Acupuncture and doxylamine-pyridoxine combo may alleviate moderate to severe nausea and vomiting during pregnancy

Researchers have found in a randomized, controlled, double-blinded trial involving more than 350 pregnant women that the use of acupuncture or doxylamine-pyridoxine relieved moderate to severe nausea and vomiting during pregnancy. Further Use of both treatments offered even greater relief. The study is published in Annals of Internal Medicine.

Nausea and vomiting impacts up to 85 percent of pregnant women. While 80 to 90 percent of those cases are mild, severe nausea and vomiting, or hyperemesis gravidarum (HG), develops in 10 percent of cases. In addition, up to 10 percent of wanted pregnancies that are complicated by HG are terminated because of intolerable symptoms and complications. Despite the need for an effective treatment and hesitation of medication amongst pregnant women, very few recommendations can be made about optimal and alternative treatments because of inadequate sample sizes and poor study quality.

Researchers from First Affiliated Hospital, Heilongjiang University of Chinese Medicine, and Heilongjiang Provincial Hospital, Harbin, China randomly assigned 352 women in early pregnancy with moderate to severe nausea and vomiting to receive daily active or sham acupuncture for 30 minutes and/or doxylamine-pyridoxine or placebo for 14 days to assess the efficacy and safety of either intervention or the combination of both.

The authors found that active acupuncture and doxylamine–pyridoxine were modestly superior to sham acupuncture and placebo, respectively, in reducing the severity symptoms and improving quality of life among pregnant women. However, combination of both treatments offered numerically larger benefits than each treatment alone. The authors note that antinausea drugs may be underprescribed by general practitioners because of concerns about potential risks for birth defects. Acupuncture could serve as an alternative for patients who are unwilling to use pharmacologic treatments during pregnancy.

Reference:

Xiao-Ke Wu, Jing-Shu Gao, Hong-Li Ma, Yu Wang, Bei Zhang, Zhao-Lan Liu, Jian Li, Jing Cong, Hui-Chao Qin, Xin-Ming Yang, Qi Wu, Xiao-Yong Chen, Zong-Lin Lu, Ya-Hong Feng, Chun-Mei An, Li-Li Zhou,  Yu-Hong Hu, Yi-Juan Cao, Ying Yan, https://doi.org/10.7326/M22-2974.