*3.2. Methodological Quality of Included Studies*

The risk of bias for included studies is shown in Figures 2 and 3. All studies were assessed as having low or uncertain levels of risk of bias, except in the domains of allocation and follow-up. We present the details of the risk of bias assessment in Supplementary Materials (Table S2). In general, the quality was moderate in all included studies, except for four studies [20,22,23,25] that were assessed as having a high risk of bias in the domain of either allocation or follow-up.

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**Figure 2.** Methodological quality summary: reviews authors' judgement on each methodological quality item for each included study. **Figure 2.** Methodological quality summary: reviews authors' judgement on each methodological quality item for each included study.

**Figure 3.** Methodological quality graph: reviews authors' judgement on each methodological quality item presented as percentage for each included study. **Figure 3.** Methodological quality graph: reviews authors' judgement on each methodological quality item presented as percentage for each included study.

#### *3.3. Efficacy of interventions 3.3. Efficacy of Interventions*

 The meta-analysis of the included studies revealed a beneficial effect of acupuncturetype interventions on correcting breech presentation at delivery (average RR = 1.45; 95% CI = 1.28–1.65; random effect model, I2 = 66%) (Figure 4). The forest plot was divided into The meta-analysis of the included studies revealed a beneficial effect of acupuncturetype interventions on correcting breech presentation at delivery (average RR = 1.45; 95% CI = 1.28–1.65; random effect model, I<sup>2</sup> = 66%) (Figure 4). The forest plot was divided into three subgroups: (1) moxibustion, (2) acupuncture, and (3) moxibustion plus acupuncture.

three subgroups: (1) moxibustion, (2) acupuncture, and (3) moxibustion plus acupuncture. Fetal presentation was investigated in the results of 13 studies with 2063 participants comparing moxibustion with control [10,11,15,16,19,21–25,27–29]. The pooled data show a significant increase in cephalic presentation at birth (RR = 1.39; 95% CI = 1.21–1.58; ran-Fetal presentation was investigated in the results of 13 studies with 2063 participants comparing moxibustion with control [10,11,15,16,19,21–25,27–29]. The pooled data show a significant increase in cephalic presentation at birth (RR = 1.39; 95% CI = 1.21–1.58; random effect model, I2 = 64%). The NNT is 6 (95% CI = 4–11).

dom effect model, I2 = 64%). The NNT is 6 (95% CI = 4–11). Two clinical trials involving 146 patients compared acupuncture with control [17,22]. Two clinical trials involving 146 patients compared acupuncture with control [17,22]. The meta-analysis reveals no differences between treatment and control groups (RR = 2.78; 95% CI = 0.84–9.19; random effect model, I2 = 85%).

The meta-analysis reveals no differences between treatment and control groups (RR = 2.78; 95% CI = 0.84–9.19; random effect model, I2 = 85%). Pooled data from two trials with 346 participants reveals significant difference be-Pooled data from two trials with 346 participants reveals significant difference between moxibustion plus acupuncture and control groups in the meta-analysis [20,26] (RR = 1.53; 95% CI = 1.26–1.86; random effect model, I2 = 0%). The NNT is 5 (95% CI = 3–9).

### tween moxibustion plus acupuncture and control groups in the meta-analysis [20,26] (RR = 1.53; 95% CI = 1.26–1.86; random effect model, I2 = 0%). The NNT is 5 (95% CI = 3–9). *3.4. Sensitivity Analysis: Excluding Four Trials with a High Risk of Bias*

Limiting the meta-analysis to the 12 trials with moderate to low risk of bias [10,11,15– 17,19,21,24,26–29] which investigated the effects of acupuncture-type interventions including moxibustion, acupuncture, and moxibustion plus acupuncture reveal significant effects on correcting fetal malposition (RR = 1.36; 95% CI = 1.23–1.51; random effect model, I <sup>2</sup> = 41%) (Figure 5). The sensitivity analysis for the moxibustion subgroup reveals a result like that of the previous analysis (RR = 1.34; 95% CI = 1.19–1.51; random effect model, I <sup>2</sup> = 47%). The NNT is 7 (95% CI = 5–12). Only one trial that evaluated acupuncture versus control shows more cephalic presentation in the acupuncture group (RR = 1.68; 95% CI = 1.11–2.55). The NNT is 4 (95% CI = 2–20). Only one trial reports that moxibustion plus acupuncture had more cephalic presentation relative to control (RR = 1.42; 95% CI = 1.06–1.90). The NNT is 7 (95% CI = 3–45).

tion.


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**Figure 4.** Forest plot of each comparison: Acupuncture-type interventions versus Control; Outcome: Cephalic presenta-**Figure 4.** Forest plot of each comparison: Acupuncture-type interventions versus Control; Outcome: Cephalic presentation.
