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Grand Rounds

Is Acupuncture during Pregnancy Associated with Adverse Perinatal Complications

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BACKGROUND AND PURPOSE:

  • There is increasing demand for complementary and alternative medicine (CAM)
    • There are limited randomized trials on the use of CAM in pregnancy
    • Data on safety profiles of these practices during pregnancy are limited
  • Moon et al. (BJOG, 2019) assessed the safety of acupuncture therapy (AT) during pregnancy

METHODS:

  • Retrospective cohort study
  • Setting
    • Korea
  • Participants and data sources
    • Women with confirmed pregnancy between 2003 and 2012
    • Data derived from the 2002–13 Korean National Health Insurance Service (NHIS) sample cohort
  • Groups
    • Intervention group: Women who received AT during pregnancy
    • Control group: No AT therapy
  • Study design
    • Other factors aside from analgesia were also extracted including age, rate of high-risk pregnancy, and multiple pregnancy
    • In the acupuncture group, the most frequent acupuncture diagnosis codes and the timing of treatment were also obtained
  • Primary outcome
    • Incidence of full-term delivery, preterm delivery and stillbirth
      • Stratified by pregnancy duration and high-risk and multiple pregnancy groups

RESULTS:

  • Data from 20,799 analyzed
    • AT group: 4.95%
    • Control group: 95.05%
    • No differences in age (most common cohort 30 to 39 years) and income level   
    • More women with multifetal pregnancies were in the control group (2.71% vs 0.97%)
  • Preterm delivery: There was no significant difference between groups
    • Overall
      • Odds ratio (OR) 1.23 (95% CI, 0.98 to 1.54)
    • High-risk pregnancies
      • OR 1.09 (95% CI, 0.73 to 1.64
  • Stillbirths
    • AT group: 0
    • Control group: 7 (0.035%)

CONCLUSION:

  • The authors acknowledge limitations of this study, including retrospective study design and the difference in multifetal pregnancy between groups (multifetal pregnancy result in bias away from AT)
  • There were no significant differences between groups for
    • Stillbirth
    • Preterm delivery  
  • They conclude that acupuncture may be a safe practice in pregnancy that has not been shown to lead to preterm delivery or stillbirth  

Learn More – Primary Sources:

Safety of acupuncture during pregnancy: a retrospective cohort study in Korea

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Related ObG Topics:

Are Herbal Medicinal Products Associated with Adverse Outcomes in Pregnancy and Postpartum?
Does Acupuncture Help Women Undergoing In Vitro Fertilization Achieve a Live Birth?
Does Acupuncture Decrease Incidence of Migraines?

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