Acupuncture and Herbal Medicine for Nausea and Vomiting in Pregnancy: An Overview and Quality Assessment of Systematic Reviews

Su-Ji Choi,1 Seoyoon Choi,2 Dong-Il Kim2 1Department of Obstetrics & Gynecology, College of Korean Medicine, Dong-eui University, Busan, Republic of Korea; 2Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University, Goyang-si, Republic of KoreaCorrespondence: Dong-Il Kim, Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10326, Republic of Korea, Email [email protected]: Up to 85% of pregnant women experience nausea and vomiting in pregnancy (NVP), which can impact both the pregnant woman and developing fetus. Traditional East Asian Medicine (TEAM) including acupuncture and herbal medicine has been used to treat NVP; however, its effectiveness remains under debate. This study aimed to systematically review the existing evidence from systematic reviews on the effectiveness of TEAM for NVP and to critically evaluate the quality of these reviews.Methods: Nine databases were searched from their inception until January 2024. Search terms included, “Hyperemesis gravidarum”, “Nausea”, “Vomiting”, “acupuncture” and “herbal medicine”. Systematic reviews (SRs) that evaluated the effect of TEAM treatment for NVP were included. We evaluated methodological quality, reporting quality, and risk of bias using the AMSTAR-2, ROBIS tool, and PRISMA guidelines.Results: In total, 20,121 publications were retrieved from the databases. Twenty-five SRs met the inclusion criteria, indicating that acupuncture and related techniques, and herbal medicines are effective in alleviating NVP. Various methods including traditional acupuncture, acupressure, acupoint injection, electroacupuncture, herbal acupoint patching, and herbal decoctions were used. Herbs like ginger and additional aromatherapies such as lemon and cardamom have also shown beneficial effects. However, there are controversies regarding the consistency of results and the quality of methodologies. Despite low risk of bias across reviews, all were deemed low or critically low in methodological quality, with none fully adhering to PRISMA guidelines.Conclusion: This comprehensive review underscores the potential of TEAM in managing NVP but highlights significant gaps in research quality and reporting. Future studies of higher methodological quality are essential to validate these findings and guide clinical practice.Keywords: systematic review, complementary therapies, morning sickness, acupuncture, herbal medicine