Does Acupuncture Have a Place as an Adjunct Treatment During Pregnancy? A Review of Randomized Controlled Trials and Systematic Reviews

Centre for Complementary Medicine Research, University of Western Sydney, New South Wales, Australia.
Birth (Impact Factor: 1.26). 09/2009; 36(3):246-53. DOI: 10.1111/j.1523-536X.2009.00329.x
Source: PubMed


Complementary medicine has become popular throughout many Western countries and is widely used by women across all stages of their life cycle. Acupuncture is used by women during their pregnancy, and research suggests that acupuncture may be used as an adjunct to their existing conventional care. The aim of this paper was to summarize the evidence examining the effectiveness of acupuncture during pregnancy and birthing, and to discuss its role as an adjunct treatment.
We conducted a systematic literature search using several electronic databases. We included all placebo-controlled randomized trials of parallel design, and systematic reviews that evaluated the role of acupuncture during pregnancy and birthing. A critical appraisal of clinical trials and systematic reviews was undertaken.
The summarized findings indicated a small but growing body of acupuncture research, with some evidence suggesting a benefit from acupuncture to treat nausea in pregnancy. Findings from the review also highlighted promising evidence for the effectiveness of acupuncture to manage back and pelvic pain, acupuncture-type interventions to induce change in breech presentation, and pain relief in labor. The methodological quality of recent trials has improved, and the quality of systematic reviews was high.
Interest is growing in the use of acupuncture to treat some complaints during pregnancy and childbirth, and evidence is beginning to consolidate that acupuncture may assist with the management of some complaints during pregnancy. However, definitive conclusions about its effectiveness cannot be reached and further research is justified.

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    • "Considering the fact that pregnant women frequently take these without report to their prenatal care provider, the uncritical CAM usage must be considered a problem.[13] While some CAM methods may be a serious health problem, others are used in spite of proven efficacy.[1415] CAM usage during pregnancy and during childbirth has primarily been studied in the United States of America, Norway, Canada, Sweden, Italy, Australia and China.[5] "
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    ABSTRACT: Background: This study was done to assess the use of traditional/complementary and alternative medicine (TM/CAM) during pregnancy and the reasons behind it from the mother’s perspective. Materials and Methods: In a cross-sectional study, 919 pregnant mothers attending at prenatal care units of governmental health centers recruited through a multistage sampling and completed a self-report questionnaire about the use of TM/CAM during pregnancy. Findings: TM/CAM was used by 83.7% of women during pregnancy. Diet/nutrition change was applied by 42.3%, herbal preparations by 49.2%, vitamin and mineral by 30.1%, body based practices by 24.7% and spiritual methods by 22.9% of mothers. Most frequently used herbal products were frankincense in 28.6% and date fruit in 26.4% of mothers. The most common indication of diet/nutrition changes and herbal products used related to mothers was gastro-intestinal disorders. Most of the TM/CAM methods used (64.32%) were happening or beginning from the first trimester of pregnancy. Conclusions: The use of TM/CAM methods in pregnancy is very common, mainly included the methods suggested by traditional Islamic Iranian medicine. Thus, clinicians should be informed to address CAM methods at each obstetric visit. Safety and efficacy of CAM must be explored and taught in every health education program. Future studies should focus on the safety and efficacy of TM/CAM in pregnancy and clinicians should be educated to address these methods at prenatal visits.
    Iranian journal of nursing and midwifery research 03/2012; 17(4):263-269.
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    • "One healthcare area which has attracted attention and debate among practitioners and policymakers in many countries has been the use of CAM during pregnancy (Nordeng & Havnen 2004, Refuerzo et al. 2005, Warriner 2007, Adams & Tovey 2008, Holst et al. 2008, Skouteris et al. 2008, Adams et al. 2009, Low Dog 2009). Although recent discussion has identified the need to develop an integrated approach to maternity care (Dooley 2006) and the efficacy of some CAM use in pregnancy is gradually emerging (Fugh-Berman & Kronenberg 2003, Huntley et al. 2004, Anderson & Johnson 2005, Smith & Cochrane 2009), there is a lack of understanding of attitudes and practice behaviours of mainstream maternity care professionals towards complementary and alternative treatments. "
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    ABSTRACT: This paper presents an integrative literature review examining the attitudes and referral practices of midwives and other maternity care professionals with regard to complementary and alternative treatment and its use by pregnant women. Use of complementary and alternative medicine during pregnancy is a crucial healthcare issue. Recent discussion has identified the need to develop an integrated approach to maternity care. However, there is a lack of understanding of attitudes and behaviours of maternity care professionals towards these treatments. A database search was conducted in MEDLINE, CINAHL, Health Source, AMED and Maternity and Infant Care for the period 1999-2009. An integrative review method was employed. Studies were selected if they reported results from primary data collection on professional practice/referral or knowledge/attitude towards complementary and alternative medicine by obstetricians, midwives and allied maternity care providers. A total of 21 papers covering 19 studies were identified. Findings from these studies were extracted, grouped and examined according to three key themes: 'prevalence of practice, recommendation and referral', 'attitudes and views' and 'professionalism and professional identity'. There is a need for greater respect and cooperation between conventional and alternative practitioners as well as communication between all maternity care practitioners and their patients about the use of complementary and alternative medicine. There is a need for in-depth studies on the social dimension of practice as well as the inter- and intra-professional dynamics that shape providers' decision to use or refer to complementary and alternative medicine in maternity care.
    Journal of Advanced Nursing 03/2011; 67(3):472-83. DOI:10.1111/j.1365-2648.2010.05510.x · 1.74 Impact Factor
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    • "Acupuncture is the ancient Chinese tradition of the inserting and manipulating needles into various points on the body to treat pathologic processes and relieve pain. It has been investigated for the treatment of depression in the general population with mixed results,138 and has been increasingly investigated as adjunctive treatment in pregnancy for nausea, pain, breech presentation and induction of labor.139 There is no data about the use of acupuncture in postnatal depression, but one small pilot study by Manber et al compared the effectiveness of targeted acupuncture vs controls of a nontargeted acupuncture and massage in the treatment of pregnant depressed women.140 "
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    ABSTRACT: Postpartum depression (PPD) is a common complication of childbearing, and has increasingly been identified as a major public health problem. Untreated maternal depression has multiple potential negative effects on maternal-infant attachment and child development. Screening for depression in the perinatal period is feasible in multiple primary care or obstetric settings, and can help identify depressed mothers earlier. However, there are multiple barriers to appropriate treatment, including concerns about medication effects in breastfeeding infants. This article reviews the literature and recommendations for the treatment of postpartum depression, with a focus on the range of pharmacological, psychotherapeutic, and other nonpharmacologic interventions.
    International Journal of Women's Health 12/2010; 3(1):1-14. DOI:10.2147/IJWH.S6938
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