October 16th, 2009 
A special acupuncture technique can help ease lower back and pelvic pain in pregnant women, new research shows.
In a study, women who had pressure needles held in place with tape at three acupuncture points in their ears for one week, were more likely to experience significant reductions in lower back and pelvic pain than those who had the needles placed at three “sham” points or women in a control group who didn’t get real or fake acupuncture.
Pregnant women often suffer from pain in the lower back and pelvis — and this can set the stage for chronic pain later on, Dr. Shu-Ming Wang of the Yale School of Medicine in New Haven, Connecticut and colleagues note in the American Journal of Obstetrics & Gynecology.
Ear acupuncture might offer a drug-free way to help ease pain in these women, Wang and colleagues say.
They randomly assigned 159 women in the 25th to 38th week of pregnancy to receive real acupuncture, acupuncture delivered to points that would theoretically not affect pain in the pelvic or lower back area, and a control group.
Every woman was also instructed to use self-care as needed, including resting, taking acetaminophen, and applying warm and cold compresses.
All of the 152 women who completed the two-week study reported some degree of pain reduction and improvement in their ability to function.
A 30 percent or greater reduction in pain was reported by 81 percent of women in the acupuncture group, 59 percent of women in the sham acupuncture group and 47 percent of women in the control group. The difference between the sham and control groups wasn’t statistically significant.
Thirty-seven percent of women in the acupuncture group were pain-free after a week of acupuncture, compared to 22 percent in the sham group and 9 percent of the control group. Improvements in function were significantly greater among women who had real acupuncture compared to those who got the fake version or received no treatment.
But the pain relief didn’t persist for some; a week after the end of acupuncture treatment, 68 percent of those who received the real thing still had a 30 percent or greater reduction in pain compared to the beginning of treatment, while 32 percent in the sham acupuncture group and 18 percent of the control group sustained this level of pain reduction. There was no significant difference among the groups in the percentage remaining free of pain two weeks into the study.
The only side effect was temporary tenderness in the ear area, reported by one woman in the acupuncture group and three in the sham acupuncture group.
The treatment is inexpensive, the researchers note, at a cost of $17 to $20 for a pack of 100 needles, and it takes about three minutes for the needles to be put in place if an experienced person is doing the job.
Related
- Acupuncture Found Effective Against Depression During Pregnancy
In a study to be presented February 4 at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in Chicago, researchers will unveil findings that show that acupuncture may be an effective treatment for depression during pregnancy.
“Depression during pregnancy is an issue of concern because it has negative effects on both the mother and the baby as well as the rest of the family,” said Dr. Schnyer, one of the study’s authors.
About 10% of pregnant women meet criteria for major depression and almost 20% have increased symptoms of depression during pregnancy. The rates of depression in pregnant women are comparable to rates seen among similarly aged non-pregnant women and among women during the postpartum period, but there are far fewer treatment studies of depression during pregnancy than during the postpartum period.
Dealing with depression is difficult for pregnant women because the use of anti-depressants poses concerns to the developing fetus and women are reluctant to take medications during pregnancy.
In the study, an evaluator-blinded randomized trial, 150 participants who met the Diagnostic & Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for Major Depressive Disorder were randomized to receive either acupuncture specific for depression (SPEC, n=52) or one of two active controls: control acupuncture (CTRL, n=49) or massage (MSSG, n=49). Treatments lasted eight weeks (12 sessions). Junior acupuncturists masked to treatment assignment needled participants at points prescribed by senior acupuncturists. Massage therapists and patients were not blinded. The primary outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline and after four and eight weeks of treatment. Data were analyzed using mixed effects models and by intent-to-treat.
The results showed that the women who received SPEC experienced a significantly greater decrease in depression severity compared to the combined controls or CTRL acupuncture alone. They also had a higher response rate (63.0%) than the combined controls or CTRL acupuncture alone. Symptom reduction and response rates did not differ significantly between controls (CTRL 37.5% and MSSG 50.0%). Mild and transient side effects were reported by 43/150 participants (4 in MSSG; 19 in CTRL, 20 in SPEC). Significantly fewer participants reported side-effects in MSSG than the two acupuncture groups.
“The results of our study show that the acupuncture protocol we tested could be a viable treatment option for depression during pregnancy” said Dr. Schnyer.
- Osteopathic care may ease late-pregnancy back pain
Doctors in osteopathic medicine (DOs) are medical doctors additionally trained in gentle manipulative techniques to help restore function, range of motion, and lessen pain in bones and adjoining muscles supporting the neck, back, chest, shoulders, and hips.
Osteopathic manipulation may particularly benefit pregnant women seeking medication-free back pain relief, note Dr. John C. Licciardone and colleagues at University of Texas Health Science Center in Fort Worth.
The study, in the American Journal of Obstetrics and Gynecology, included 144 otherwise healthy pregnant women, about 24 years old on average, with moderate levels of back pain and related movement difficulties during late pregnancy.
The women were randomly assigned to one of three groups: usual obstetric care only, usual obstetric care plus weekly 30-minute osteopathic manipulation treatments from the 30th week of pregnancy through delivery, or usual obstetric care plus sham ultrasound skin stimulation sessions.
