| Title | Efficacy and safety of non-pharmacological interventions for labour pain management: A systematic review and Bayesian network meta-analysis |
| Authors | Hu, Yinchu Lu, Hong Huang, Jing Zang, Yu |
| Affiliation | Peking Univ, Sch Nursing, Beijing 100191, Peoples R China Hebei Med Univ, Sch Nursing, Shijiazhuang, Hebei, Peoples R China |
| Keywords | RANDOMIZED CONTROLLED-TRIAL NERVE-STIMULATION TENS 1ST STAGE WOMENS EXPERIENCES MUSIC-THERAPY SELF-HYPNOSIS ACUPUNCTURE CHILDBIRTH ANXIETY RELIEF |
| Issue Date | Jun-2021 |
| Publisher | JOURNAL OF CLINICAL NURSING |
| Abstract | Aims and objectives: To compare and rank the efficacy and safety of non-pharmacological interventions in the management of labour pain. Background: Recently, various non-pharmacological interventions have been applied to manage labour pain and have shown positive effects. However, evidence identifying which type of non-pharmacological intervention is more efficient and safer is limited. Design: Systematic review and Bayesian network meta-analysis based on PRISMA-NMA. Methods: Seven databases were searched from database inception-March 2020. Two reviewers independently performed study selection, quality appraisal and data extraction. Conventional meta-analysis was conducted using either fixed-effects model or random-effects model according to statistical heterogeneity. The Bayesian network meta-analysis was conducted using the consistency model. Results: 43 studies involving nine non-pharmacological interventions were included. The Bayesian network meta-analysis showed that acupressure (SMD = -2.00, 95% CrI -3.09 to -0.94), aromatherapy (SMD = -2.01, 95% CrI -3.70 to -0.35) and massage therapy (SMD = -1.26, 95% CrI -2.26 to -0.30) had significant positive effects on alleviating labour pain, with aromatherapy being the most effective. The results also revealed that yoga (SMD = -130.85, 95% CrI -212.01 to -59.32) and acupressure (SMD = -10.14, 95% CrI -20.24 to -0.41) were the most effective interventions for shortening the first stage and the second stage of labour, respectively. There were no significant differences between non-pharmacological interventions and usual care or placebo control on the use of pharmacological methods and neonatal 5-min Apgar score. Conclusions: The evidence in this network meta-analysis illustrates that non-pharmacological interventions are effective and safe for labour pain management in low-risk pregnant women. In the future, well-designed studies are needed to validate the conclusion of this network meta-analysis. Relevance to clinical practice: The results support the use of non-pharmacological interventions, especially aromatherapy and acupressure, to relieve labour pain in low-risk pregnant women. Non-pharmacological interventions for labour pain management are recommended to apply according to maternal women's preference and values. |
| URI | http://hdl.handle.net/20.500.11897/614586 |
| ISSN | 0962-1067 |
| DOI | 10.1111/jocn.15865 |
| Indexed | SCI(E) SSCI |
| Appears in Collections: | 护理学院 |
