Effect of auricular acupressure on labour analgesia: A systematic review and meta-analysis

BACKGROUND: Labour pain significantly influences maternal childbirth experiences and outcomes. Auricular acupressure has shown potential as a non-pharmacological method for labour analgesia. However, comprehensive evidence regarding its efficacy across distinct stages of Labour-specifically the latent and active phases remain unclear, and optimal practice protocols require further clarification. METHODS: Computerized searches of Chinese and English databases were conducted to identify randomized controlled trials (RCTs) examining auricular acupressure for labour analgesia. Meta-analyses were performed using RevMan 5.4 software. Primary analyses were stratified by labour stage (latent vs. active phase), supplemented with subgroup analyses based on acupoint number, practitioner training, and the timing of outcome measurement. RESULTS: Auricular acupressure significantly reduced pain during both the latent phase (SMD = -2.89, 95% CI: -4.03 to -1.75; P < 0.001) and the active phase (SMD = -1.62, 95% CI: -2.37 to -0.87; P < 0.001). During the latent phase, stimulation of six or more auricular points produced a greater analgesic effect (SMD = -4.13) than stimulation of fewer than six points (SMD = -2.38). During the active phase, fewer than six points showed a numerically greater effect (SMD = -1.83) than six or more points (SMD = -1.60), but this finding was unstable in sensitivity analyses. Studies reporting trained providers showed greater pain reduction (SMD = -1.97 vs. -1.30), although the between-subgroup difference was not statistically significant (P = 0.38), and only one latent-phase study reported formal practitioner training. CONCLUSION: Auricular acupressure may reduce labour pain and may be useful as a non-pharmacological adjunct to routine care. However, the certainty of these findings is limited by predictable allocation in two studies, incomplete reporting of blinding, and substantial heterogeneity. Therefore, the findings should be interpreted cautiously and should not be regarded as definitive evidence of effectiveness.