The Effect of Chewing Gum on Anxiety and Labor Pain: A Systematic Review and Meta-Analysis

Abstract

Background and Aims: Childbirth as a physiological phenomenon is painful. Fear and anxiety about labor pain increase the likelihood of women choosing cesarean delivery. Nonpharmacological interventions may enhance maternal comfort during labor. This study investigated the effect of chewing gum on anxiety and labor pain. Methods: Studies from 2000 to 2024 were identified through searches of Web of Science, PubMed, Scopus, Google Scholar, and Embase, with no restrictions on language or geographical location. Meta-analysis using Stata v17 employed a random-effects model to calculate standardized mean differences (SMD) with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I2 statistic. Results: An analysis of five trials (326 women, high to low quality, varying inclusion criteria) showed that chewing gum for 20 min in active and second phases significantly reduced pain and anxiety. Pain scores were lower in the gum-chewing group during the active (SMD: −1.23, 95% CI: −2.30 to −0.16, p < 0.00, I2 = 93.97%) and transition phases (SMD: −1.63, 95% CI: −2.35 to −0.90, p = 0.00, I2 = 85.17%) and anxiety scores were also reduced (SMD: −1.44, 95% CI: −1.03 to 3.92, p < 0.00, I2 = 98.41% and SMD: −0.55, 95% CI: −0.79 to −0.30, p = 0.00, I2 = 0.00%, respectively). Conclusion: Chewing gum use may reduce labor pain and anxiety and shorten labor duration, according to this study. However, more rigorous research is necessary to confirm these findings.