BACKGROUND: Nausea and vomiting, which cause considerable multifaceted effects, are commonly experience in early pregnancy. Various therapeutic strategies are employed, including both conventional agents and complementary medicine. However, the effectiveness of complementary medicine remains controversial. The objective of this meta-analysis is to evaluate efficacy and safety of acupuncture and moxibustion in pregnant women. METHODS: We conducted a comprehensive search using electronic databases such as PubMed, Embase, ISI Web, Medline, Cochrane, ClinicalTrials.gov, and several Chinese databases. A total of 21 randomized controlled trials were included in this study for quantitative analysis. Forest plots were utilized to evaluate the efficacy and safety of acupuncture and moxibustion. Egger's test was employed to assess publication bias. RESULTS: The pooled analysis revealed that the acupuncture/moxibustion group was more effective than control group in alleviating nausea and vomiting in early pregnant women (RR 0.28; 95%CI 0.21 to 0.37). Similar results were observed when comparing the acupuncture group to traditional herbs (RR 0.08; 95% CI 0.01 to 0.60), conventional therapy (RR 0.15; 95% CI 0.04 to 0.57), and the blank control group (RR 0.33; 95% CI 0.22 to 0.51). Moxibustion also exhibited the ability to alleviate nausea and vomiting compared with the blank control group (RR 0.21; 95% CI 0.08 to 0.52). As for safety, there were no significant differences in severe adverse events between the acupuncture group and the control group (RR 0.77; 95%CI 0.52 to 1.14), the blank control group (RR: 0.61; 95%CI 0.34 to 1.10), the sham acupuncture group (RR 1.05; 95%CI 0.63 to 1.73), or the conventional therapy group (RR 0.32; 95%CI 0.06 to 1.55). CONCLUSION: Acupuncture and moxibustion might be effective for the management of nausea and vomiting in early pregnant women. Moreover, acupuncture might be a relatively safe treatment for pregnancy.

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