Effect of Acupuncture on Nausea of Pregnancy: A Randomized, Controlled Trial

This randomized controlled trial investigated the efficacy of traditional Chinese acupuncture in the treatment of morning sickness in pregnant women between 6 and 10 weeks of gestation. The research was conducted at the Royal Devon and Exeter Hospital, United Kingdom, with 55 women who presented with nausea with or without vomiting during early pregnancy.

The methodological design was rigorous, using double-blinding in which neither the participants nor the investigator responsible for data collection knew which treatment was being applied. Women were randomized into two groups: traditional acupuncture (n=28) and sham acupuncture (n=27). The real acupuncture group received treatment based on Traditional Chinese Medicine diagnosis, with needles inserted at specific points such as PC-6, ST-36, and others, depending on the pattern of disharmony identified. The control group received stimulation with a blunt stick on bony prominences, without skin penetration.

The treatment protocol consisted of approximately 15-minute sessions, applied twice in the first week and once weekly in the following two weeks, totaling 3-4 sessions per participant. The primary endpoint was measured through a 100-mm visual analog scale for nausea intensity, recorded daily by the participants. Secondary endpoints included anxiety and depression scores via the Hospital Anxiety and Depression Scale.

Results showed significant improvement in both groups but no statistically significant difference between them. In the acupuncture group, median nausea scores decreased from 85.5 to 47.5, while in the sham group the reduction was from 87.0 to 48.0. Statistical analysis revealed strong evidence of a time effect (p < 0.001), indicating that both groups improved over the course of the study, but no evidence of a difference between groups (p = 0.9) or group-time interaction (p = 0.8).

The authors observed that the most pronounced reduction in nausea scores occurred between the first and second days of treatment, suggesting that nonspecific factors such as attention, professional care, and placebo effect may have contributed significantly to the observed improvement. Participants reported high satisfaction with treatment in both groups, with a median global effectiveness rating of 4 (on a 1-5 scale).

Regarding adverse events, 19 cases were reported, distributed equally between the groups, including tiredness, sleep disturbances, and taste alterations, all of mild nature. Blinding was effective, with only one participant in each group suspecting they had received sham treatment.

The clinical implications of this study are important for the practice of acupuncture in obstetrics. Although acupuncture did not demonstrate superiority over the sham procedure, both groups experienced clinically significant symptom improvement. This suggests that nonspecific elements of acupuncture — such as the therapeutic relationship, individualized attention, and rituals of care — may be important components of the total therapeutic effect.

Limitations include the relatively small sample size, variations in session scheduling due to practical constraints, and the impossibility of determining whether the sham intervention was completely inert. The study also raises questions about the validity of traditional Chinese diagnoses, which lack formal validation or established inter-rater reliability. These findings contribute to the debate about the specificity of acupuncture effects and highlight the importance of considering contextual factors in the treatment of pregnancy-related nausea.