Acupuncture for labour pain relief: A systematic review and a network meta-analysis

Article type
Authors
Zhang J1, Xing X2, Li X3, Ling J4, Ge L4, Tian J5, Yang K5
1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Provinc, Lanzhou
2Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou; School of Public Health, Lanzhou University, Lanzhou ;
3Evidence-Based Medicine Center, School of Basic Medical Sciences, LanzhouKey Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University,
4Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University,
5Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou
Abstract
Background:Acupuncture is used for labour pain relief frequently, but the evidence is not clear enough.

Objectives:The purpose of this study is to systematically review the literature for randomised-controlled trials of acupuncture therapy for labour pain relief and critically evaluate them. Then a network meta-analysis was conducted to evaluate the effect of acupuncture for labour pain relief.

Methods:Four electronic databases were searched from their inception until June 2016. The inclusion criteria are that they were prospective, randomised-controlled trials. The involved pregnant women at term who received acupuncture alone or as an adjunct to other therapies for pain relief. The primary outcome is pain intensity at one hour after acupuncture on a 100-mm visual analogue scale (VAS). The secondary outcomes include the duration of labour, caesarean delivery rates, postpartum haemorrhage, Apgar score at 1 minute, and neonatal birth weight.

Results: According to our search strategy, 31 trials with a total of 5809 participants were included. 15 studies are available for network meta-analysis of VAS, while 11 for total duration of labour, 10 for the duration of first stage, 19 for the duration of second stage, 14 for the duration of third stage, 14 for caesarean delivery rates, 12 for postpartum haemorrhage, 11 for Apgar score at 1 minute and 10 for neonatal birth weight.

Conclusions:The effect of acupuncture for labour pain is only better than standard care significantly. It cannot be decided if it is better or worse than other therapies. Further researches may be needed.