Is pomegranate juice good during pregnancy?

We do not know, because it has not been tested in the women asking. We found no randomized trial of pomegranate juice in ordinary pregnancies with a clinical outcome. The pregnancy trials that exist are small and in special groups. In 99 mothers whose babies were not growing well, 8 oz of juice a day until delivery was reported to lower infant brain injury, while an earlier pilot in 77 such mothers found no difference. Late in pregnancy, high intake of polyphenol-rich foods has been linked to changes in the fetal heart that reversed when mothers cut back, though those studies did not name pomegranate.

Unsettled. The answer is open because the trials are few, small and aimed at a narrow group. Three of the four were in fetal growth restriction, the fourth measured a marker in 12 placentas, and none has been repeated in ordinary pregnancies.

What the trials found

When the baby is not growing well

Most of the pregnancy research is about fetal growth restriction, where the baby is smaller than expected. In a US pilot, 77 mothers diagnosed at 24 to 34 weeks drank 8 oz of pomegranate or placebo juice a day until delivery. The trial found no group differences in infant brain injury, brain size or brain volumes. A second US trial in 99 mothers reported a lower risk of white or gray matter injury on brain scans with pomegranate juice. Only 57 infants were scanned, the authors called it exploratory, and brain volumes did not differ.

An Iranian trial randomized 54 women with fetal growth restriction to 7.8 fl oz (230 ml) of pomegranate juice a day for 6 weeks or to sildenafil, a drug. Birth weight and Apgar scores did not differ between the two groups. The trial had no placebo group, so a similar result is not evidence that either helped.

The placenta

Women randomized at 35 to 38 weeks to 8 oz a day of pomegranate or apple juice until delivery had lower oxidative stress in the placenta with pomegranate. That is a laboratory marker measured in 12 placentas, 4 from the pomegranate group. The trial did not report any outcome for mother or baby.

Nausea and vomiting

A 2026 network meta-analysis of 24 randomized trials in 3017 pregnant women ranked vitamin B6 with pomegranate and mint second for easing nausea and vomiting, behind quince. That ranking rests on a single Iranian trial of a syrup that combined pomegranate with spearmint, given with B6, and on indirect comparisons. It tells you nothing about pomegranate on its own. A 2020 systematic review of herbal remedies listed pomegranate and spearmint syrup among options for mild to moderate symptoms, and pooled no numbers to support it.

Blood pressure and blood sugar, outside pregnancy

The firmest pomegranate results come from adults who were not pregnant. Across 8 randomized placebo controlled trials, pomegranate juice lowered systolic blood pressure by 4.96 mmHg, with a confidence interval of 2.25 to 7.67, and diastolic by 2.01 mmHg, interval 0.31 to 3.71. The largest pooling, 53 trials in 2306 adults, found small falls in blood pressure and fasting glucose and no change in HbA1c, insulin or insulin resistance.

Myth. These results cannot be assumed to carry over to pregnancy. A 2025 meta-analysis of polyphenol products for preeclampsia found 14 trials of six candidates, and none was pomegranate. Juice is not a treatment for high blood pressure in pregnancy, and we found no trial that tested it as one.

Who should be careful

The nausea review that ranked the pomegranate syrup could not judge safety for any remedy, because adverse events were too sparsely reported across its 24 trials to pool. That is missing data, and it should not be read as a clean safety record.

Not for everyone. Late in pregnancy, large amounts of polyphenol-rich food are a real question for the fetal heart. In a Brazilian cohort, fetuses of mothers eating the most polyphenol-rich foods in the third trimester, over 1089 mg a day, had faster flow in the ductus arteriosus, 0.96 against 0.61 m/s, than those eating under 127 mg. This is observational and covers all such foods, with pomegranate not named.

The same group studied 51 third-trimester fetuses with a narrowed ductus arteriosus and no exposure to anti-inflammatory drugs. After their mothers stopped polyphenol-rich foods for at least 3 weeks, 48 of them (96 percent) showed complete reversal. The trial was open and not randomized, and pomegranate was not named. One result points the other way. In the US trial of 99 mothers, a subset had a fetal heart scan after 2 weeks on 8 oz of juice a day and showed no narrowing. That scan covered 2 weeks, not the rest of the pregnancy.

On medicines, we found one case report. A 64-year-old woman on warfarin who drank pomegranate juice 2 to 3 times a week saw her INR fall below target after she stopped. She was not pregnant, and one case cannot show how often this happens. If you take a blood thinner, do not start or stop large amounts of the juice without telling the doctor who manages it.

