The Effects of Oral and Vaginal Administration of Evening Primrose Oil on Cervical Ripening and Birth Outcomes: A Systematic Review and Meta-Analysis

Background: Given the conflicting results of three previous systematic reviews, drawing definitive conclusions about the effect of primrose oil on cervical ripening remains challenging.Aim: This meta-analysis aimed to identify and evaluate studies that have examined the effects of oral and/or vaginal evening primrose oil on cervical ripening and birth outcomes.Method: A comprehensive search of English and Persian articles from May ۱۹۹۰-March ۲۰۲۳ was performed in the PubMed, Web of Science, Cochrane Library, Scopus, SID and Magiran databases to identify randomized, placebo, controlled trials (RCTs) of primrose oil.Results: In the review of ۱۶ RCTs, the results revealed a significant difference in the duration of the second phase of labor in the oral EPO capsule (mean difference (MD) = -۹.۶۸, ۹۵% confidence interval (CI): -۱۷.۲۳, -۲.۱۴, I۲ = ۰%). Three studies reported significantly higher Bishop scores for the vaginal capsule in the EPO group than in the placebo group (MD=۱.۸۱, ۹۵% CI: ۰.۲۴; ۳.۳۸, I۲=۱۰۰%). Three studies reported significant improvements in ۵-minute Apgar scores with the use of the EPO vaginal capsule (MD = ۰.۶۰; ۹۵% CI: ۰.۴۹, ۰.۷۱). Cesarean section rates were significantly lower in the group given vaginal EPO (odds ratio (OR) = ۰.۶۲; ۹۵% CI: ۰.۴۰–۰.۹۶; I۲ = ۰.۱%).Implications for Practice: Oral EPO shortens the duration of the second phase of labor and reduces cesarean section rates but does not yield a noteworthy increase in the Bishop score. Vaginal EPO seems to affect cervical ripening, reduce cesarean section rates, and improve ۵-minute Apgar scores.

کلیدواژه ها:

Cervical Ripening ، Evening Primrose Oil ، labor ، oral administration ، Pregnancy outcome ، Vaginal Administration