A Systematic Review and Meta‑Analysis of the Effect of Acupressure on Relieving the Labor Pain

Leila Karimi, Mitra Mahdavian, Somayeh Makvandi

Abstract


Background: Numerous studies have been conducted on the effect of acupressure on labor pain, some of which have reported conflicting results. Thus, the present study was performed to critically review the previous studies related to the effect of acupressure administered during labor for relieving labor pain.

Materials and Methods: In this study, databases of the Cochrane Central Register of the Controlled Trials, PubMed/MEDLINE, Scopus, and Web of Science were searched from their establishment until November 5, 2019. All the Randomized Controlled Trials (RCTs) that had compared the use of acupressure with either placebo or nonintervention for relieving the labor pain were included in the study. Meta‑analysis was performed using the Comprehensive Meta‑Analysis (CMA) software Version 2. The random‑effects model was used for pooling the effect sizes across the included studies. The p value <0.05 was considered as statistically significant.

Results: Totally, 5853 primary papers were identified in the search, which were narrowed down to 22 studies. The results of meta‑analysis showed that the acupressure decreased the labor pain in the intervention group vs. control (‑1.67 [‑2.29 to ‑ 1.05], z = ‑ 5.25, p < 0. 001) (Q‑value = 788.98, p < 0.001, I‑squared = 96.83). No publication bias was found in the included studies (Egger’s regression intercept = ‑ 1.02, p = 0.76).

Conclusions: Although the findings of this meta‑analysis showed that the acupressure significantly reduced the labor pain during the active phase of labor compared to the nonintervention or placebo; considering that the quality of the included studies was generally moderate, rigorous RCTs with better design and higher quality are needed to obtain definitive conclusions.


Keywords


Acupressure, labor pain, pain management, parturition

Full Text:

PDF

References


Agah J, Baghany R, Safiabaditali SH, Tabarrai Y, Rad A. Maternal side effects of continuous vs. intermittent method of entonox during labor: A randomized clinical trial. Iran J Pharm Res 2016;15:641‑6.

Lang A, Sorrell J, Rodgers C, Lebeck M. Anxiety sensitivity as a predictor of labor pain. Eur J Pain 2006;10:263‑70.

Makvandi S, Mirteimoori M, Mirzaiinajmadi K, Sadeghi R. A review of randomized clinical trials on the effect of aromatherapy with lavender on labor pain relief. Nurse Care Open Acces J 2016;1:1‑6.

Makvandi S, Latifnejad Roudsari R, Sadeghi R, Karimi L. Effect of birth ball on labor pain relief: A systematic review and meta‑analysis. J Obst Gynaecol Res 2015;41:1679‑86.

Surucu SG, Ozturk M, Vurgec BA, Alan S, Akbas M. The effect of music on pain and anxiety of women during labour on first time pregnancy: A study from Turkey. Complement Ther Clin Pract 2018;30:96‑102.

Jones L. Pain management for women in labour: An overview of systematic reviews. J Evid Based Med 2012;5:101‑2.

Forrester LT, Maayan N, Orrell M, Spector AE, Buchan LD, Soares-Weiser K. Aromatherapy for dementia.Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD003150. DOI: 10.1002/14651858.CD003150.pub2.

Makvandi S, Zargar Shoshtari S, Montazeri S, Ahangarpour A. The effect of chewing sugar‑free gum on the anxiety level of active phase of labor in nulliparous women. Razi J Med Sci 2013;20:9‑15

Makvandi S, Mirzaiinajmabadi K, Mirteimoori M, Sadeghi R. An update on the effect of massage and inhalation aromatherapy with lavender on labor pain relief: A systematic review and meta‑analysis. J Obstet Gynecol Cancer Res 2018;3:29‑37.

Hmwe NTT, Subramanian P, Tan LP, Chong WK. The effects of acupressure on depression, anxiety and stress in patients with hemodialysis: A randomized controlled trial. Int J Nurs Stud 2015;52:509‑18.

Huang L. Auricular Medicine: A Complete Manual of Auricular Diagnosis and Treatment. Auricular International Research & Training Center; 2005.

Carotenuto M, Gallai B, Parisi L, Roccella M, Esposito M. Acupressure therapy for insomnia in adolescents: A polysomnographic study. Neuropsychiatr Dis Treat 2013;9:157‑62.

