The efficacy and safety of acupuncture and moxibustion for the management of nausea and vomiting in pregnant women: A systematic review and meta-analysis

Acupuncture and moxibustion in the treatment of nausea and vomiting in pregnant women represent an area of growing medical interest, especially given the need for safe alternatives for pregnant women facing these common symptoms. Nausea and vomiting during pregnancy affect between 50% and 90% of pregnant women, with symptoms ranging from mild to severe that can significantly impact quality of life. In more severe cases, known as hyperemesis gravidarum, these conditions can lead to malnutrition, dehydration, and serious complications for mother and baby. Although antiemetic medications are available, many women and health professionals look for complementary treatments that minimize the risk of side effects to the fetus.

This study aimed to systematically and comprehensively assess the efficacy and safety of acupuncture and moxibustion in controlling these symptoms during pregnancy. The researchers performed a rigorous meta-analysis, a type of study that combines results from multiple investigations to produce more precise and reliable conclusions. To this end, they conducted extensive searches in international and Chinese medical databases, including PubMed, Cochrane, and other specialized sources, covering studies published through July 2023. In the end, they selected 21 randomized controlled clinical trials that met rigorous quality criteria, involving a total of 2,392 pregnant women with mean ages of approximately 28 years and in early pregnancy, around the 8th gestational week.

The results showed that acupuncture and moxibustion were significantly more effective than control groups in reducing nausea and vomiting symptoms. Specifically, when compared with traditional Chinese herbs, conventional therapy, and untreated control groups, acupuncture was consistently superior. Moxibustion also showed promising results when compared with control groups. The researchers assessed efficacy through different symptom scales, including specific scales for traditional Chinese medicine symptoms and standardized questionnaires for quantifying emesis during pregnancy.

Interestingly, when acupuncture was compared with sham acupuncture (where needles are inserted at non-therapeutic points), there was no significant difference, suggesting that the effect may be related both to the specific points and to the act of needle insertion itself.

For patients and health professionals, these findings provide important evidence about a relatively safe therapeutic alternative. The study demonstrated that there were no significant differences in the occurrence of serious adverse events between women who received acupuncture and those in control groups, including risks such as miscarriage, fetal death, or congenital malformations. This suggests that acupuncture can be considered a safe option during pregnancy. However, a higher incidence of minor adverse events related to needles was observed, such as pain, itching, or bruising at application sites, when compared with sham acupuncture.

These effects, while more frequent, are considered mild and temporary. For pregnant women suffering from intense nausea and vomiting and seeking to avoid medications, this therapy may represent a viable alternative, especially when performed by qualified professionals.

Despite the encouraging results, the study has some important limitations that must be considered. Significant heterogeneity was observed among the analyzed studies, that is, methodological differences that may influence the interpretation of results. These differences include variations in the acupuncture points used, treatment duration, and characteristics of the populations studied. In addition, possible publication bias was identified, in which studies with positive results may be more likely to be published than those with negative results.

Most of the included studies were conducted in China, which may limit the applicability of results to other populations. With respect to moxibustion specifically, the number of studies was limited, making it more difficult to draw definitive conclusions about its safety. The researchers emphasize that more long-term clinical studies with standardized methodology are needed to confirm these findings and establish more precise treatment protocols for different patient profiles.