Evidence map›Paper›PMID 35440017›Full record

Trial reportBMC pregnancy and childbirth2022

Effect of a carbohydrate-rich beverage on rate of cesarean delivery in primigravidae with epidural labor analgesia: a multicenter randomized trial.

Ting Ding, Chun-Mei Deng, Xiao-Feng Shen, Yao-Wu Bai, Xiao-Lan Zhang, Ji-Ping Liu, Li-Juan Yang, Hai-Tao Yu, Lei Xie, Hong Chen and 6 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ting Ding *Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China.
Chun-Mei Deng *Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China.
Xiao-Feng ShenDepartment of Anesthesiology, Woman's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Yao-Wu BaiDepartment of Anesthesiology, Tangshan Maternity and Child Health Care Hospital, Tangshan, Hebei, China.
Xiao-Lan ZhangDepartment of Anesthesiology, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China.
Ji-Ping LiuDepartment of Anesthesiology, Foshan Maternal and Child Health Hospital, Foshan, Guangdong, China.
Li-Juan YangDepartment of Anesthesiology, Urumqi Women and Child Health Care Hospital, Urumqi, Xinjiang, China.
Hai-Tao YuDepartment of Anesthesiology, Linyi people's hospital, Linyi, Shandong, China.
Lei XieDepartment of Anesthesiology, Anhui Women and Child Health Care Hospital, Hefei, Anhui, China.
Hong ChenDepartment of Anesthesiology, Women's Hospital of Zhejiang University, Zhejiang, Hangzhou, China.
Dong-Liang MuDepartment of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China.
Yuan QuDepartment of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China.
Hui-Xia YangDepartment of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Ai-Rong BaoDepartment of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Sai-Nan ZhuDepartment of Biostatistics, Peking University First Hospital, Beijing, China.
Dong-Xin WangDepartment of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China. dxwang65@bjmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLabor represents a period of significant physical activity. Inefficient energy supply may delay labor process and even lead to cesarean delivery. Herein we investigated whether ingestion of a carbohydrate-rich beverage could reduce cesarean delivery in laboring women with epidural analgesia.

methodsThis multicenter randomized trial was conducted in obstetrician-led maternity units of nine tertiary hospitals in China. Primigravidae with single term cephalic pregnancy who were preparing for vaginal birth under epidural analgesia were randomized to intake a carbohydrate-rich beverage or commercially available low-carbohydrate beverages during labor. The primary outcome was the rate of cesarean delivery. Secondary outcomes included maternal feeling of hunger, assessed with an 11-point scale where 0 indicated no hunger and 10 the most severe hunger, and maternal and neonatal blood glucose after childbirth.

resultsBetween 17 January 2018 and 20 July 2018, 2008 women were enrolled and randomized, 1953 were included in the intention-to-treat analysis. The rate of cesarean delivery did not differ between the two groups (11.3% [111/982] with carbohydrate-rich beverage vs. 10.9% [106/971] with low-carbohydrate beverages; relative risk 1.04, 95% CI 0.81 to 1.33; p = 0.79). Women in the carbohydrate-rich beverage group had lower subjective hunger score (median 3 [interquartile range 2 to 5] vs. 4 [2 to 6]; median difference - 1; 95% CI - 1 to 0; p < 0.01); their neonates had less hypoglycemia (1.0% [10/968] vs. 2.3% [22/956]; relative risk 0.45; 95% CI 0.21 to 0.94; p = 0.03) when compared with those in the low-carbohydrate beverage group. They also had higher rates of maternal hyperglycemia (6.9% [67/965] vs. 1.9% [18/953]; p < 0.01) and neonatal hyperglycemia (9.2% [89/968] vs. 5.8% [55/956]; p < 0.01), but none required special treatment.

conclusionsFor laboring primigravidae with epidural analgesia, ingestion of a carbohydrate-rich beverage compared with low-carbohydrate beverages did not reduce cesarean delivery, but relieved maternal hunger and reduced neonatal hypoglycemia at the expense of increased hyperglycemia of both mothers and neonates. Optimal rate of carbohydrate supplementation remains to be determined.

trial registrationwww.chictr.org.cn ; identifier: ChiCTR-IOR-17011994 ; registered on 14 July 2017.

Indexed as

Analgesia, EpiduralAnalgesia, ObstetricalHyperglycemiaHypoglycemiaInfant, Newborn, DiseasesAnalgesicsBeveragesCarbohydratesFemaleHumansInfant, NewbornMalePregnancyAnalgesicsCarbohydratesCarbohydrate-rich beverageEpidural labor analgesiaIncidence of cesarean deliveryNeonatal hypoglycemia

Identifiers

PMID35440017
PMCPMC9019984

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.