Effect of Acupressure Point (LI4) on Anxiety Levels of Pregnant Women during Labor: A Systematic Review and Meta-Analysis


1 Anesthesiologist, Assistant Professor of Intensive Care, North Khorasan University of Medical Sciences, Bojnord, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, Neonatal and Maternal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Neda Dehghani: Department of Midwifery, Firoozabad Branch, Islamic Azad University,Firoozabad, Iran.


Background: Using medication to reduce pain has adverse effects. It is, therefore, better to use non-pharmacological methods for pain relief. One of these methods is acupressure. The present study aimed to investigate the effect of acupressure point (LI4) on the anxiety levels of pregnant women during labor.
Materials and Methods: In this systematic review and meta-analyses, online databases, including Medline, Cochrane Library, EMBASE, and Scopus were searched up to November 2020 using keywords such as (Anxiety) AND (Acupressure). The final version of the Jadad scale, which comprises three important items, was used for evaluating the quality of trials.
Results: Results showed that the patients in the acupressure with ice group were not different from patients in touch group [SMD= -1.26; 95% CI: -2.86 to 0.614; p=0.205; heterogeneity; I2: 96.58%; p<0.001; 2 trials]. Women in the group of acupressure without ice [SMD= -0.83; 95% CI: -1.147 to -0.520; p<0.001; heterogeneity; I2:0%; 2 trials] reported significantly lower anxiety than those in the control group. Also, the meta-analysis showed that acupressure without ice was more effective than acupressure with ice in decreasing anxiety levels [SMD=-0.86; 95% CI: -1.18 to -0. 55; p<0.001; heterogeneity; I2:64.47%; p=0.09; 2 trials].
Conclusion: Based on the results, acupressure point (LI4) with ice was not different from touch, but acupressure without ice resulted in significantly lower anxiety than the control group. However, these findings should be interpreted with caution due to the small sample size and the low number of studies.