What expert bodies say

We found no position on pomegranate in pregnancy from ACOG, NICE, the NIH Office of Dietary Supplements, NCCIH or EFSA. For nausea and vomiting, the nearest guidance is from NICE, which advises suggesting ginger to pregnant women with mild to moderate symptoms who prefer a non-drug option. It names no pomegranate remedy.

How we searched

What would change this answer

• A placebo-controlled randomized trial of pomegranate juice in ordinary pregnancies, with clinical outcomes such as preeclampsia, gestational diabetes or birth weight. None exists.
• A larger trial in fetal growth restriction with a clinical main outcome, to settle whether the brain scan result in 99 mothers holds up or matches the null pilot in 77.
• Results from two registered trials in women whose waters broke early. Both have been listed with an unknown status since 2014 and have posted nothing.
• A systematic review of pomegranate for nausea and vomiting with more than one trial in it.
• Fetal heart data on pomegranate juice itself in the third trimester, over weeks rather than 2 of them.

Sources

1. ev-pompg-01 · Meta-analysis or systematic review · systematic review and network meta-analysis of randomized controlled trials · n = 3017
   P-scores indicated that quince administration is likely to result in the most considerable reduction in NVP scores, followed by B6 and pomegranate and mint, acupressure P6, dimenhydrinate, and acupuncture and doxylamine–pyridoxine (see Figure 3).
   
   Who: Pregnant women with nausea and vomiting in 24 randomized controlled trials, 16 intervention categories
   Effect: ranked second by P-score for reduction of nausea and vomiting scores at 1 week; the B6 plus pomegranate and mint node rests on a single trial and mostly indirect comparisons
   Certainty: The "B6 + pomegranate + mint" node = one Iranian RCT (ref 30); pomegranate was given in a mixture with mint and B6, so there is no separate effect of pomegranate. The authors: ranking from indirect comparisons, with caution; quality low-moderate (CINeMA).
   Nutrients, 2026 · checked 2026-10-07 · we read the fulltext
2. ev-pompg-02 · Meta-analysis or systematic review · systematic review and network meta-analysis of randomized controlled trials · n = 3017
   However, high heterogeneity and sparse reporting of adverse effects warrant caution when translating these results into clinical practice.
   
   Who: Pregnant women with nausea and vomiting in 24 randomized controlled trials
   Effect: no pooled safety analysis possible; high heterogeneity
   Certainty: Absence of safety data, not proof of safety.
   Nutrients, 2026 · checked 2026-10-07 · we read the abstract
3. ev-pompg-03 · Meta-analysis or systematic review · systematic review of clinical trials · n = not stated in abstract
   Herbal medicines such as matricaria chamomilla, elettaria cardamomum, pomegranate and spearmint syrup, lemon provide safe and effective medical alternatives for treating pregnant women with mild to moderate NVD.
   
   Who: Pregnant women with nausea and vomiting in trials of herbal medicines (PubMed, Cochrane Library, Scopus to January 2019)
   Effect: qualitative conclusion only; no pooled effect size for pomegranate and spearmint syrup
   Certainty: The conclusion "safe and effective" rests on a single small Iranian RCT of pomegranate syrup with mint against B6 (IRCMJ 2017, outside PubMed). No full text (no_pmc, paywall).
   J Obstet Gynaecol, 2020 · checked 2026-10-07 · we read the abstract
4. ev-pompg-04 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 14 trials
   Fourteen trials investigating six candidates were included.
   
   Who: Pregnant women in randomized trials of polyphenol-containing extracts or supplements versus placebo or standard care
   Effect: 14 trials of six polyphenol candidates included; no pomegranate trial among them
   Certainty: Axis 9: the review has no randomized trial of pomegranate in preeclampsia (candidates: EGCG, resveratrol, Salvia miltiorrhiza, Bryophyllum, raspberry, cranberry). The effect of pomegranate on preeclampsia in humans has not been tested.
   BJOG, 2025 · checked 2026-10-07 · we read the abstract
5. ev-pompg-05 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized controlled trials · n = 8 RCTs
   Quantitative data synthesis from 8 RCTs showed significant reductions in both systolic [weighed mean difference (WMD): -4.96mmHg, 95% CI: -7.67 to -2.25, p<0.001) and diastolic BP (WMD: -2.01mmHg, 95% CI: -3.71 to -0.31, p=0.021) after pomegranate juice consumption.
   
