2022 Frontiers in Endocrinology

PCOS patients suggests that combining acupuncture with metformin might enhance pregnancy and ovulation rates, as well as improve insulin resistance.

The study initially screened 330 relevant articles, eventually including nine randomized controlled trials (RCTs) that met the inclusion criteria. These trials encompassed 1,159 patients with PCOS who underwent acupuncture or acupuncture combined with metformin treatment. Using the GRADE method, a "Summary of Findings" table was employed to evaluate the quality of evidence for various outcome measures. The main results indicated that acupuncture combined with metformin exhibited superiority over metformin alone in terms of pregnancy rate, ovulation rate, and HOMA-IR (insulin resistance). Subgroup analysis highlighted that diagnostic criteria and random methods contributed to heterogeneity in results.

However, the evidence's quality was predominantly low or very low due to study limitations, inconsistencies, and imprecisions. The intervention measures, such as acupuncture methods and treatment parameters, varied substantially among studies. Challenges in contacting original authors and incomplete information posed further limitations. The study suggested potential improvements in pregnancy rate, ovulation rate, and HOMA-IR with acupuncture combined with metformin, but these findings were subject to uncertainties related to diagnostic criteria and overall evidence quality. Consequently, the conclusive efficacy of acupuncture combined with metformin for treating PCOS remains uncertain due to the dearth of high-quality research. The study called for well-designed and well-executed RCTs to address this question under standardized diagnostic criteria and treatment protocols for acupuncture and metformin.

Acupuncture combined with metformin versus metformin alone to improve pregnancy rate in polycystic ovary syndrome: A systematic review and meta-analysis Chen X, Lan Y, Yang L, Liu Y, Li H, Zhu X, Zhao Y, Long C, Wang M, Xie Q, Li Z, Wu J

2022 Journal of Asian Multicultural Research for Medical and Health Science Study

Honey, combined with Iron (Fe), effectively enhances hemoglobin levels and reduces oxidative stress markers in anemic expectant mothers.

This quasi-experimental study with a pretest-posttest design involved 30 pregnant women divided into two groups: one receiving Fe (Control Group) and the other Honey + Fe (Intervention Group) for 60 days. Blood and urine analyses revealed a remarkable increase in hemoglobin levels in the Honey + Fe group (2.80 ± 0.26 g/dl), surpassing the Fe control group (0.80 ± 0.13 g/dl). Moreover, the Intervention Group demonstrated a notable decrease in 8-Ohdg levels (-4.23 ± 1.32 nmol/ml, p = 0.031), indicating reduced oxidative stress, while the Fe control group exhibited less significant changes (2.98 ± 1.30 nmol/ml, p = 0.322). Independent T Test confirmed the Honey + Fe group's superior effectiveness in increasing hemoglobin levels and decreasing 8-Ohdg levels in anemic pregnant women (p = 0.001 and p = 0.002, respectively).

The study underscores the synergistic benefits of honey and iron supplementation in enhancing hemoglobin levels and mitigating oxidative stress among anemic pregnant women. The robust findings, supported by statistical significance, emphasize the potential clinical relevance of incorporating honey into anemia management strategies, offering a more effective approach compared to iron supplementation alone.

Effect of Honey to Levels Hemoglobin and Levels of 8-Hydroxy-2-Deoxyguanosin (8-Ohdg) in Pregnant Women with Anemia A A, Astuti A, Leli L, Saad R

2021 Evidence-Based Complementary and Alternative Medicine

Acupuncture is an effective approach for hyperemesis gravidarum and has a great potential to mitigate ketonuria, ease nausea and vomiting, increase food intake, and shorten the hospital stay.

Studies meeting inclusion criteria, from 1995 to 2020, have been incorporated into this meta-analysis to make evaluations on the outcome of acupuncture in the treatment of hyperemesis gravidarum (HG). Totally, 16 studies and 1043 patients (531 vs 512) were covered. According to this study, acupuncture was more effective than the conventional treatment of HG; it could better promote the conversion of the urinary ketone to improve ketonuria. In terms of symptoms, acupuncture seems to be more effective in reducing nausea and vomiting and increasing food intake.

