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Background <p>Nausea and vomiting of pregnancy (NVP) are common symptoms during early pregnancy that significantly impact maternal quality of life and fetal development. Given concerns about the safety of pharmacological treatments, non-pharmaceutical Chinese medical therapies (NPCT) have been new topics of great interest due to their minimal side effects.</p> Objective <p>To evaluate the efficacy and safety of NPCT for the management of NVP through an umbrella review of systematic reviews and meta-analyses of randomized controlled trials.</p> Methods <p>Eligible data were retrieved from online databases up to August 31, 2024 for subsequent analyses. The quality of included reviews and the certainty of evidence were evaluated using the AMSTAR-2 tool and the GRADE criteria, respectively. Subgroup analyses were performed based on intervention types, treatment methods, and control conditions to explore potential sources of heterogeneity. Primary outcomes included the severity of NVP, treatment effectiveness, and safety.</p> Results <p>This study included a total of 22 systematic reviews or meta-analyses on various NPCT interventions. The AMSTAR-2 assessment rated 6 studies as high quality, 2 as moderate, and 14 as low or very low quality. The GRADE evaluation categorized evidence as moderate for 5 comparisons, low for 15, and very low for 5 out of the 25 outcome measures. Further analyses revealed the superior effects of acupuncture in decreasing the Pregnancy-Unique Quantification of Emesis score (MD, −1.32; 95% CI, −1.69 to −0.95; moderate evidence), increasing the rate of negative urinary ketone bodies (RR, 1.32; 95% CI, 1.14 to 1.53; moderate evidence); as well as reducing anxiety (MD, 0.78; 95% CI, −1.13 to 2.6; moderate evidence) and depression scores (MD, 0.20; 95% CI, −2.05 to 2.46; moderate evidence).</p> Conclusions <p>NPCT, particularly acupuncture, may have potential benefits in alleviating NVP. However, due to limited overall quality and certainty of evidence, studies with more rigorous designs and larger sample sizes should be included to produce higher-quality evidence, thereby better informing clinical practice. (PROSPERO registration No. CRD42024590714)</p>

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Non-pharmaceutical Chinese Medical Therapies for Nausea and Vomiting of Pregnancy: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Controlled Trials

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Yi-xuan Xie,
  • Ya-nan Sun,
  • Chang-he Yu

摘要

Background

Nausea and vomiting of pregnancy (NVP) are common symptoms during early pregnancy that significantly impact maternal quality of life and fetal development. Given concerns about the safety of pharmacological treatments, non-pharmaceutical Chinese medical therapies (NPCT) have been new topics of great interest due to their minimal side effects.

Objective

To evaluate the efficacy and safety of NPCT for the management of NVP through an umbrella review of systematic reviews and meta-analyses of randomized controlled trials.

Methods

Eligible data were retrieved from online databases up to August 31, 2024 for subsequent analyses. The quality of included reviews and the certainty of evidence were evaluated using the AMSTAR-2 tool and the GRADE criteria, respectively. Subgroup analyses were performed based on intervention types, treatment methods, and control conditions to explore potential sources of heterogeneity. Primary outcomes included the severity of NVP, treatment effectiveness, and safety.

Results

This study included a total of 22 systematic reviews or meta-analyses on various NPCT interventions. The AMSTAR-2 assessment rated 6 studies as high quality, 2 as moderate, and 14 as low or very low quality. The GRADE evaluation categorized evidence as moderate for 5 comparisons, low for 15, and very low for 5 out of the 25 outcome measures. Further analyses revealed the superior effects of acupuncture in decreasing the Pregnancy-Unique Quantification of Emesis score (MD, −1.32; 95% CI, −1.69 to −0.95; moderate evidence), increasing the rate of negative urinary ketone bodies (RR, 1.32; 95% CI, 1.14 to 1.53; moderate evidence); as well as reducing anxiety (MD, 0.78; 95% CI, −1.13 to 2.6; moderate evidence) and depression scores (MD, 0.20; 95% CI, −2.05 to 2.46; moderate evidence).

Conclusions

NPCT, particularly acupuncture, may have potential benefits in alleviating NVP. However, due to limited overall quality and certainty of evidence, studies with more rigorous designs and larger sample sizes should be included to produce higher-quality evidence, thereby better informing clinical practice. (PROSPERO registration No. CRD42024590714)