(288) Integrating Complementary Medicine during Labor Induction: Insights from a Retrospective Cohort Study

Objective: The use of acupuncture and reflexology has been rapidly increasing in obstetrics and gynecology. Nevertheless, their effect on maternal and neonatal outcomes remains uncertain. The aim of this study was to compare outcomes between patients who had labor induction with and without complementary medicine integrated into their standard medical care.

Study Design: Retrospective study of patients who had IOL in a single tertiary medical center from 2020-2023. Those receiving acupuncture or reflexology integrated with standard care (study group) were compared to standard care (control group). Data was retrieved from electronic medical records. Inclusion criteria were live singleton fetus, cephalic presentation, > 34 weeks of gestation without contraindication for vaginal delivery. Patients with ruptured membranes before IOL and those lacking data on the IOL method were excluded. Primary outcome was oxytocin use. Secondary outcomes included mode of delivery, indications for immediate delivery, intrapartum maternal fever ≥ 38°C, Apgar at 5 min ≤ 7 and admission to neonatal intensive care unit.

Results: Of 1906 eligible patients, 410 had complimentary treatment and 1496 were in the control group. Nulliparity and induction with prostaglandins were more common in the study group. Complimentary medicine group had lower rates of oxytocin use (17.3% vs 23.6%, p = 0.007) but longer oxytocin to delivery interval. These differences remained significant after adjustment for nulliparity and prostaglandins for labor induction. The rates of cesarean delivery and intrapartum maternal fever were higher in the study group. Other maternal and neonatal outcomes were similar.

Conclusion: Integration of complementary medicine during induction of labor was associated with lower rates of oxytocin use but longer duration of oxytocin administration, higher rates of maternal fever and cesarean deliveries. Selection bias, local practices as well as other confounders warrant prospective studies in order to confirm these findings.