In short, acupuncture is an effective approach for HG and has a great potential to mitigate ketonuria, ease nausea and vomiting, increase food intake, and shorten the hospital stay. There is some evidence that acupuncture may be utilized as a supplement and alternative to HG. However, the poor quality of the incorporated studies and potential publication bias can exert a certain impact on the results. For the better clinical application and promotion of acupuncture in the treatment of HG, more large-scale samples, multi-center, and top-quality RCTs are needed urgently. In the future, it is necessary to further study the relationship between acupuncture and conventional medication and acupuncture placebo to obtain the best clinical solution.

Effectiveness of Acupuncture in the Treatment of Hyperemesis Gravidarum: A Systematic Review and Meta-Analysis Haizhen Lu, Chengwen Zheng, Yanmei Zhong, Linhao Cheng, Yi Zhou

2021 World Journal of Acupuncture-Moxibustion

Acupuncture treatment for postpartum depression is effective and can improve Hamilton Depression (HAMD) Scale, Edinburgh Postnatal Depression Scale (EPDS) and serum estradiol scores.

Meta analysis was conducted in the literature in recent 10 years relating to clinical randomized controlled trials of acupuncture in treatment of postpartum depression, which provided references for acupuncture in treatment of postpartum depression.

Fourteen articles were included in this study, among which, acupuncture group was set as treatment group, and oral administration of fluoxetine as control group in 4 articles; acupuncture group was set as treatment group, and oral administration of maltodextrin granules as control group in 2 articles. The differences in the 6 articles were statistically significant, without interference from other compound factors.

Meta analysis on acupuncture for postpartum depression WANG, J., TAN, L., MEI, Q., ZHENG, Q., YANG, S., & MEI, Z.

2021 Disease and Diagnosis

Lavender aromatherapy, whether administered through massage or inhalation, appears effective in reducing active phase labor pain.

The researchers conducted their study by performing a detailed search using a number of specific keywords such as lavender, childbirth, labor, pregnancy, labor pain, aromatherapy, and delivery across multiple databases. These databases included MEDLINE/PubMed, Scopus, and Google Scholar. Using these keywords they extracted relevant data from the seven most reliable studies they found, two of which originated in Egypt and Indonesia, and remaining five in Iran. The chosen studies depicted a range of qualities, with some using massage aromatherapy, and others applying inhalation as their method of practice.

In analyzing these studies, it was found that all of them indicated that lavender aromatherapy, regardless of whether it was applied via massage or inhalation, had the potential to lessen the pain felt during the active phase of labor. The studies provided basis for insightful consideration of the application of lavender aromatherapy as a viable method for managing labor pain.

Effect of Aromatherapy with Lavender on Labor Pain: A Literature Review Hatami Rad R

2020 BioMed Research International

Endometriosis and Adenomyosis can have impact on miscarriage risk in pregnancy.

The study analyzed 39 publications involving 697,984 women to assess the impact of endometriosis (EMS) and adenomyosis (AD) on miscarriage risk. Women with EMS showed increased miscarriage risk in spontaneous conception (SC), but similar risk in assisted reproductive technology (ART) compared to tubal infertility. AD was associated with higher miscarriage risk in ART. Sensitivity analyses supported these conclusions. EMS staging did not significantly alter miscarriage risk. Early-stage EMS showed higher early abortion risk. No significant associations were found between EMS and low birthweight, placental abruption, intrauterine growth restriction, or preeclampsia. EMS correlated with higher odds of antepartum hemorrhage, postpartum hemorrhage, preterm birth, placenta praevia, and stillbirth. SUP and DIE were linked to increased miscarriage risk, while OMA showed no significant association. The findings suggest the need for closer monitoring and follow-up for pregnant women with EMS or AD, particularly in early pregnancy. Standardized recording of EMS types, stages, and miscarriage timing is recommended for future studies.

Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis Yangxue Huang, Xianhong Zhao, Yiyuan Chen, Jie Wang, Weilin Zheng, Lixing Cao

2019 BioMed Research International

Acupuncture could reduce Hamilton Rating Scale for Depression (HAMD) scores for postpartum depression.

Though our meta-analysis revealed that acupuncture had a lower efficacy compared to other antidepression treatments, symptoms of depression relief were observed in the majority of the studies analysed. These findings indicate that although the efficacy of acupuncture was lower compared to antidepressants, the benefits of acupuncture were still attractive to women with postpartum depression due to their negligible side-effects.

In summary, despite the limitations mentioned above, this current systematic review suggests that acupuncture could reduce HAMD scores. However, EPDS, clinical response, and serum estradiol levels were unaffected by acupuncture treatment. Furthermore, our analysis revealed that treatment efficacy was variable and depended on the control types used. Large-scale and well-designed RCTs are required before a conclusive statement could be made regarding the efficacy of acupuncture for the treatment of postpartum depression.

Effectiveness of Acupuncture Used for the Management of Postpartum Depression: A Systematic Review and Meta-Analysis Li W, Yin P, Lao L, Xu S

2019 Women and Birth

Aromatherapy significantly reduces labor pain and duration without impacting emergency caesarean section, membrane rupture, and the onset of spontaneous labor.

Researchers undertook a meta-analysis of randomized controlled trials for determining the efficacy of aromatherapy in mitigating labor pain and reducing its duration. Various academic and scientific databases such as PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Clinicaltrials.gov were employed to find relevant trials. A total of 17 trials involving low-risk laboring women were identified and included in the meta-analysis.

Observations from the meta-analysis revealed that aromatherapy effectively alleviated labor pain during the transition phase and reduced the periods of active phase and third stage labor. Additionally, a trend of decreasing duration was noticed during the second stage. Notably, aromatherapy did not have any marked effects on emergency caesarean sections, membrane ruptures, or the initiation of spontaneous labor, indicating its general safety for expectant mothers. However, the diversity of outcomes across different trials was noted.

Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials Chen SF, Wang CH, Chan PT, Chiang HW, Hu TM, Tam KW, Loh EW

2018 Acupuncture in Medicine

Acupuncture appears to be effective for postpartum depression with respect to certain outcomes.

Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group. Moreover, acupuncture significantly increased oestradiol levels compared with the control group. Regarding the Hamilton Rating Scale for Depression (HAMD) and Edinburgh Postnatal Depression Scale (EPDS) scores, no difference was found between the two groups.

Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis Li S, Zhong W, Peng W, Jiang G

2018 British Journal of Midwifery

Acupuncture in postpartum depression was at least as effective as fluoxetine hydrochloride, supporting the notion that acupuncture may be a safe and effective option.

Of the 1592 studies reviewed, three met the inclusion criteria for quantitative analysis. Two studies reported no significant differences between acupuncture and fluoxetine for depression, while the third reported significant improvements.

Acupuncture versus antidepressants in the management of postpartum depression: A systematic review Akari Komori, David Arthur, Samara Radford, Hsiewe Ying Tan, Li Zheng, Mira An, Rika Umeda, and Zhen Zheng

2018 Nursing and Midwifery Studies

Inhalation aromatherapy with Boswellia Carterii essential oil can significantly reduce labor pain intensity in nulliparous women.

In this randomized controlled trial, 126 nulliparous women were split into two groups — an aromatherapy group and a placebo group. A piece of gauze was soaked with Boswellia Carterii essential oil diluted in normal saline for the aromatherapy group and was attached to the collar of each woman in this group. This intervention was repeated at 30-minute intervals up to a cervical dilation of 10 centimeters. The placebo group intervention mirrored those of the aromatherapy group but used only normal saline on the gauze. The intensity of labor pain was assessed before the intervention and at certain cervical dilation stages using a numeric pain rating scale.

The results revealed that the aromatherapy group experienced significantly less labor pain compared to the placebo group at all tracked stages of cervical dilation. It was found that Boswellia Carterii essential oil can indeed mitigate labor pain when used in inhalation aromatherapy. No significant differences were observed concerning the 1 and 5 minute Apgar scores across both groups.