   Who: Adults in 8 randomized placebo-controlled trials of pomegranate juice; no pregnant women
   Effect: SBP WMD -4.96 mmHg (95% CI -7.67 to -2.25); DBP WMD -2.01 mmHg (95% CI -3.71 to -0.31)
   Certainty: Not about pregnancy; do not transfer to gestational hypertension or preeclampsia. Pregnant women with hypertension are treated per protocol, juice does not replace medication.
   Pharmacol Res, 2017 · checked 2026-10-07 · we read the abstract
6. ev-pompg-06 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of randomized controlled trials · n = 2306
   After the screening of the search results a 53 RCTs with 2306 participants included in this meta-analysis.
   
   Who: Adults in 53 randomized controlled trials of pomegranate supplementation; no pregnant women
   Effect: SBP SMD -0.49 (95% CI -0.68 to -0.31); FBG SMD -0.15 (95% CI -0.26 to -0.04); no change in HbA1c, insulin, HOMA-IR
   Certainty: Not about pregnancy; standardized differences, clinical size small. For gestational diabetes there are no RCT data (axis 9).
   Nutr Metab Cardiovasc Dis, 2025 · checked 2026-10-07 · we read the abstract
7. ev-pompg-07 · Randomized controlled trial(s) · double-blind randomized controlled trial (exploratory) · n = 99
   A subset of participants underwent fetal echocardiogram after 2 weeks on juice with no evidence of ductal constriction.
   
   Who: Mothers with fetal growth restriction diagnosed at 24-34 weeks, Brigham and Women's Hospital; 103 fetuses
   Effect: no evidence of ductal constriction on fetal echocardiogram after 2 weeks on juice, in a subset (size not stated); brain outcomes are carded in pomj-r3-15
   Certainty: Pilot, only 57 infants with MRI; secondary endpoint; POM Wonderful funding in the previous cohort. Echo is a subsample after 2 weeks, not for the whole period.
   Sci Rep, 2021 · checked 2026-10-07 · we read the abstract
8. ev-pompg-08 · Randomized controlled trial(s) · randomized, placebo-controlled, double-blind pilot study · n = 77
   There were no group differences in brain injury, metrics or volumes.
   
   Who: Mothers with fetal growth restriction at 24-34 weeks, Barnes-Jewish Hospital; juice for a mean 20 to 27 days until delivery
   Effect: no group differences in brain injury, metrics or volumes; reduced diffusivity in the internal capsule and altered functional connectivity; no direct health effects
   Certainty: Pilot; only 55 infants with MRI; diffusion findings are a surrogate, clinical meaning unknown.
   PLoS One, 2019 · checked 2026-10-07 · we read the abstract
9. ev-pompg-09 · Randomized controlled trial(s) · randomized clinical trial · n = 54
   The results showed that there was no significant difference between the two groups in terms of mean Apgar score of 1 minute (P=0.631), 5 minutes (P=0.323) and birth weight (P=0.580).
   
   Who: Pregnant women with intrauterine growth retardation, Arak, Iran; 21 pomegranate and 23 sildenafil cases analyzed
   Effect: no difference in birth weight (P=0.580), Apgar 1 and 5 min, uterine or umbilical artery PI; estimated fetal weight gain greater with sildenafil (P=0.009)
   Certainty: No placebo: comparison with sildenafil, which itself has no established benefit in FGR (STRIDER). "A similar effect" does not mean benefit.
   International Journal of Fertility and Sterility, 2025 · checked 2026-10-07 · we read the abstract
10. ev-pompg-10 · Randomized controlled trial(s) · randomized trial with laboratory outcomes, plus in vitro experiments · n = 12
    Placental tissues from 12 patients (4 in the pomegranate group and 8 in the control group) were collected for analysis of oxidative stress.
    
    Who: Women with singleton pregnancies at 35-38 weeks; placentas from 4 pomegranate and 8 control patients analyzed
    Effect: decreased placental oxidative stress versus apple juice; no clinical outcomes reported
    Certainty: A biomarker in the placenta, not a clinical outcome; 12 placentas. The in vitro part of this article = D, not used here.
    American Journal of Physiology - Endocrinology and Metabolism, 2012 · checked 2026-10-07 · we read the abstract
11. ev-pompg-11 · Observational data · prospective cohort · n = 143
    In the exposed fetuses, ductal velocities were higher (systolic: 0.96+/-0.23 m/s; diastolic: 0.17+/-0.05 m/s) and right-to-left ventricular ratio was higher (1.23+/-0.23) than in unexposed fetuses (systolic: 0.61+/-0.18 m/s, P<0.001; diastolic: 0.11+/-0.04 m/s, P=0.011; right-to-left ventricular ratio: 0.94+/-0.14, P<0.001).
    
