Investigating the Effects of Acupressure and Auriculotherapy on Anxiety During Labor, Neonatal Outcomes, and Maternal-fetal Attachment: A Systematic Review and Meta-analysis

Background: Divergent findings reported in the literature on the impact of acupressure on improvement in mothers’ anxiety during labor and consequently on birth outcomes. However, there is no existing meta-analysis on this issue. Objectives: This systematic review assesses the effect of acupressure and auriculotherapy on anxiety during labor, neonatal outcomes, and maternal-fetal attachment. Methods: The Cochrane central register of controlled trials, MEDLINE/PubMed, ISI, and Scopus online databases were searched by two researchers up to January 2023. The quality of studies was assessed based on the Jade scale. Results: Nine studies were included in the systematic review and meta-analysis. Acupressure significantly decreased anxiety compared to touching (standardized mean difference=-3.29; P 0.001; I²=8%; P=0.295; the fixed effect model) and routine care (standardized mean difference=-1.08; confidence interval=-2.46 to 0.30; P=0.12; I²=96.19%; P 0.001). Maternal-fetal attachment was higher in both groups who received acupressure and auriculotherapy compared to the control group (P 0.001). Meanwhile, auriculotherapy did not impact neonatal outcomes, such as newborns’ weight and Apgar score. Conclusions: Acupressure was an effective tool to improve anxiety during labor and it consequently improved fetal oxygenation.