• Yuanyan Feng, Fengjuan Zhu, Junfeng Zhang, Zishan Zeng, and Qiumei Li.
• Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China.
• Medicine (Baltimore). 2024 May 17; 103 (20): e37594e37594.

BackgroundThe effectiveness of different medical interventions in managing labor pain has yielded mixed results. Therefore, this systematic review and network meta-analysis aimed to provide a comprehensive summary of the available evidence on the impact of different strategies for reducing labor pain.MethodsWe systematically searched 3 English databases (Pubmed, Embase and the Cochrane Library) from inception to January 2023. Randomized controlled trials (RCTs) or controlled clinical trials that investigating the effects of different strategies for reducing labor pain were included in this network meta-analysis. Risk of bias (ROB) was assessed using the Cochrane ROB tools. Network meta-analysis was performed using the R software (version 4.2.1) with gemtc package.ResultsA total of 9 studies involving 823 patients, including 9 treatments (acupressure, birth ball exercise, Bonapace method, distraction techniques, ice pressure, LI4 acupressure, lidocaine spray, smartphone-based music intervention and placebo). The surface under the cumulative ranking (SUCRA) shows that Bonapace method ranked first (SUCRA, 79.5%), LI4 acupressure ranked second (SUCRA, 65.6%), distraction technique ranked third (SUCRA, 57.6%), birth ball exercise ranked fourth (SUCRA, 51.8%).ConclusionsAccording to the results of the network meta-analysis, among the different strategies examined, the Bonapace Method stands out as the most effective nonpharmacological intervention for reducing labor pain. The results of this meta-analysis can aid both patients and healthcare professionals in choosing the most effective techniques to reduce labor pain.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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