Auricular magnetic bead acupressure improves postpartum sleep quality and fatigue, and reduces epidural-related maternal fever in primiparas: a randomized controlled trial

Purpose Postpartum sleep disturbances and severe fatigue are prevalent health concerns among primiparas and may be associated with neuroendocrine and immune activation during the perinatal period. Auricular magnetic bead acupressure (AMBA), a non-invasive therapy rooted in traditional Chinese medicine, has been reported to provide analgesic and anti-inflammatory effects and to modulate autonomic function, and may offer an adjunctive approach to improve postpartum sleep disturbances and fatigue. Patients and methods This prospective randomized controlled trial included 144 primiparas who underwent epidural analgesia. Participants were randomly allocated to either the AMBA intervention group (AMBA combined with Patient-Controlled Epidural Analgesia, PCEA) or the control group (PCEA). The primary outcomes assessed were postpartum sleep quality, evaluated using the Athens Insomnia Scale (AIS), and fatigue severity, assessed via the Postpartum Fatigue Scale (PFS). Secondary outcomes encompassed the incidence of epidural-related maternal fever (ERMF), levels of inflammatory cytokines (IL-6, IL-1β), and sleep-related biomarkers such as melatonin and serotonin (5-HT). Results A total of 122 parturients completed the study. The AMBA group demonstrated a significantly lower AIS score on postpartum day 5 compared with the control group (4.72 ± 2.77 vs. 6.03 ± 3.13, p = 0.0064), as well as a significantly enhanced fatigue score (16.13 ± 2.91 vs. 20.40 ± 0.89, p = 0.0003). Additionally, the AMBA group exhibited higher postpartum levels of melatonin and 5-HT, lower levels of IL-6 and IL-1β, reduced incidence of ERMF (8.19% vs. 24.59%, p = 0.0265), a shorter second stage of labor, and lower total analgesic consumption and oxytocin dose (all p < 0.05). Conclusion Auricular magnetic bead acupressure effectively enhances postpartum sleep quality and alleviates fatigue in primiparas receiving epidural analgesia, while also reducing the incidence of ERMF. The underlying mechanism may involve the modulation of neuroendocrine and immune system functions. AMBA constitutes a safe, non-invasive, and non-pharmacological intervention strategy that is well-suited for comprehensive perinatal management. Clinical trial registration http://itmctr.ccebtcm.org.cn/ , identifier ITMCTR2025002105.