Article
Acupuncture for relief of pregnancy-related conditions in ambulatory care – a systematic review of reviews
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Published: | March 6, 2018 |
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Background and objective: Many pregnant women are dealing with complaints caused by hormonal and musculoskeletal changes. Turning to non-pharmacological treatments, acupuncture is one of several alternatives promising relief. Acupuncture is part of Traditional Chinese Medicine and based on the stimulation of specific points on the body surface, the acupuncture points. A normal treatment consists of insertion of a varying number of needles up to 30 which are removed after 20-30 minutes. During pregnancy, the therapist must avoid certain acupuncture points that are supplying the cervix and the uterus and are used to induce labor.
Our aim was to critically appraise the best available evidence for traditional needle acupuncture treatment of pregnancy-related conditions in ambulatory care.
Methods: We searched MEDLINE, The Cochrane Library, and DARE for systematic reviews, meta-analyses, and Health Technology Assessments in English or German in November 2015 and updated our searches in March 2017. We included unselected or low-risk pregnant women of all ages and at any stage of pregnancy treated by needle acupuncture compared to standard care, no treatment, placebo, or sham acupuncture in an ambulatory setting. As outcome of interest, we considered course of pregnancy, labor pain, nausea, retching, vomiting, back pain, and adverse events. Methodological quality was assessed by the AMSTAR checklist. Two reviewers independently screened titles, abstracts, and full-texts and decided about the eligibility of articles; data extraction and quality assessment was cross-checked.
Results: We included five systematic reviews fulfilling our predefined criteria. They compared traditional acupuncture to sham acupuncture, usual care, or any exercise. The evidence was based on single studies showing a benefit by acupuncture treatment concerning evening pelvic pain, pelvic and low back pain, nausea, functional disability, and sleep quality and insomnia. Due to the heterogeneity of interventions and outcome parameters, data pooling was not possible.
Conclusions: The methodological quality of the systematic reviews in general was good but the single studies on acupuncture included small sample sizes with additional methodological flaws. Therefore, the evidence in favor of acupuncture compared to sham acupuncture, usual care, or any exercise for relief of pregnancy-related conditions is very limited.