however, controlled studies evaluating the safety of R. coriaria during pregnancy are lacking. Concentrated extracts and supplements therefore warrant caution until adequate preclinical and clinical studies establish pregnancy-specific safety margins.