The Effects of Virtual Reality in Maternity Delivery: A Systematic Review and Meta-analysis. (Preprint)

BACKGROUND Extreme labor pain has negative effects; pharmacologic analgesic modalities are effective but are accompanied by adverse effects. Virtual reality (VR) works as a distracting non－pharmacologic intervention for pain and anxiety relief; however, the effect of VR use in laboring women is unknown. OBJECTIVE Our study aimed to determine the safety and effectiveness of VR technology during labor and delivery, and to investigate whether it impacts labor and patient satisfaction. METHODS Seven databases (PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure and Wan-Fang Database) were systematically searched for randomized controlled trials (RCTs) of VR use in pregnancy and childbirth from the time of database construction until November 24, 2021. Two researchers extracted data and evaluated study quality using the Cochrane Risk of Bias tool 2.0. Outcome measures were labor pain, anxiety, duration, satisfaction, and adverse events. Meta-analyses were performed where possible. RESULTS A total of 12 studies with 1095 participants were included of which 11 and 1 studies were rated as B and A for risk of bias, respectively. Of the 12 studies, 11 reported labor pain, 7 reported labor anxiety, and 4 reported labor duration. Meta－analysis revealed that VR use could relieve pain during labor (mean difference (MD) －1.81, 95% confidence interval (CI) －2.04 to －1.57, P CONCLUSIONS VR is safe and effective in relieving maternal labor pain and anxiety, however, due to the heterogeneity among studies conducted to date, more rigorous, large－scale, standardized RCTs are required to provide a higher－quality evidence base for the use of VR technology in maternal labor, with the aim of improving experience and outcomes. CLINICALTRIAL