Highlights:
- Both acupuncture and doxylamine-pyridoxine alone reduced morning sickness symptoms.
- Doxylamine-pyridoxine has been shown to be associated with a higher risk of having a small-for-gestational age fetus compared with placebo.
Acupuncture and doxylamine-pyridoxine, alone or in combination, are effective in reducing morning sickness symptoms during pregnancy, researchers report. Annals of Internal Medicine.
Currently, severe nausea and vomiting during pregnancy is primarily treated with antiemetics such as doxylamine pyridoxine and hospitalization. Combining antiemetics with other treatments may be more effective than using each in sequence.” Xiao-ke Wu, M.D., Ph.D. of “However, justification for adding acupuncture as a complementary therapy in the context of antiemetics is still lacking,” wrote the researchers from the Department of Gynecology, The First Affiliated Hospital, Heilongjiang University of Traditional Chinese Medicine, China, and the Reproductive Medicine Center of Heilongjiang Provincial Hospital.
Wu and colleagues conducted a multicenter, randomized, double-blind, placebo-controlled trial in 352 early-pregnancy women with moderate-to-severe pregnancy nausea and vomiting at 13 tertiary care institutions in China from June 2020 to February 2022. All women were randomly assigned to receive either active acupuncture plus doxylamine-pyridoxine (n = 88), sham acupuncture plus doxylamine-pyridoxine (n = 88), active acupuncture plus placebo (n = 88), or sham acupuncture plus placebo (n = 88) for 30 minutes daily for 14 days.
The primary outcome was reduction in vomiting scores on gestational day 15. Secondary outcomes included quality of life, adverse events, and maternal and perinatal complications.
The researchers observed no significant interactions among the four interventions: the mean change in quantified pregnancy-specific vomiting scores was -5.7 for women who received active acupuncture plus doxylamine pyridoxine, -5 for women who received sham acupuncture plus doxylamine pyridoxine, -4.7 for women who received active acupuncture plus placebo, and -4 for women who received sham acupuncture plus placebo.
Active acupuncture (mean difference, –0.6; 95% CI, –1.1 to –0.1) and doxylamine-pyridoxine (mean difference, –1.2; 95% CI, –1.7 to –0.7) resulted in significant reductions in VAS scores compared with the control group. Doxylamine-pyridoxine resulted in significant reductions in Nausea and Vomiting During Pregnancy Quality of Life scores (mean difference, –17.4; 95% CI, –27.1 to –7.8), Zung Self-Rating Depression Scale scores (mean difference, –3.5; 95% CI, –6 to –1), and Zung Self-Rating Anxiety Scale scores (mean difference, –2.8; 95% CI, –5.1 to –0.4) compared with the control group.
Additionally, the researchers observed that women who received doxylamine-pyridoxine had an increased risk of giving birth to a small-for-gestational age baby compared with women who received placebo (OR = 3.8; 95% CI, 1-14.1).
“The combination of both treatments demonstrated a numerically larger, potentially clinically meaningful benefit than either treatment alone,” the researchers wrote. “This finding is particularly important given the urgent need to establish safe treatment regimens during pregnancy and comprehensive guidelines for managing severe nausea and vomiting during pregnancy.”
