Pregnancy
Acupuncture for labour pain management – Journal of Chinese Medicine, Oct 2011
A Cochrane Database systematic review has concluded that acupuncture and acupressure may have a role in reducing pain, increasing satisfaction with pain management and reducing use of pharmacological management for women in labour. Thirteen trials with data on 1986 women were included. Nine trials reported on acupuncture and four on acupressure. Less intense pain was found with acupuncture compared with no intervention. One trial showed increased satisfaction with pain relief compared with placebo. Reduced use of pharmacological analgesia was found in one trial of acupuncture compared with placebo and one compared with standard care. Fewer instrumental deliveries were found with acupuncture compared with standard care. Pain intensity was reduced with acupressure, compared with placebo and control and a combined control. Trials showed significant heterogeneity and all showed some risk of bias. (Acupuncture or acupressure for pain management in labour. Cochrane Database Syust Rev. 2011 Jul 6;(7):CD009232).
Acupuncture effective against pregnancy depression – Journal of Chinese Medicine, Jun 2010
Acupuncture is an effective treatment for depression during pregnancy, according to a new American study. A hundred and fifty pregnant women with a diagnosis of major depression were randomised to receive 12 sessions of acupuncture consisting of a standardised point prescription specific for depression, or one of two active controls – control acupuncture or massage – over eight weeks. Women who received specific acupuncture experienced a greater rate of decrease in symptom severity compared with the combined controls or control acupuncture alone. They also showed a significantly greater response rate (63.0%) than the combined controls (44.3%) and control acupuncture alone (37.5%). Symptom reduction and response rates did not differ significantly between the controls. The authors conclude that the results achieved with acupuncture are similar to those achieved with standard depression treatments of similar duration. (Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol. 2010 Mar;115(3):511-20).
An update of a 2005 Cochrane systematic review concludes that there is currently insufficient evidence to recommend the use of acupuncture for people with depression, but notes that recommendations for practice cannot be made until further high quality research has been undertaken. Twenty-three new studies were added to the original pooled data, giving a total of 30 trials with 2812 participants in the meta-analysis. The authors concluded that there was insufficient evidence of a consistent beneficial effect from acupuncture compared with a wait list control or sham acupuncture control. Despite this, acupuncture performed well in comparisons against medication – the majority of trials found them to be equally effective in reducing the severity of depression. Two trials found acupuncture may have additional benefit when combined with medication compared with medication alone. A subgroup of participants with depression as a co-morbidity experienced a reduction in depression with manual acupuncture compared with SSRIs (three trials, 94 participants). (Acupuncture for depression. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD004046).
Back
Acupuncture could help treat depression during pregnancy – The Daily Telegraph, Feb 2010
Acupuncture may offer a drug-free alternative for treating depression in pregnant women, researchers have found. A study found that more pregnant women with depression benefited from acupuncture than those who had a sham treatment with needles or an ordinary massage. Two thirds who had the genuine acupuncture reported a significant improvement in their symptoms, compared with less than half of those who had the other treatments.
The study of 150 women with depression was conducted by a team at Stanford University in California and is published in the Journal of Obstetrics & Gynaecology. The approach may be particularly beneficial because depression in pregnancy can cause serious complications if untreated and yet women are reluctant to take drugs while carrying their child. Prof Rachel Manber, the lead author, said: “This standardised acupuncture protocol could be a viable treatment option for depression during pregnancy. “Because there is this concern about medication among pregnant women and their physicians, it’s important to find an alternative.”
Around 14 per cent of pregnant women may have depression and the condition is less well recognised than post-natal depression. It is thought the extra hormones during pregnancy may play a role in causing the condition or women may feel overwhelmed by the major changes they are undergoing.
The Daily Telegraph, Tuesday 23rd February 2010
Acupuncture improves sperm motility – Journal of Chinese Medicine, Oct 2009
The first prospective, randomised, single-blind, placebo-controlled study of the effect of acupuncture in infertile men with severe oligoasthenozoospermia has shown that acupuncture can improve sperm motility. The German study, involving 29 men compared TCM acupuncture with placebo acupuncture. A significantly higher percentage of motile sperm was found after real acupuncture. No effect of acupuncture on sperm concentration was observed. (A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertil Steril. 2009 Apr 24. [Epub ahead of print]).
