A multicenter, randomized, double-blind, placebo-controlled, 2 × 2 factorial trial demonstrated that both acupuncture and doxylamine-pyridoxine as standalone therapies along with the combination of acupuncture and doxylamine–pyridoxine are effective in treating moderate-to-severe nausea and vomiting of pregnancy (NVP). The researchers sought to evaluate how effective and safe acupuncture, doxylamine-pyridoxine, and a combination of both treatments were for women experiencing morning sickness.

The study involved 352 female participants in the early stages of pregnancy who experienced NVP. These participants were divided into groups and received either active or sham acupuncture sessions for 30 minutes daily, along with either doxylamine-pyridoxine or a placebo for a period of 14 days. The major endpoint of the study was to assess the decrease in Pregnancy-Unique Quantification of Emesis (PUQE) score at day 15 compared to the initial baseline. Secondary endpoints incorporated the participants' quality of life, any adverse events, as well as perinatal and maternal complications.

The interventions did not show any significant interaction. Participants who received acupuncture (mean difference [MD], -0.7), doxylamine-pyridoxine (MD, -1.0), or a combination of both (MD, -1.6) experienced a greater reduction in PUQE score compared to their corresponding control groups (sham acupuncture, placebo, and sham acupuncture + placebo). Nevertheless, in comparison to the placebo group, administering doxylamine-pyridoxine demonstrated a higher likelihood of delivering infants who were born small for gestational age (odds ratio, 3.8).

Moderate to severe NVP can be effectively alleviated with both acupuncture and doxylamine-pyridoxine as standalone therapies. But, the clinical significance of this impact remains uncertain due to its relatively small impact. Combining acupuncture with doxylamine-pyridoxine may potentially provide a greater benefit compared to using each treatment individually.