{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:48:50Z","timestamp":1786121330784,"version":"build-2736575974"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Background<\/jats:title>\n Nausea and vomiting during pregnancy (NVP) are common symptoms in early pregnancy. NVP can further affect the physical and mental health of pregnant women. Acupuncture has shown potential clinical value in treating NVP and can be considered a beneficial supplemental therapy for NVP. However, existing systematic reviews (SRs) and meta-analyses (MAs) on the efficacy and safety of acupuncture for NVP have yielded inconsistent conclusions, and their methodological and reporting quality has not yet been systematically and comprehensively evaluated.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To synthesize the existing evidence on the efficacy and safety of acupuncture for the treatment of NVP and to assess the quality and risk of bias of the available SRs\/MAs.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Two researchers independently searched nine databases for relevant literature, screened studies according to predefined inclusion and exclusion criteria, and extracted data from the eligible SRs and MAs. The methodological quality, reporting completeness, risk of bias, and strength of evidence were rigorously evaluated using AMSTAR 2, PRISMA-A, ROBIS, and GRADE, respectively. In addition, the GROOVE tool was used to assess the degree of overlap among the original studies by calculating the corrected covered area (CCA).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We retrieved a total of 288 studies, and 9 SRs\/MAs were ultimately included in this review. The methodological quality of one study was moderate, while two studies were rated as low and the remaining six as critically low. According to the PRISMA-A statement, the reporting items of the included SRs\/MAs were relatively complete. Furthermore, it revealed a slight overlap among the original studies, with a CCA of 3.64%. The results based on GRADE showed that of the 52 outcomes, 2 were rated as moderate quality, 20 as low quality, and 30 as very low quality. Descriptive analysis showed that acupuncture combined with medication could reduce the frequency of nausea and vomiting, accelerate the ketonuria-negative rates, and maintain serum electrolyte balance. Acupuncture also appeared to reduce the frequency of nausea and vomiting compared with medication alone.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Acupuncture appears to relieve the symptoms of NVP to a certain extent. However, the current evidence is limited by low reliability, methodological flaws, publication bias, and inaccurate data. Therefore, the true efficacy remains unclear. Although acupuncture shows preliminary clinical potential, high-quality randomized controlled trials with standardized outcome indicators are still needed to draw definite conclusions.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n , identifier CRD420261326889.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1886667","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:21:42Z","timestamp":1786076502000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Acupuncture for nausea and vomiting during pregnancy: an overview of systematic reviews"],"prefix":"10.3389","volume":"17","author":[{"given":"Jingxuan","family":"Cui","sequence":"first","affiliation":[{"name":"Heilongjiang University of Chinese Medicine, Heilongjiang","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Ai","sequence":"additional","affiliation":[{"name":"Heilongjiang University of Chinese Medicine, Heilongjiang","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Shen","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Han","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"649.e641","DOI":"10.1016\/j.ajog.2025.06.055","article-title":"Prepregnancy metformin use associated with lower risk of severe nausea and vomiting of pregnancy and hyperemesis gravidarum","volume":"233","author":"Sharma","year":"2025","journal-title":"Am J Obstet Gynecol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1111\/1471-0528.17739","article-title":"The management of nausea and vomiting in pregnancy and hyperemesis gravidarum (Green-top Guideline No. 69)","volume":"131","author":"Nelson-Piercy","year":"2024","journal-title":"Bjog"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-025-04113-7","article-title":"Interventions initiated before and after pregnancy for women who experience severe nausea and vomiting of pregnancy: A scoping review","volume":"29","author":"El-Dirani","year":"2025","journal-title":"Matern Child Health J"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.809270","article-title":"Emerging progress in nausea and vomiting of pregnancy and hyperemesis gravidarum: Challenges and opportunities","volume":"8","author":"Liu","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.122593","article-title":"Nausea and vomiting of pregnancy in an evolutionary perspective","volume":"186","author":"Sherman","year":"2002","journal-title":"Am J Obstet Gynecol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291718004105","article-title":"Hormonal and psychological factors in nausea and vomiting during pregnancy","volume":"50","author":"Dekkers","year":"2020","journal-title":"Psychol Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X710885","article-title":"Nausea and vomiting in pregnancy is not just 'morning sickness': Data from a prospective cohort study in the UK","volume":"70","author":"Gadsby","year":"2020","journal-title":"Br J Gen Pract"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14124300","article-title":"Associations of nausea and vomiting of pregnancy with maternal and fetal outcomes","volume":"14","author":"De Bonis","year":"2025","journal-title":"J Clin Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/s0140-6736(25)01454-0","article-title":"Hyperemesis gravidarum","volume":"407","author":"Nana","year":"2026","journal-title":"Lancet"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.03.006","article-title":"Hyperemesis