Acupuncture helps with labour pain – Journal of Chinese Medicine, Oct 2009
Danish clinicians carrying out the largest randomised controlled trial of acupuncture for relief of labour pain have found it to be a good supplement to existing pain relief methods, reducing the need for pharmacological and invasive methods during delivery. A randomised controlled trial was conducted with 607 healthy women in labour at term who received acupuncture, TENS, or traditional analgesics. Acupuncture was individualised, based on women’s mobility and localisation of pain, with points chosen from a list of 34 specified points. Although pain scores were comparable across the three groups, the use of pharmacological and invasive methods was significantly lower in the acupuncture group. Acupuncture did not influence the duration of labour or the use of oxytocin. In addition, indications of neonatal wellbeing (Apgar score and umbilical cord pH value) were significantly better among infants in the acupuncture group compared with infants in the other groups. (Acupuncture as pain relief during delivery: a randomized controlled trial. Birth. 2009 Mar;36(1):5-12).
Nuts during pregnancy increase asthma risk – Journal of Chinese Medicine, Oct 2008
A cohort of 4,146 pregnant Dutch women was asked about their frequency of consumption of fruit, vegetables, fish, egg, milk, milk products, nuts, and nut products during the preceding month. The children’s diets were assessed at age two years, and their asthma and allergy status was assessed yearly until eight years of age. Daily consumption of nut products by mothers during pregnancy was found to increase the risk of their children developing asthma symptoms by more than 50%, compared with women who rarely consumed nut products during pregnancy. (Maternal food consumption during pregnancy and the longitudinal development of childhood asthma. Am J Respir Crit Care Med. 2008 Jul 15;178(2):124-31).
Caffeine and miscarriage – Journal of Chinese Medicine, Jun 2008
Too much caffeine during pregnancy may double the risk of miscarriage. In an American cohort study, 1,063 pregnant women were interviewed about their caffeine intake. An increasing dose of daily caffeine during pregnancy was associated with an increased risk of miscarriage, compared with no caffeine intake. Of 264 women who had consumed no caffeine, 12.5% had miscarriages. The miscarriage rate was 24.5% in the 164 women who consumed 200 mg (equivalent to less than two cups of brewed coffee or four cups of black tea) or more per day. (Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study. Am J Obstet Gynecol. 2008 Mar;198(3):279.e1-8).
Acupuncture improves IVF success rate – Journal of Chinese Medicine, Jun 2008
A meta-analysis of seven clinical trials in which acupuncture was used to support embryo transfer during IVF has concluded that it improves rates of pregnancy and live birth. Dutch and American researchers analysed results from seven clinical trials (selected as eligible from a total of 108), all published since 2002 and carried out in four Western countries. They included data on 1366 women and compared acupuncture given within one day of embryo transfer, with sham acupuncture or no additional treatment. All except one used a similar acupuncture protocol (based on Paulus et al). The analysis showed that combining real acupuncture with embryo transfer was associated with significant and clinically relevant improvements in clinical pregnancy rate. Women who underwent acupuncture were 65% more likely to have a successful embryo transfer procedure and 91% more likely to have a live birth. On the basis of ‘number needed to treat’, this means that ten women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. (Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008 Mar 8;336(7643):545-9).
Or does it?
However, a new randomised controlled trial of acupuncture for embryo transfer support, carried out in America, found no increase in clinical pregnancy rate. The study, which involved 150 patients, also used the Paulus acupuncture point protocol and compared it with lying quietly as a control. The use of acupuncture was not associated with increased pregnancy rates, but patients who received it reported feeling relaxed and optimistic about their treatment. (The impact of acupuncture on in vitro fertilization outcome. Fertil Steril. 2008 Mar 1 [Epub ahead of print])
Relaxed mum = relaxed baby – Journal of Chinese Medicine, Feb 2008
Researchers in the USA measured foetal responses to a guided meditation designed to induce maternal relaxation during the 32nd week of pregnancy. The 18-minute guided imagery intervention generated significant changes in maternal heart rate, skin conductance, respiration period and respiratory sinus arrhythmia. Significant alterations in foetal behaviour were also observed, including decreased foetal heart rate (FHR), increased FHR variability and suppression of foetal movement. Significant associations were found between measures of maternal stress and foetal heart patterns, between lower umbilical and uterine artery resistance and increased FHR variability, and between declining maternal salivary cortisol and foetal activity. (Fetal responses to induced maternal relaxation during pregnancy. Biol Psychol 2007 Aug 31 [Epub ahead of print]).
Apples and fish during pregnancy protect against atopy – Journal of Chinese Medicine, Feb 2008
Intake of apples and fish by women during pregnancy may reduce the risk of their children developing atopic conditions, according to the results of a longitudinal cohort study of nearly 2000 Dutch children. Mothers completed a food frequency questionnaire (FFQ) during pregnancy, and children in the cohort were followed up at five years of age with a symptom questionnaire and FFQ. Food groups analysed were fruit, vegetables, fruit juice, whole-grain products, fish, dairy products and fat spreads. Maternal consumption of apples was found to have a protective effect on the children against asthma, while fish consumption was associated with protection against eczema. (Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children. Thorax. 2007 Sep;62(9):773-9).