Acupuncture for nausea and vomiting during pregnancy: an overview of systematic reviews.

Background: Nausea and vomiting during pregnancy (NVP) are common symptoms in early pregnancy. NVP can further affect the physical and mental health of pregnant women. Acupuncture has shown potential clinical value in treating NVP and can be considered a beneficial supplemental therapy for NVP. However, existing systematic reviews (SRs) and meta-analyses (MAs) on the efficacy and safety of acupuncture for NVP have yielded inconsistent conclusions, and their methodological and reporting quality has not yet been systematically and comprehensively evaluated. Objective: To synthesize the existing evidence on the efficacy and safety of acupuncture for the treatment of NVP and to assess the quality and risk of bias of the available SRs/MAs. Methods: Two researchers independently searched nine databases for relevant literature, screened studies according to predefined inclusion and exclusion criteria, and extracted data from the eligible SRs and MAs. The methodological quality, reporting completeness, risk of bias, and strength of evidence were rigorously evaluated using AMSTAR 2, PRISMA-A, ROBIS, and GRADE, respectively. In addition, the GROOVE tool was used to assess the degree of overlap among the original studies by calculating the corrected covered area (CCA). Results: We retrieved a total of 288 studies, and 9 SRs/MAs were ultimately included in this review. The methodological quality of one study was moderate, while two studies were rated as low and the remaining six as critically low. According to the PRISMA-A statement, the reporting items of the included SRs/MAs were relatively complete. Furthermore, it revealed a slight overlap among the original studies, with a CCA of 3.64%. The results based on GRADE showed that of the 52 outcomes, 2 were rated as moderate quality, 20 as low quality, and 30 as very low quality. Descriptive analysis showed that acupuncture combined with medication could reduce the frequency of nausea and vomiting, accelerate the ketonuria-negative rates, and maintain serum electrolyte balance. Acupuncture also appeared to reduce the frequency of nausea and vomiting compared with medication alone. Conclusions: Acupuncture appears to relieve the symptoms of NVP to a certain extent. However, the current evidence is limited by low reliability, methodological flaws, publication bias, and inaccurate data. Therefore, the true efficacy remains unclear. Although acupuncture shows preliminary clinical potential, high-quality randomized controlled trials with standardized outcome indicators are still needed to draw definite conclusions. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261326889.