gravidarum is associated with increased rates of termination of pregnancy and suicidal ideation: Results from a survey completed by >5000 participants","volume":"224","author":"Nana","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12884-025-08407-0","article-title":"The impact of nausea and vomiting on health related quality of life during pregnancy: A systematic review","volume":"26","author":"Gete","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp18X700745","article-title":"Nausea and vomiting of pregnancy and resource implications: The NVP Impact Study","volume":"69","author":"Gadsby","year":"2019","journal-title":"Br J Gen Pract"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1177\/1359105319859048","article-title":"The psychosocial impact of nausea and vomiting during pregnancy as a predictor of postpartum depression","volume":"26","author":"Bray","year":"2021","journal-title":"J Health Psychol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2196\/36226","article-title":"Impact of a mobile application for tracking nausea and vomiting during pregnancy (NVP) on NVP symptoms, quality of life, and decisional conflict regarding NVP treatments: MinSafeStart randomized controlled trial","volume":"10","author":"Ngo","year":"2022","journal-title":"JMIR Mhealth Uhealth"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/ogx.0000000000000654","article-title":"The management of nausea and vomiting of pregnancy: Synthesis of national guidelines","volume":"74","author":"Tsakiridis","year":"2019","journal-title":"Obstet Gynecol Surv"},{"key":"B16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1002\/ijgo.70165","article-title":"The impact and management of hyperemesis gravidarum: Current and future perspectives","volume":"171","author":"van der Minnen","year":"2025","journal-title":"Int J Gynaecol Obstet"},{"key":"B17","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1097\/ogx.0000000000000746","article-title":"Management considerations for recalcitrant hyperemesis","volume":"75","author":"Spinosa","year":"2020","journal-title":"Obstet Gynecol Surv"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/foods14030373","article-title":"A food pyramid and nutritional strategies for managing nausea and vomiting during pregnancy: A systematic review","volume":"14","author":"Rondanelli","year":"2025","journal-title":"Foods"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/pds.70367","article-title":"Medications for nausea and vomiting of pregnancy and the risks for adverse birth outcomes","volume":"35","author":"Sillis","year":"2026","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06851-3","article-title":"Evaluation of nausea and vomiting in the first trimester on the risk of adverse birth outcomes and the contribution of genetic polymorphisms: A pilot prospective study","volume":"308","author":"Li","year":"2023","journal-title":"Arch Gynecol Obstet"},{"key":"B21","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/ijgo.16032","article-title":"The potential hazards of high doses of vitamin B6 in treating nausea and vomiting in pregnancy: A systematic review","volume":"169","author":"He","year":"2025","journal-title":"Int J Gynaecol Obstet"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1108756","article-title":"The efficacy and safety of complementary and alternative medicine in the treatment of nausea and vomiting during pregnancy: A systematic review and meta-analysis","volume":"11","author":"Tan","year":"2023","journal-title":"Front Public Health"},{"key":"B23","doi-asserted-by":"publisher","first-page":"595","DOI":"10.36740\/WLek\/202550","article-title":"Acupuncture: Ancient remedy or modern placebo","volume":"78","author":"Morawik","year":"2025","journal-title":"Wiad Lek"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/s0965-2299(02)00072-9","article-title":"The placebo response and effect of time in a trial of acupuncture to treat nausea and vomiting in early pregnancy","volume":"10","author":"Smith","year":"2002","journal-title":"Complement Ther Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12389","article-title":"Nausea and vomiting in early pregnancy: Effects on food intake and diet quality","volume":"13","author":"Crozier","year":"2017","journal-title":"Matern Child Nutr"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.joim.2025.06.001","article-title":"Advancements and challenges of acupuncture randomized controlled trials","volume":"23","author":"Seetoh","year":"2025","journal-title":"J Integr Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/advs.202505318","article-title":"Advances in medical devices for augmented acupuncture therapy","volume":"12","author":"Cai","year":"2025","journal-title":"Adv Sci (Weinh)"},{"key":"B28","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1007\/s11684-023-1051-5","article-title":"Effects and mechanisms of acupuncture on women related health","volume":"18","author":"Qin","year":"2024","journal-title":"Front Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.12.013","article-title":"Acupuncture as adjunctive therapy for cervical cancer pain: A systematic review and meta-analysis","volume":"71","author":"Shi","year":"2026","journal-title":"J Pain Symptom Manage"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.13702\/j.1000-0607.20220865","article-title":"Dose-effect relationship and precise treatment of acupuncture:viewing from translational medicine","volume":"48","author":"Chen","year":"2023","journal-title":"Zhen Ci Yan Jiu"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2024.101847","article-title":"Effects of auriculotherapy on nausea and vomiting in pregnant women: A randomized clinical trial","volume":"55","author":"Fr\u00f3es","year":"2024","journal-title":"Complement Ther Clin Pract"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1590\/1518-8345.7235.4771","article-title":"Effectiveness of auriculotherapy and laser acupuncture in hyperemesis gravidarum: A randomized clinical trial","volume":"34","author":"Oliva","year":"2026","journal-title":"Rev Lat