Ling W, Lui L, So W, Chan K. Effects of acupuncture and acupressure on cancer‑related fatigue: A systematic review. Oncol Nurs Forum 2014;41:581‑92.

Yeh CH, Kwai‑Ping Suen L, Chien LC, Margolis L, Liang Z, Glick RM, et al. Day‑to‑day changes of auricular point acupressure to manage chronic low back pain: A 29‑day randomized controlled study. Pain Med 2015;16:1857‑69.

Chen J‑H, Chao Y‑H, Lu S‑F, Shiung T‑F, Chao Y‑F. The effectiveness of valerian acupressure on the sleep of ICU patients: A randomized clinical trial. Int J Nurs Stud 2012;49:913‑20.

Abbott R, Ayres I, Hui E, Hui K‑K. Effect of perineal self‑acupressure on constipation: A randomized controlled trial. J Gen Intern Med 2014;30:434‑9.

Chen H‑M, Wang H‑H, Chiu M‑H, Hu H‑M. Effects of acupressure on menstrual distress and low back pain in dysmenorrheic young adult women: An experimental study. Pain Manag Nurs 2014;16:188‑97.

Kao C‑L, Chen C‑H, Lin W‑Y, Chiao Y‑C, Hsieh C‑L. Effect of auricular acupressure on peri‑and early postmenopausal women with anxiety: A double‑blinded, randomized, and controlled pilot study. Evid Based Complement Alternat Med 2012;2012:567639.

Liu CT, Ko YL. Auricular point acupressure to improve sleep quality in taiwanese postpartum women with insomnia. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2014;1(43):S58.

Hamidzadeh A, Shahpourian F, Orak RJ, Montazeri AS, Khosravi A. Effects of LI4 acupressure on labor pain in the first stage of labor. J Midwifery Womens Health 2012;57:133‑8.

Pouresmail Z, Ibrahimzadeh R. Effects of acupressure and ibuprofen on the severity of primary dysmenorrhea. J Tradit Chin Med 2002;22:205‑10.

Yip Y, Tse SH‑M. An experimental study on the effectiveness of acupressure with aromatic lavender essential oil for sub‑acute, non‑specific neck pain in Hong Kong. Complement Ther Clin Pract 2006;12:18‑26.

Akbarzadeh M, Masoudi Z, Hadianfard MJ, Kasraeian M, Zare N. Comparison of the effects of maternal supportive care and acupressure (BL32 acupoint) on pregnant women’s pain intensity and delivery outcome. J Pregnancy 2014;2014:1‑7.

Heidari P, Mojdeh F, Mazlum S, Tanbaqui K, Judaki K. Effect of acupressure on labor pain intensity. Hakim Res J 2008;11:39‑46.

Lee MK, Chang SB, Kang D‑H. Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. J Altern Complement Med 2004;10:959‑65.

Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions. 2nd Edition. Chichester (UK): John Wiley & Sons, 2019.

Akbarzadeh M, Moradi Z, Jowkar A, Zare N, Hadianfard MJ. Comparing the effects of acupressure at the Jian Jing‑Gall Bladder Meridian (GB‑21) point on the severity of labor pain, duration and cesarean rate in mono‑and bi‑stage interventions. Womens Health Bulletin 2015;2:e24981.

Hjelmstedt A, Shenoy ST, Stener‑Victorin E, Lekander M, Bhat M, Balakumaran L, et al. Acupressure to reduce labor pain: A randomized controlled trial. Acta Obstet Gynecol Scand 2010;89:1453‑9.

Hosseinpour N, Kaviani M, Razaghi M. Comparison of effect of transcutaneous electrical nerve stimulation and acupressure in decreasing labor pain in primiparous women. IJOGI 2012;15:27‑33.

Kashanian M, Shahali S. Effects of acupressure at the Sanyinjiao point (SP6) on the process of active phase of labor in nulliparas women. J Matern Fetal Neonatal Med 2010;23:638‑41.

Salehian T, Safdari Dehcheshmaei F, Pirak A, Kazemian A, Atarodi Z, Navabi Righi SD. Comparison of the effect of Hoku point (LI4) acupressure with that of San‑Yin‑Jiao (SP6) acupressure on labor pain and the length of delivery time in primiparous women. SJKU 2011;16:64‑72.

