Acupressure and acupuncture for treating nausea and vomiting in early pregnancy

Evidence Summaries

Level of Evidence = C
Acupuncture might possibly be effective in treating nausea and vomiting in early pregnancy.

A Cochrane review 1 included 5 studies with a total of 740 women. Acupuncture (P6 or traditional), acupressure (P6 or auricular), or acustimulation showed no significant benefit to women in pregnancy.

Another Cochrane review 2 included 25 trials involving a total of 2,052 women, but the majority of 18 different comparisons included data from single studies with small numbers of participants. No primary outcome data were available when acupuncture was compared with placebo. There was no clear evidence of differences between groups for anxiodepressive symptoms, spontaneous abortion, preterm birth, or perinatal death. There was insufficient evidence to identify clear differences between acupuncture and metoclopramide in a study with 81 participants regarding reduction/cessation in nausea or vomiting (RR 1.40, 95% CI 0.79 to 2.49 and RR 1.51, 95% CI 0.92 to 2.48, respectively; very low-quality evidence).

A multicenter, randomized, double-blind, placebo-controlled trial 3 in China included 352 women with moderate to severe nausea and vomiting. Participants receiving acupuncture 30 minutes per day (mean difference [MD] -0.7, 95% CI -1.3 to -0.1), doxylamine-pyridoxine (MD -1.0, 95% CI -1.6 to -0.4), and the combination of both (MD -1.6, 95% CI -2.2 to -0.9) for 14 days had a larger reduction in PUQE score than their respective control groups (sham acupuncture, placebo, and sham acupuncture plus placebo).

Comment: The quality of evidence is downgraded by inconsistency.


1. Matthews A, Dowswell T, Haas DM, Doyle M, O'Mathúna DP. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2010 Sep 8;(9):CD007575 [Review content assessed as up-to-date: 19 January 2015].  [PMID:20824863]
2. Boelig RC, Barton SJ, Saccone G et al. Interventions for treating hyperemesis gravidarum. Cochrane Database Syst Rev 2016;(5):CD010607.  [PMID:27168518]
3. Wu XK, Gao JS, Ma HL, et al. Acupuncture and Doxylamine-Pyridoxine for Nausea and Vomiting in Pregnancy : A Randomized, Controlled, 2 × 2 Factorial Trial. Ann Intern Med 2023;176(7):922-933  [PMID:37335994]

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