Background Extreme labor pain has negative effects; pharmacologic analgesic modalities are effective but are accompanied by adverse effects. Virtual reality (VR) works as a distracting nonpharmacologic intervention for pain and anxiety relief; however, the effects of VR use in laboring women is unknown. Objective Our study aimed to determine the safety and effectiveness of VR technology during labor and delivery and investigate whether it impacts labor and patient satisfaction. Methods In all, 7 databases (PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, and Wan-Fang Database) were systematically searched for randomized controlled trials of VR use in pregnancy and childbirth from the time of database construction until November 24, 2021. Two researchers extracted data and evaluated study quality using the Cochrane Risk of Bias tool 2.0. Outcome measures were labor pain, anxiety, duration, satisfaction, and adverse events. Meta-analyses were performed where possible. Results A total of 12 studies with 1095 participants were included, of which 1 and 11 studies were rated as “Low risk” and “Some concerns” for risk of bias, respectively. Of the 12 studies, 11 reported labor pain, 7 reported labor anxiety, and 4 reported labor duration. Meta-analysis revealed that VR use could relieve pain during labor (mean difference –1.81, 95% CI –2.04 to –1.57; P<.001) and the active period (standardized mean difference [SMD] –0.41, 95% CI –0.68 to –0.14; P=.003); reduce anxiety (SMD –1.39, 95% CI –1.99 to –0.78; P<.001); and improve satisfaction with delivery (relative risk 1.32, 95% CI 1.10-1.59; P=.003). The effects of VR on the duration of the first (SMD –1.12, 95% CI –2.38 to 0.13; P=.08) and second (SMD –0.22, 95% CI –0.67 to 0.24; P=.35) stages of labor were not statistically significant. Conclusions VR is safe and effective in relieving maternal labor pain and anxiety; however, due to the heterogeneity among studies conducted to date, more rigorous, large-scale, and standardized randomized controlled trials are required to provide a higher-quality evidence base for the use of VR technology in maternal labor, with the aim of improving experience and outcomes. Trial Registration PROSPERO CRD42021295410; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295410

No abstract

BACKGROUND As an emerging non-pharmacological method of analgesia, there are no uniform conclusions on the effect of virtual reality (VR) technology in labor. OBJECTIVE Exploring the effectiveness of VR technology in maternal delivery. METHODS Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational age>34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. MD or SMD used for quantitative data, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. RESULTS 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction with delivery (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. CONCLUSIONS Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.