Cochrane · systematic review · CD009232
Acupuncture or acupressure for pain management during labour
Smith, CA, Collins, CT, Levett, KM, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
49
current version
GRADE rated
28
No studies
21
Included studies
NR
No studies 21 · 42.9%Ungraded 0 · 0%Very low 17 · 34.7%Low 7 · 14.3%Moderate 4 · 8.2%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Acupuncture compared to sham control for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity Acupuncture vs sham control | no estimate extracted | 2 studies · 325 participants | Low Downgraded: risk of bias, imprecision |
Satisfaction with pain relief in labour Acupuncture vs sham control | RR 2.38 [1.78, 3.19] | 1 study · 150 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Sense of control in labour ‐ not reported Acupuncture vs sham control | no estimate extracted | NR | No studies |
Satisfaction with childbirth experience ‐ not reported Acupuncture vs sham control | no estimate extracted | NR | No studies |
Use of pharmacological analgesia Acupuncture vs sham control | RR 0.75 [0.63, 0.89] | 2 studies · 261 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Assisted vaginal birth Acupuncture vs sham control | RR 1.1 [0.41, 2.97] | 2 studies · 261 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Caesarean section Acupuncture vs sham control | RR 1.11 [0.49, 2.48] | 3 studies · 411 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Acupuncture compared to usual care for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity Acupuncture vs usual care | no estimate extracted | 4 studies · 495 participants | Very low Downgraded: risk of bias |
Satisfaction with pain relief in labour Acupuncture vs usual care | RR 1.07 [0.96, 1.2] | 2 studies · 343 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Sense of control in labour ‐ not reported Acupuncture vs usual care | no estimate extracted | NR | No studies |
Satisfaction with childbirth experience ‐ not reported Acupuncture vs usual care | no estimate extracted | NR | No studies |
Use of pharmacological analgesia Acupuncture vs usual care | RR 0.72 [0.6, 0.85] | 6 studies · 1059 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Assisted vaginal birth Acupuncture vs usual care | RR 0.93 [0.7, 1.24] | 6 studies · 1217 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Caesarean section Acupuncture vs usual care | RR 0.72 [0.47, 1.09] | 5 studies · 861 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Acupuncture compared to no treatment for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity Lower scores indicate less pain. Acupuncture vs no treatment | no estimate extracted | 1 study · 163 participants | Very low Downgraded: risk of bias |
Satisfaction with pain relief ‐ not reported Acupuncture vs no treatment | no estimate extracted | NR | No studies |
Sense of control in labour ‐ not reported Acupuncture vs no treatment | no estimate extracted | NR | No studies |
Satisfaction with childbirth experience ‐ not reported Acupuncture vs no treatment | no estimate extracted | NR | No studies |
Use of pharmacological pain relief ‐ not reported Acupuncture vs no treatment | no estimate extracted | NR | No studies |
Assisted vaginal birth Acupuncture vs no treatment | RR 0.49 [0.18, 1.38] | 1 study · 163 participants | Very low Downgraded: risk of bias |
Caesarean section Acupuncture vs no treatment | RR 0.76 [0.35, 1.63] | 1 study · 163 participants | Very low Downgraded: risk of bias |
Acupuncture compared to water injection for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity ‐ not reported Acupuncture vs water injection | no estimate extracted | NR | No studies |
Satisfaction with pain relief ‐ not reported Acupuncture vs water injection | no estimate extracted | NR | No studies |
Sense of control in labour ‐ not reported Acupuncture vs water injection | no estimate extracted | NR | No studies |
Satisfaction with childbirth experience ‐ not reported Acupuncture vs water injection | no estimate extracted | NR | No studies |
Use of pharmacological analgesia Acupuncture vs water injection | RR 0.84 [0.54, 1.3] | 1 study · 128 participants | Very low Downgraded: risk of bias |
Assisted vaginal birth Acupuncture vs water injection | RR 1.6 [0.47, 5.39] | 1 study · 128 participants | Very low Downgraded: risk of bias |
Caesarean section Acupuncture vs water injection | RR 1.33 [0.37, 4.73] | 1 study · 128 participants | Very low Downgraded: risk of bias |
Acupressure compared to sham control for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity as measured by a 10 cm visual analogue scale. Lower scores indicate less pain Acupressure vs sham control | no estimate extracted | 6 studies · 472 participants | Very low Downgraded: risk of bias |
Satisfaction with pain relief ‐ not reported Acupressure vs sham control | no estimate extracted | NR | No studies |
Sense of control in labour ‐ not reported Acupressure vs sham control | no estimate extracted | NR | No studies |
Satisfaction with childbirth experience ‐ not reported Acupressure vs sham control | no estimate extracted | NR | No studies |
Use of pharmacological analgesia Acupressure vs sham control | RR 0.54 [0.2, 1.43] | 1 study · 75 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Assisted vaginal birth Acupressure vs sham control | RR 3 [0.13, 71.92] | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Caesarean section Acupressure vs sham control | RR 0.44 [0.27, 0.71] | 4 studies · 313 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Acupressure compared to usual care for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity as measured by numeric rating scale (NRS) and visual analogue scale (VAS). Lower scores indicate less pain. Acupressure vs usual care | no estimate extracted | 8 studies · 620 participants | Very low Downgraded: risk of bias |
Satisfaction with pain relief Acupressure vs usual care | no estimate extracted | 1 study · 105 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sense of control in labour ‐ not reported Acupressure vs usual care | no estimate extracted | NR | No studies |
Satisfaction with childbirth experience ‐ not reported Acupressure vs usual care | no estimate extracted | NR | No studies |
Use of pharmacological pain relief ‐ not reported Acupressure vs usual care | no estimate extracted | NR | No studies |
Assisted vaginal birth ‐ not reported Acupressure vs usual care | no estimate extracted | NR | No studies |
Caesarean section Acupressure vs usual care | RR 0.82 [0.54, 1.23] | 4 studies · 391 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Acupressure compared to combined control for pain management in labour
Population: pain management in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity One study used VAS pain score on scale 1 ‐ 100 mm One study used VAS pain score on scale 1 ‐ 10 mm ‐ the mean score of pre‐ and post‐intervention difference in pain perception measured by VAS was taken in three phases, latent, activ... Acupressure vs combined control | no estimate extracted | 2 studies · 322 participants | Moderate Downgraded: risk of bias |
Satisfaction with pain relief ‐ not reported Acupressure vs combined control | no estimate extracted | NR | No studies |
Sense of control in labour ‐ not reported Acupressure vs combined control | no estimate extracted | NR | No studies |
Satisfaction with childbirth Acupressure vs combined control | no estimate extracted | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Use of pharmacological analgesia Acupressure vs combined control | RR 0.94 [0.71, 1.25] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Assisted vaginal birth Acupressure vs combined control | RR 0.81 [0.39, 1.67] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Caesarean section Acupressure vs combined control | RR 0.48 [0.22, 1.04] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |