Intervention parameters of LI4 acupressure for labor pain: systematic review and meta-analysis

LI4 acupressure is a commonly used non-pharmacological method for labor pain relief; however, variations in application methods, duration, and frequency limit the development of standardized protocols. Our study aimed to combine the studies in literature examining the effects of LI4 acupressure on labor pain and systematically evaluating the intervention parameters.

Following PRISMA guidelines, a systematic literature search was conducted across eight databases from 2012 to September 2024. Studies included randomized controlled trials, experimental, and quasi-experimental designs assessing LI4 acupressure for labor pain relief. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I tools. Certainty of evidence was evaluated using GRADE. Meta-analyses were conducted using RevMan 5.4.1. Heterogeneity was assessed using χ², I², and τ² statistics.

This systematic review and meta-analysis of nine studies found that LI4 acupressure significantly reduced labor pain (MD -2.24; 95% CI -3.05, -1.42). The highest pain reduction was observed in women with 4-7 cm cervical dilatation (MD -2.66; 95% CI -3.06, -2.27). The most effective application was the conventional method (MD -2.50; 95% CI -3.65, -1.34), performed during contraction (MD -1.52; 95% CI -2.02, -1.02), and delivered in three sessions (MD -3.10; 95% CI -3.56, -2.64). Higher session frequency and greater numbers of pressures per session were also associated with enhanced pain relief.

LI4 acupressure effectively reduces labor pain. Standardizing intervention parameters: including timing, method, duration, and session frequency, may improve clinical applicability. Standardizing intervention parameters may enhance clinical applicability.