title: The safety of pediatric acupuncture: a systematic review.
abstract: BACKGROUND
  Acupuncture is increasingly used in children; however, the safety of pediatric acupuncture has yet to be reported from systematic review.
  
  
  OBJECTIVE
  To identify adverse events (AEs) associated with needle acupuncture in children.
  
  
  METHODS
  Eighteen databases were searched, from inception to September 2010, irrespective of language. Inclusion criteria were that the study (1) was original peer-reviewed research, (2) included children from birth to 17 years, inclusively, (3) involved needle acupuncture, and (4) included assessment of AEs in a child. Safety data were extracted from all included studies.
  
  
  RESULTS
  Of 9537 references identified, 450 were assessed for inclusion. Twenty-eight reports were included, and searches of reference lists identified 9 additional reports (total: 37). A total of 279 AEs were identified, 146 from randomized controlled trials, 95 from cohort studies, and 38 from case reports/series. Of the AEs, 25 were serious (12 cases of thumb deformity, 5 infections, and 1 case each of cardiac rupture, pneumothorax, nerve impairment, subarachnoid hemorrhage, intestinal obstruction, hemoptysis, reversible coma, and overnight hospitalization), 1 was moderate (infection), and 253 were mild. The mild AEs included pain, bruising, bleeding, and worsening of symptoms. We calculated a mild AE incidence per patient of 168 in 1422 patients (11.8% [95% confidence interval: 10.1-13.5]).
  
  
  CONCLUSIONS
  Of the AEs associated with pediatric needle acupuncture, a majority of them were mild in severity. Many of the serious AEs might have been caused by substandard practice. Our results support those from adult studies, which have found that acupuncture is safe when performed by appropriately trained practitioners.
authors: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors: Denise
authors: D
authors: Adams
authors: Florence
authors: F
authors: Cheng
authors: Hsing
authors: H
authors: Jou
authors: Steven
authors: S
authors: Aung
authors: Yutaka
authors: Y
authors: Yasui
authors: Sunita
authors: S
authors: Vohra
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012720:Severity of Illness Index