    Who: Third-trimester fetuses: 102 with maternal polyphenol-rich food intake above the 75th percentile (over 1089 mg/day), 41 below the 25th (under 127 mg/day)
    Effect: systolic ductal velocity 0.96 vs 0.61 m/s (P<0.001); right-to-left ventricular ratio 1.23 vs 0.94
    Certainty: About all polyphenol-rich foods (tea, cocoa, grapes, orange, etc.), not pomegranate separately; one research group (Zielinsky, Brazil). Opposite signal: in an RCT in IUGR after 2 weeks of 8 oz juice there was no constriction (ev-pompg-07).
    J Perinatol, 2010 · checked 2026-10-07 · we read the abstract
12. ev-pompg-12 · Observational data · open, non-randomized clinical trial · n = 77
    After discontinuation of PRF (≥3 weeks), 48/51 fetuses (96%) showed complete reversal of DC, with decrease in mean ductal systolic velocity (1.74±0.20 m s(-1) to 1.31±0.34 m s(-1), P<0.001), mean diastolic velocity (0.33±0.09 m s(-1) to 0.21±0.07 m s(-1), P<0.001) and mean right to left ventricular dimension ratio (1.37±0.26 to 1.12±0.17, P<0.001) and increase in mean ductal pulsatility index (PI) (1.98±0.36 to 2.46±0.23, P<0.001).
    
    Who: 51 third-trimester fetuses with ductus arteriosus constriction, no NSAID history; 26 normal fetuses as controls
    Effect: complete reversal in 48 of 51 (96%) after at least 3 weeks without polyphenol-rich foods
    Certainty: Nonrandomized, open-label; control is other fruits without constriction. Pomegranate not named separately. Practical conclusion: large daily volumes of concentrated polyphenol juices in the third trimester are a question for the doctor, not a ban.
    J Perinatol, 2012 · checked 2026-10-07 · we read the abstract
13. ev-pompg-13 · Laboratory or animal data · case report · n = 1
    She stopped drinking the juice, and her INRs became subtherapeutic.
    
    Who: One 64-year-old woman on warfarin 4 mg/day for recurrent deep vein thrombosis
    Effect: subtherapeutic INR after stopping juice; warfarin dose increased; possible relationship by Drug Interaction Probability Scale
    Certainty: Not pregnant, but relevant for pregnant women on anticoagulants: consistency of juice intake matters more than the juice itself. In pregnancy heparin is more common, not warfarin.
    Pharmacotherapy, 2009 · checked 2026-10-07 · we read the abstract
14. ev-pompg-14 · Position of an expert body · clinical guideline
    For pregnant women with mild-to-moderate nausea and vomiting who prefer a non-pharmacological option, suggest that they try ginger.
    
    Who: Pregnant women with mild to moderate nausea and vomiting, NICE antenatal care guideline NG201, recommendation 1.4.3
    Effect: ginger is the only food-type remedy suggested for nausea and vomiting of pregnancy
    Certainty: T2, E. Web quote: curl of the Recommendations HTML page and separately the NG201 PDF (63 pp., pdftotext), the sentence matches verbatim (the HTML has non-breaking hyphens).
    NICE guideline NG201, Antenatal care, 2021, recommendation 1.4.3 · checked 2026-10-07 · we read the section
15. pomj-r3-15 · Randomized controlled trial(s) · double-blind exploratory randomized controlled trial · n = 99
    No significant group differences were found in brain volumes or white matter microstructure; however, infants whose mothers consumed pomegranate juice demonstrated lower risk for brain injury, including any white or cortical grey matter injury compared to placebo.
    
    Who: 99 mothers with IUGR diagnosed at 24-34 weeks, 8 oz pomegranate (n=56) or placebo (n=47) juice daily to delivery, 57 infants scanned
    Effect: no difference in brain volumes or white matter, lower risk of any white or cortical gray matter injury with pomegranate; no ductal constriction on fetal echo
    Certainty: exploratory, only 57 infants imaged, effect size not given in abstract; NCT04394910
    Sci Rep, 2021 · checked 2026-09-29 · we read the abstract