The effects of inhalation aromatherapy with Boswellia carterii essential oil on the intensity of labor pain among nulliparous women Esmaelzadeh-Saeieh S, Rahimzadeh M, Khosravi-Dehaghi N, Torkashvand S

2016 BMC Pregnancy and Childbirth

Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention.

Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a ‘watchful waiting’ approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage.

Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention. Further research is required to further explore acupuncture use for this common complication and whether it can reduce the incidence of miscarriage.

Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews Betts D, Smith CA, Dahlen HG.

2016 BMC Complementary Medicine and Therapies

Acupoint stimulation shows promise in alleviating nausea and vomiting in pregnancy.

This review assesses acupoint stimulation techniques for treating nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG). Of 29 studies, 20 were included in quantitative analyses. Acupressure, acupuncture, auricular acupressure, and moxibustion were examined. While acupressure showed a 41% reduction in symptom severity, acupuncture had double the effect of control groups, and moxibustion improved symptoms by 65%. Continuous outcome measures did not show significant relief. Adverse events were minimal. The study calls for more rigorous trials, emphasizing the need for blinding and standardizing treatment protocols for conclusive results on acupoint stimulation's efficacy in NVP and HG.

Effect of acustimulation on nausea and vomiting and on hyperemesis in pregnancy: a systematic review of Western and Chinese literature Van den Heuvel, E., Goossens, M., Vanderhaegen, H. et al.

2014 Journal of Advanced Nursing

Acupuncture showed both clinically important changes and statistically significant results for management of low back and/or pelvic pain (LBPP) in pregnancy.

Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low.

A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy Close C, Sinclair M, Liddle SD, Madden E, McCullough JE, Hughes C.

2014 Acupuncture in Medicine

Acupuncture during pregnancy appears to be associated with few adverse events when correctly applied.

Of 105 included studies, detailed adverse events (AE) were reported only in 25 studies represented by 27 articles (25.7%). AEs evaluated as certain, probable or possible in the causality assessment were all mild/moderate in severity, with needling pain being the most frequent. Severe AEs or deaths were few and all considered unlikely to have been caused by acupuncture. Total AE incidence was 1.9%, and the incidence of AEs evaluated as certainly, probably or possibly causally related to acupuncture was 1.3%.

The Safety of Acupuncture during Pregnancy: A Systematic Review Park J, Sohn Y, White AR, Lee H.

2013 Medical Acupuncture

Acupuncture's efficacy in treating gynecologic and obstetric disorders

This comprehensive review evaluates acupuncture's efficacy and safety in treating gynecologic and obstetric disorders. Examining systematic reviews and randomized controlled trials, the study addresses conditions like pregnancy-related pelvic and low-back pain, labor pain, primary dysmenorrhea, and menopausal symptoms. The results are inconclusive, with some evidence supporting acupuncture's potential in reducing pelvic and back pain during pregnancy and alleviating climacteric vasomotor symptoms. However, more rigorous research is necessary for definitive conclusions. Adverse effects were minimal. The review emphasizes the need for well-designed studies to enhance the precision and reliability of findings regarding acupuncture's therapeutic benefits in these disorders.

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview Selva Olid A, Martinez Zapata MJ, Sola I, Stojanovic Z, Uriona Tuma SM, Bonfill Cosp X.

2012 BMC Complementary Medicine and Therapies

Complementary and alternative medicine (CAM) therapies have the potential to provide supportive care for women presenting with threatened miscarriage.

Within fertility research, acupuncture demonstrates beneficial hormonal responses with decreased miscarriage rates, raising the possibility acupuncture may promote specific beneficial effects in early pregnancy. With the lack of current medical options for women presenting with threatened miscarriage it is timely to examine the possible treatment benefits of providing CAM therapies such as acupuncture.

Acupuncture as a therapeutic treatment option for threatened miscarriage Betts D, Smith CA, Hannah DG.