Am Enfermagem"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1615635","article-title":"Electroacupuncture and vagus nerve stimulation are emerging therapies for hyperemesis gravidarum management","volume":"16","author":"Zhang","year":"2025","journal-title":"Front Neurol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.16929","article-title":"Acupuncture-a question of culture","volume":"2","author":"Karst","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1590\/1980-220X-REEUSP-2021-0515en","article-title":"Integrative and complementary practices to control nausea and vomiting in pregnant women: A systematic review","volume":"56","author":"Nassif","year":"2022","journal-title":"Rev Esc Enferm Usp"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.7326\/l23-0425","article-title":"Acupuncture and doxylamine-pyridoxine for nausea and vomiting in pregnancy","volume":"177","author":"Fan","year":"2024","journal-title":"Ann Intern Med"},{"key":"B37","doi-asserted-by":"publisher","first-page":"E477","DOI":"10.1503\/cmaj.221502","article-title":"Diagnosis and treatment of hyperemesis gravidarum","volume":"196","author":"Jansen","year":"2024","journal-title":"Cmaj"},{"key":"B38","article-title":"Clinical observation of acupuncture therapy for hyperemesis gravidarum","volume":"21","author":"Ling Y","year":"2012","journal-title":"Modern J Integrated Traditional Chin Western Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.jclinepi.2023.01.011","article-title":"The problems with systematic reviews: A living systematic review","volume":"156","author":"Uttley","year":"2023","journal-title":"J Clin Epidemiol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/s13643-021-01819-x","article-title":"A comparison of two assessment tools used in overviews of systematic reviews: ROBIS versus AMSTAR-2","volume":"10","author":"Perry","year":"2021","journal-title":"Syst Rev"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.13288\/j.11-2166\/r.2020.17.013","article-title":"Data analysis method for overview of systematic reviews and research status in the field of traditional Chinese medicine","volume":"61","author":"Mei H","year":"2020","journal-title":"J Traditional Chin Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"Bmj"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.06.005","article-title":"ROBIS: A new tool to assess risk of bias in systematic reviews was developed","volume":"69","author":"Whiting","year":"2016","journal-title":"J Clin Epidemiol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12906-019-2624-3","article-title":"Reporting items for systematic reviews and meta-analyses of acupuncture: The PRISMA for acupuncture checklist","volume":"19","author":"Wang","year":"2019","journal-title":"BMC Complement Altern Med"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: An emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"Bmj"},{"key":"B46","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.jphys.2020.07.003","article-title":"Clinimetrics: grading of recommendations, assessment, development and evaluation (GRADE)","volume":"67","author":"Xie","year":"2021","journal-title":"J Physiother"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1557","article-title":"Graphical representation of overlap for overviews: GROOVE tool","volume":"13","author":"P\u00e9rez-Bracchiglione","year":"2022","journal-title":"Res Synth Methods"},{"key":"B48","doi-asserted-by":"publisher","first-page":"2731446","DOI":"10.1155\/2021\/2731446","article-title":"Effectiveness of acupuncture in the treatment of hyperemesis gravidarum: A systematic review and meta-analysis","volume":"2021","author":"Lu","year":"2021","journal-title":"Evid Based Complement Alternat Med"},{"key":"B49","first-page":"93","article-title":"Network meta-analysis of the efficacy of various acupuncture therapies for the treatment of hyperemesis gravidarum","volume":"8","author":"Wenzhuo A","year":"2025","journal-title":"Bachu Med J"},{"key":"B50","article-title":"A meta-analysis of treating hyperemesis gravidarum by acupoint application [J","volume":"12","author":"QingZhi W","year":"2020","journal-title":"Clin J Chin Med"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.eujim.2022.102130","article-title":"Effect of auriculotherapy on nausea and vomiting during pregnancy: A systematic review","volume":"53","author":"Yue","year":"2022","journal-title":"Eur J Integr Med"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2024.103079","article-title":"Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis","volume":"85","author":"Jin","year":"2024","journal-title":"Complement Ther Med"},{"key":"B53","article-title":"Meta analysis of clinical effect of Shenque acupoint application on hyperemesis gravidarum","volume":"31","author":"TingTing","year":"2022","journal-title":"Chin J Ethnomedicine Ethnopharmacy"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjam.2019.03.004","article-title":"A systematic review and meta-analysis of domestic acupuncture for treatment of hyperemesis gravidarum","volume":"19","author":"Yi","year":"2017","journal-title":"J Liaoning Univ TCM"},{"key":"B55","article-title":"Clinical efficacy of acupoint injection in treating hyperemesis gravidarum: A meta-analysis","volume":"35","author":"Xiaoyang","year":"2019","journal-title":"J Clin Acupuncture Moxibustion"},{"key":"B56","doi-asserted-by":"publisher","first-page":"8","DOI":"10.55111\/j.issn2709-1961.202205028","article-title":"A meta analysis on effect of auricular point sticking and pressing therapy in the treatment of hyperemesis gravidarum","volume":"8","author":"Tian","year":"2022","journal-title":"Chin J Integr Nurs"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1886667\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:21:45Z","timestamp":1786076505000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1886667\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":56,"alternative-id":["10.3389\/fendo.2026.1886667"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1886667","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1886667"}}