Abstract

Low back pain (LBP) during pregnancy is associated with heightened maternal stress and systemic inflammation, contributing to adverse outcomes such as preterm birth and low birth weight. While paracetamol is commonly used for pain relief in pregnant women, its effects on inflammatory pathways and pregnancy outcomes remain inconclusive. Red ginger (Zingiber officinale Roscoe) has demonstrated anti-inflammatory potential through downregulation of Interleukin 6 (IL-6) and tumor necrosis factor-alpha and upregulation of interleukin 10 (IL-10) in various inflammatory models. However, studies evaluating the combined use of red ginger and paracetamol in animal models have not yet been conducted. This study aimed to evaluate the effects of red ginger extract, alone and in combination with paracetamol, on inflammatory biomarkers, physiological stress, and pregnancy outcomes in Wistar rats with nerve growth factor (NGF)-induced LBP. Thirty pregnant rats were divided into five groups: normal control, negative control (NGF induction), paracetamol only, red ginger only, and combination therapy. Treatments were given orally from gestational day 7 to 20. Measured parameters included systemic and placental IL-6, IL-10, plasma cortisol, uterine Heat Shock Protein 70 (HSP70), and NGF-induced LBP, which increased IL-6, cortisol, and uterine HSP70 but decreased IL-10, accompanied by reduced fetal growth and shorter gestation. Red ginger, alone or combined with paracetamol, shifted these biomarkers toward normal and improved fetal growth and gestational length (with the combination showing the largest median changes among treatment groups). In summary, red ginger extract demonstrates therapeutic potential as a complementary co-therapy to mitigate inflammation and stress during pregnancy with LBP, with enhanced effects when combined with paracetamol.

Key words: Keywords:Red ginger, low back pain, pregnancy, inflammation, fetal growth, Wistar rats