The effect of olive oil and the Saj® cream in prevention of striae gravidarum: A randomized controlled clinical trial

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Summary

Objective

To compare the clinical efficacy of olive oil and the Saj® cream on the occurrence and severity of striae gravidarum.

Design

Parallel randomized controlled clinical trial.

Setting

West Health Centre, Lolagar and Akbarabadi Hospitals, Tehran, Iran.

Interventions

360 Nulliparous women at their second trimester of pregnancy randomly (simple randomization) allocated into three groups of olive oil, the Saj® cream, and control that finally 150 of them (50 subjects in each group) completed the study. Control group did not receive any medication/intervention. At gestational age of 38–40 weeks the participants were evaluated regarding the occurrence of striae on abdominal skin and its severity that were primary outcome of the study.

Results

In the olive oil group, striae occurred in 72% of the participants, which were mild, moderate, and severe in 32%, 26%, and 6% of the cases, respectively. In those who received Saj® cream, striae occurred in 64% of the cases, which were mild, moderate and severe in 16%, 34%, and 14% of the cases, respectively. With regard to the control group, striae occurred in 60% of the participants, among which striae were mild, moderate, and severe in 22%, 24%, and 14% of the cases, respectively. There were no statistically significant differences among the three studied groups regarding the incidence or severity of striae.

Conclusion

Neither olive oil nor the Saj® cream were effective in preventing the occurrence of striae gravidarum or affecting its severity. Further studies to examine the effect of other herbal/chemical preparations on occurrence of striae gravidarum are recommended.

Introduction

Striae of pregnancy are one of the most common skin changes of pregnancy (seen in 50–90% of pregnancies). It represents as slightly retracted red1 and purple2 streaks on the skin of the abdomen, and sometimes the breasts, thighs, and axillae.1 The lesions are usually accompanied by itching.3 In more than 90% of the cases, the striae occur in the third trimester of pregnancy.1, 3, 4 The length of the streak is usually a few centimeters, with the width of 1–10 mm.3

Although the major etiology of striae gravidarum is not specified,4 some causative factors are genetic susceptibility,5 family history, skin type and its color, young age at the time of pregnancy, child's birth weight,3, 4 malnutrition,3 and gestational diabetes.6 This dermatologic condition may result in cosmetic concerns for mother,7 and in some cases it would cause problems in self-image,8 loss of self-esteem, and psychological problems.9

Many women who are going to become pregnant for the first time may ask their health care providers about prevention of striae gravidarum.3, 10 Although, so far no definite method has been proposed for treatment of striae of pregnancy, different studies have proposed different ideas in this respect. Moreover, many women use different types of creams and lotions such as vitamin E cream and Trofolastin cream which contains tocopherol and collagen-elastin hydrolysates.11

In Iran, the Saj cream® is produced by a local company (Seoidrood Co., Iran). It contains lanolin, stearin, triethanolamine, almond oil, and bizovax glycerin amidine. These materials can maintain the balance of normal skin moisture, and facilitate the steps of skin regeneration. Therefore, the cream has been recommended by the manufacturer for prevention of loosening of abdomen and breast skin during the pregnancy.12

Oils such as cocoa butter, almond oil, glycerin,10 and olive oil have been used during pregnancy for this purpose, but enough evidence to support their effectiveness is not available.4 In fact, the lotions and creams reduce the skin dryness and can be used to manage itching sensation accompanying striae of pregnancy.12 Olive oil is one of the oils of plant origin used for the treatment of striae, and is rich in vitamin E.3 In the comparative study carried out by Poidevin and Sydney on 116 women, it was concluded that topical administration of olive oil is not effective in prevention of striae of pregnancy.13 However, Davey carried out a retrospective study by asking 70 women in the post-partum period, and olive oil was considered as one of the items that reduced the striae.14

In pregnancy and post-partum period, one of the important roles of midwifery services is to improve the physical, psychological, and personal health level of pregnant women. It should be considered that according to our experience, many women experience stress in pregnancy and post-partum period about development of striae. Therefore, the current study was performed to compare the clinical efficacy of olive oil and the Saj® cream on the development and severity of striae gravidarum.

Section snippets

Materials and methods

This study was a parallel randomized controlled clinical trial that was conducted at the West Health Centre, Lolagar and Akbarabadi Hospitals, Tehran, Iran from August 2009 to May 2010.

The study population consisted of nulliparous females with gestational age of 18–20 weeks and the age ranged from 20 to 30 years. The range of body mass index (BMI) was from 18.5 to 25.

After the study objectives were described for the participants, written informed consent was obtained and they were informed that

Results

Mean (±SD) ages of olive oil, the Saj cream, and control groups were 23.8 (±2.7), 24.2 (±3.3), and 23.8 (±2.6) years, respectively. The highest academic degree was high school diploma in all groups. Most women participated in the study (93%) did not have the history of miscarriage. The three groups were not different in terms of having the history of miscarriage. Moreover, in 58% of the participants, the history of striae of pregnancy in their first-degree relatives was positive, and according

Discussion

According to the results provided above, olive oil and Saj cream® had no significant effects on development and severity of striae gravidarum. In a study in Japan, Belda et al. reported the prevalence of striae gravidarum as 56%.11 Our results are consistent with their findings.

Table 3 provides the data about severity of striae. It was observed that in the control group, the percentage values of mild, moderate, and severe striae were 22%, 24%, and 14%, respectively. In the study carried out by

Conclusion

Neither olive oil nor the Saj® cream was effective in reducing the incidence and/or severity of striae gravidarum in nulliparous women. Carrying out further research on other plant oils such as almond oil, glycerin, and cocoa butter; and also creams available on market, particularly those produced by local companies, is suggested. The studies could be performed to achieve the most desirable preventive effect in development of striae and control of its severity; and thus, regarding the safety of

Conflict of interest statement

None declared.

Funding

This study is supported by Deputy of Research of Medical Science University of Iran and the Sepidroo Company, manufacturer of beauty and health products.

Acknowledgements

The authors wish to thank the Research Chancellor of Tehran University of Medical Sciences for their financial support. Moreover, the cooperation of managers and staff of West Health Center, and Loulagar and Shahid Akbarabadi Hospitals in fulfillment of the research is highly appreciated. We wish to thank Farzan Institute for Research and Technology for technical assistance.

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Registration: This trial was registered in IRCT registration with number IRCT138807282172N2.

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