The effect of heat therapy on pain intensity, duration of labor during first stage among primiparous women and Apgar scores: A systematic review and meta-analysis

INTRODUCTION: Heat therapy may help in reducing pain during labor as it blocks the receptors of pain, according to gate control theory. This systematic review and meta-analysis study aims to evaluate the effect of heat therapy (HT) systematically and critically on pain intensity, duration of labor during the first stage of labor and Apgar scores. METHODS: We searched for randomized controlled trials published until October 2020 in PubMed/Medline, EMBASE, ClinicalKey, Ovid Discovery, and other sources. Randomized controlled trials (RCTs) comparing heat therapy with standard treatment were selected. RESULTS: Out of 7625 screened, 10 studies met the inclusion criteria. The results of pooled data have shown that heat therapy was significantly effective in reducing pain intensity in the first stage of labor (standard mean difference, SMD= -1.31; 95% CI: -1.88 – -0.73; p<0.001). Heat therapy had significantly reduced the duration of the first stage of labor (pooled MD= -50.09; 95% CI: -89.70–10.48; p=0.01) and was also superior to the standard therapy group in terms of better Apgar scores at the 5th minute of birth of the newborn (pooled MD= -0.10; 95% CI: -0.19–0.02; p=0.02). CONCLUSIONS: Current evidence shows that heat therapy effectively decreases labor pain intensity and shortens the duration of labor in the first stage, and it can be used as nonpharmacological management for labor pain.