Sebastian M. Effect of acupressure on labour pain during first stage of labour among Primi mothers in a selected hospital of Delhi. Nurs J India 2013;105:136‑9.

Sehhatie‑Shafaie F. The Effect of acupressure on Sanyinjiao and Hugo Points on labor pain in nulliparous women: A randomized clinical trial. J Caring Sci 2013;2:123‑9.

Calik KY, Komurcu N. Effects of SP6 acupuncture point stimulation on labor pain and duration of labor. Iran Red Crescent Med J 2014;16:e16461.

Türkmen H, Turfan EÇ. The effect of acupressure on labor pain and the duration of labor when applied to the SP6 point: Randomized clinical trial. Jpn J Nurs Sci 2019; 17(1):1-9.

Gönenç IM, Terzioğlu F. Effects of massage and acupressure on relieving labor pain, reducing labor time, and increasing delivery satisfaction. J Nurs Res 2020;28(1):1-9.

Ozgoli G, Mobarakabadi SS, Heshmat R, Majd HA, Sheikhan Z. Effect of LI4 and BL32 acupressure on labor pain and delivery outcome in the first stage of labor in primiparous women: A randomized controlled trial. Complement Ther Med 2016;29:175‑80.

Abd El Hamid NAEF, Obaya HE, Gaafar HM. Effect of acupressure on labor pain and duration of delivery among laboring Women Attending Cairo University Hospital. IOSR J Nurs Health Sci 2012;1:8‑14.

Chung U‑L, Hung L‑C, Kuo S‑C, Huang C‑L. Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. J Nurs Res 2003;11:251‑60.

Dabiri F, Shahi A. The effect of LI4 acupressure on labor pain intensity and duration of labor: A randomized controlled trial. Oman Med J 2014;29:425‑9.

Kordi M, Rouhani Mashhadi S, Fadaei A, Esmaeili H. Effects of sp6 acupressure on reducing the labor pain during first stage of delivery.IJOGI 2009;12:7‑12.

Hamlacı Y, Yazici S. The Effect of acupressure applied to point LI4 on perceived labor pains. Holist Nurs Pract 2017;31:167‑76.

Mafetoni RR, Shimo AKK. The effects of acupressure on labor pains during child birth: Randomized clinical trial. Rev Lat Am Enfermagem 2016;24:1‑8.

Samadi P, Lamiyan M, Heshmat R, Faghihzadeh S. Effect of acupressure at SP6 point on labor pain intensity. Hormozgan Med J 2010;14:55‑64.

Yasuhiro H, Akira T, Satoshi H. Effect of a four‑week self‑administered acupressure intervention on perceived stress over the past month. Open J Med Psychol 2012;1:20‑4.

Horiuchi S, Tsuda A, Honda Y, Kobayashi H, Naruse M, Tsuchiyagaito A. Mood changes by self‑administered acupressure in Japanese collegestudents: A randomized controlled trial. Glob J Health Sci 2014;7:40‑4.

Chang K‑pK. Effect of acupressure on women with urodynamic stress incontinence. The Hong Kong Polytechnic University; 2011.

Chen HM, Chen CH. Effects of acupressure at the Sanyinjiao point on primary dysmenorrhoea. J Adv Nurs 2004;48:380‑7.

Melzack R, Wall PD. Pain mechanisms: A new theory. Survey of anesthesiology 1967;11:89‑90.

Fernando MLC. A scientific review of acupuncture. S Afr Fam Pract 1982;3(5):13–7.

Bello AI, Kuwornu S. 5% Ibuprofen iontophoresis compared with transcutaneous electrical nerve stimulation in the management of knee osteoarthritis: A feasibility study. OJTR 2014;2:166.

Adams ED, Bianchi AL. A practical approach to labor support. J Obstet Gynecol Neonatal Nurs 2008;37:106‑15.

Mollart LJ, Adam J, Foureur M. Impact of acupressure on onset of labour and labour duration: A systematic review. Women Birth 2015;28:199‑206.

Schulz KF, Grimes DA. Allocation concealment in randomised trials: Defending against deciphering. Lancet 2002;359:614‑8


Refbacks

  • There are currently no refbacks.