Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis

# Acupuncture for Nausea and Vomiting During Pregnancy: A Comprehensive Scientific Analysis

Nausea and vomiting of pregnancy (NVP) represent one of the most common complaints among pregnant women, affecting up to 85% of expectant mothers. This problem can progress to a more severe condition known as hyperemesis gravidarum, which affects approximately 0.3% to 3.6% of pregnant women and can cause serious complications such as dehydration, excessive weight loss, electrolyte imbalances, and even neurologic problems. In addition to the physical impact, these conditions can have significant psychological consequences, including depression and anxiety, substantially interfering with women's quality of life during a period that is already naturally challenging.

Chinese and international researchers conducted a comprehensive scientific study to investigate whether acupuncture could offer a safe and effective alternative for treating these conditions. The study consisted of a systematic review and meta-analysis, considered the gold standard in medical research because it rigorously gathers and analyzes data from multiple studies. The researchers examined 24 randomized controlled clinical trials involving 2,390 pregnant women from different countries, including China, the United Kingdom, Australia, and Croatia. The methodology included searches in nine major medical databases, ensuring a comprehensive collection of scientific evidence available through May 2024.

The results demonstrated that combining acupuncture with conventional medications was significantly more effective than medication alone in reducing nausea and vomiting symptoms. Pregnant women who received acupuncture together with standard medical treatment had better scores on the PUQE scale (Pregnancy-Unique Quantification of Emesis), a standardized instrument for measuring the severity of these symptoms. In addition, the combined treatment resulted in lower rates of therapeutic failure, faster ketonuria improvement (presence of ketones in the urine, an important indicator of severity), reduced length of hospital stay, and better symptom-related quality of life. When acupuncture was compared directly with conventional medications, the results showed it can be equally effective, with comparable—and in some respects superior—efficacy rates.

These findings have important clinical implications for both patients and health professionals. For pregnant women, acupuncture emerges as a promising therapeutic option, especially for those who experience limited relief with conventional medications, have concerns about possible side effects of medications on the developing baby, or have contraindications to certain drugs. The study identified that the most frequently used and effective acupuncture points are Neiguan (PC-6), located on the wrist, Zusanli (ST-36), on the leg, and Zhongwan (CV-12), on the abdomen. According to traditional Chinese medicine, these points work by harmonizing the flow of energy (qi, 氣) and regulating digestive function.

For health professionals, the results provide robust scientific evidence to consider acupuncture as part of an integrated treatment plan, providing more therapeutic options for their patients.

The safety aspect was also carefully evaluated in the study. Researchers found no significant differences in the incidence of serious adverse events between women who received acupuncture and those treated with medications alone or sham acupuncture (placebo). Side effects related to acupuncture were rare and mild, occasionally including mild pain at the application site, small bruises, or itching, all resolving quickly without need for medical intervention. This safety evidence is particularly important during pregnancy, a period in which any therapeutic intervention must be carefully considered against possible risks to mother and baby.

However, it is important to acknowledge the study's limitations. The quality of evidence was rated as moderate to very low, mainly due to variability among the analyzed studies in terms of acupuncture techniques used, treatment duration, specific points selected, and outcome assessment methods. Most included studies were conducted in China and published in Chinese journals, which may introduce some cultural or methodological bias. In addition, many studies did not provide detailed information about long-term treatment effects or about delivery outcomes and infant health.

Researchers also noted that evaluating the efficacy of acupuncture poses unique challenges, since it is difficult to create a truly inert placebo, given that even sham acupuncture can produce some therapeutic effects.

Therefore, although the results are encouraging and suggest that acupuncture can be a valuable addition to the treatment of nausea and vomiting of pregnancy, the researchers emphasize the need for larger, better-controlled future studies with more rigorous methodology to definitively confirm these findings and establish standardized treatment protocols. Pregnant women interested in this therapeutic option should always consult their obstetricians to discuss whether acupuncture is appropriate for their specific situation and seek out qualified, experienced practitioners in the treatment of pregnant patients.