Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials

Abstract

ObjectiveAcupuncture is emerging as a potential therapy for relieving pain, but the effectiveness of acupuncture for relieving low back and/or pelvic pain (LBPP) during the pregnancy remains controversial. This meta-analysis aims to investigate the effects of acupuncture on pain, functional status and quality of life for women with LBPP pain during the pregnancy.DesignSystematic review and meta-analysis.Data sourcesThe PubMed, EMBASE databases, Web of Science and Cochrane Library were searched for relevant randomised controlled trials (RCTs) from inception to 15 January 2022.Eligibility criteria for selecting studiesRCTs evaluating the effects of acupuncture on LBPP during the pregnancy were included.Data extraction and synthesisThe data extraction and study quality assessment were independently performed by three reviewers. The mean differences (MDs) with 95% CIs for pooled data were calculated. We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework.Main outcomes and measuresThe primary outcomes were pain, functional status and quality of life. The secondary outcomes were overall effects (a questionnaire at a post-treatment visit within a week after the last treatment to determine the number of people who received good or excellent help), analgesic consumption, Apgar scores >7 at 5 min, adverse events, gestational age at birth, induction of labour and mode of birth.ResultsThis meta-analysis included 10 studies, reporting on a total of 1040 women. Overall, acupuncture significantly relieved pain during pregnancy (MD=1.70, 95% CI: (0.95 to 2.45), p<0.00001, I2=90%) and improved functional status (MD=12.44, 95% CI: (3.32 to 21.55), p=0.007, I2=94%) and quality of life (MD=−8.89, 95% CI: (−11.90 to –5.88), p<0.00001, I2= 57%). There was a significant difference for overall effects (OR=0.13, 95% CI: (0.07 to 0.23), p<0.00001, I2= 7%). However, there was no significant difference for analgesic consumption during the study period (OR=2.49, 95% CI: (0.08 to 80.25), p=0.61, I2=61%) and Apgar scores of newborns (OR=1.02, 95% CI: (0.37 to 2.83), p=0.97, I2= 0%). Preterm birth from acupuncture during he study period was reported in two studies. Although preterm contractions were reported in two studies, all infants were in good health at birth. In terms of gestational age at birth, induction of labour and mode of birth, only one study reported the gestational age at birth (mean gestation 40 weeks). Thus, prospective randomised clinical studies or clinical follow-up studies were hence desirable to further evaluate these outcomes.ConclusionsAcupuncture significantly improved pain, functional status and quality of life in women with LBPP during the pregnancy. Additionally, acupuncture had no observable severe adverse influences on the newborns. More large-scale and well-designed RCTs are still needed to further confirm these results.PROSPERO registration numberCRD42021241771.

Acupuncture for the treatment of pregnancy-related low back pain: a systematic review and network meta-analysis

“…Yao et al 29 and Yang et al 20 showed that acupuncture was superior to the treatment provided to the control group. However, they focused on evaluating the efficacy of acupuncture and SC; SAcu was not involved and there was no appropriate blinding.…”

“…Despite the effectiveness of acupuncture in the treatment of musculoskeletal pain, many physical therapists are unwilling to use it in pregnant women, as they believe that some points might trigger uterine contractions, inducing preterm labor, associated with the risk of litigation. 2 A recent systematic review 20 involving 10 studies with 1040 women with LBP and/or PGP during pregnancy showed that compared with standard care (SC), acupuncture was associated with pain relief, functional status, and quality of life (QOL) improvement. Moreover, no severe adverse effects were observed in the newborns.…”

“…Although small bruises and subcutaneous hematomas, transient ear tenderness that resolved spontaneously, and paresthesia in the arm have been reported in some trials, 2,[15][16][17] no serious consequences persisted. According to relevant studies, 20,[37][38] no significant side effects were observed in either the mother or the fetus, including obstetrical and neonatal morbidity, mean birthweight, and caesarean delivery rate.…”

Evaluation and Medical Management of Chronic Pelvic Pain

“…17 and endometriosis-related pain. 21,22 A systematic review and meta-analysis of four randomized controlled trials in women with CPP concluded that the addition of acupuncture may benefit routine pain treatment, though the study quality was mostly interpreted as low. 23 Despite this, focused studies evaluating acupuncture intervention for patients with CPP are needed.…”

Acupuncture Activity in the Management of Labor Pain: A Systematic Review

“…Bu sayede özel noktaların altından geçen enerji kanalları ile bu kanallar üzerinde bulunan organlar arasında ilişki kurulmaktadır. 2,3,6 Akupunktur, geleneksel Çin Tıbbı'nın Jing Luo (hatağ) teorisine dayalıdır. Bu teoriye göre insan vücudundaki organ ve dokular özel hat ve ağlar ile bağlanmakta ve yaşam enerjisi ile dolmaktadır.…”