Over the course of the study, women in the osteopathic group reported improved back pain and related symptoms, Licciardone noted in an email to Reuters Health. The sham ultrasound group reported no pain improvement and those in the standard care group reported increased pain. However, none of these differences were statistically significant.
Late pregnancy back-related movement problems generally worsened until delivery, but did so to a lesser degree in the osteopathic manipulation group.
Overall, these results suggest osteopathic manipulation may compliment conventional obstetric care, Licciardone and colleagues conclude.
- Pregnant Women Who Smoke Caught Lying by Scientists
A new study casts doubt on the accuracy of self-reported smoking during pregnancy. The study, published last week in the British Medical Journal, involved a random sample of 3,475 pregnant women in Scotland. Researchers compared the women’s self-reported smoking status with results of blood tests that measured the women’s recent nicotine exposure.
According to the results, 24% of women admitted smoking during their pregnancy, yet the “gotcha” blood tests revealed that the real percentage of smokers was more like 30%—meaning that one-fifth of smokers were well…pleading the fifth.
How does that translate to the U.S.? Among reproductive age women in the U.S., an estimated 22% smoke. And even if a 9-month hiatus from the habit was an easy order, not all women consider pregnancy sufficient reason to stop puffing.
Between 10 and 12% of American women smoke during pregnancy, according to the Centers for Disease Control and Prevention. The CDC also estimates that 30% of low birth weight babies (often weighing less than 5.5 pounds), 10% of premature births, and 5% of infant deaths in the U.S. are a result of prenatal smoking.
Back in Scotland, the study authors conclude by calling for better methods of identifying pregnant smokers so that accurate data is used to form policy and provide patient care, such as greater access to smoking cessation services.
- Massage Reduces Depression in Pregnant Women
New research shows massage therapy reduced depression in pregnant women, and also reduced the incidence of massaged women’s babies being born prematurely.
The study was conducted by researchers at the Touch Research Institutes, where pioneering research about massage has been conducted since 1992.
Pregnant women diagnosed with major depression were given 12 weeks of massage, twice per week, by their significant other. A control group did not receive massage, according to an abstract published on www.pubmed.gov.
The massage-therapy group versus the control group not only had reduced depression by the end of the massage-therapy period, they also had reduced depression and cortisol levels during the postpartum period.
The massaged women’s newborns were also less likely to be born prematurely and low birthweight, pubmed noted, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.
- Most Pregnant Women Never Tested for the Most Common Birth Defect
Three out of five women who have given birth to a child with a congenital heart defect (CHD) — the number-one birth defect and leading killer of infants and newborns — were never tested for the defect during pregnancy. This is according to a survey just released by Little Hearts, Inc.
These findings come just as CHD Awareness Week begins (Feb. 7 – 14). The Little Hearts survey found that 60 percent of parents did not know their child had a CHD until after giving birth — because the mothers were not tested for heart defects during pregnancy.
Of these parents, nearly three out of four (71.6 percent) wished they had known their child had a CHD during pregnancy — mostly because they would have given birth at a hospital more equipped to handle the care of newborns with a CHD (41.6 percent).
“Congenital heart defects kill more children than childhood cancer, and yet, pregnant women are not routinely tested — and newborns are not routinely screened — for this defect,” says Lenore Cameron, President and Executive Director, Little Hearts, Inc. “Early detection is absolutely critical to the successful treatment of congenital heart defects and, in countless cases, it saves lives.”
Those families that did know their child had a CHD before giving birth (40.0 percent) reaped tremendous benefits from knowing in advance:
- Three out of five (59.5 percent) said they gave birth at a hospital more equipped to handle the care of newborns with a CHD
- One in five (19.8 percent) prepared themselves mentally and emotionally for the arrival of a seriously ill child
- Others did their homework: 14.9 percent of respondents said they arranged for a pediatric cardiologist in advance of their baby’s arrival, and 5.8 percent said that knowing in advance was most beneficial because it gave them time to do research on CHDs during the pregnancy
More Survey Results
- Four out of five respondents (81.7 percent) said neither parent of the heart child had any family history of CHDs
- Giving birth to a child with a CHD was more common for women in their 30s (65.2 percent) than in any other age group
- Three out of four respondents (76.1 percent) said the mother did not take prescription drugs (which is considered a CHD risk factor) while pregnant with the heart child
- Almost all respondents (96.4 percent) have only one child with a congenital heart defect; 3.6 percent have two or more children with a CHD
Nearly three out of five respondents (58.0 percent) said their heart child has two or more CHDs; 42.0 percent said their heart child has one CHD
- The most common CHD among children of respondents was Hypoplastic Left Heart Syndrome (30.3 percent), a very serious heart defect that occurs when the left side of the heart does not develop completely
There are approximately 35 different types of CHDs. Some may be treated with surgery, medicine and/or devices, such as artificial valves and pacemakers. In the last 25 years, advances in the treatment of heart defects have enabled half a million U.S. children with serious CHDs to survive into adulthood. However, many cases of sudden cardiac death in young athletes are caused by undiagnosed CHDs and childhood-onset heart disease.
