Investigation of the effects of peanut ball during labor: An updated systematic review and meta-analysis
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Somayeh Makvandi1, Leila Karimi2, Mona Larki3,4
1Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Peanut balls significantly shorten the first stage of labor and reduce cesarean section rates for women with epidural analgesia. This non-invasive aid also improves maternal satisfaction during childbirth.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Care
- Evidence-Based Medicine
Background:
- Peanut balls are labor positioning aids designed to enhance maternal comfort and facilitate fetal descent.
- Their impact on labor progression and delivery outcomes requires rigorous evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the effects of peanut balls on the duration of the first stage of labor.
- To assess the influence of peanut balls on cesarean section rates and maternal satisfaction.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Web of Science, Cochrane Library) up to October 2023.
- Included studies were randomized controlled trials or quasi-experimental trials involving laboring women using peanut balls.
- Data synthesis involved fixed-effect and random-effects models, with risk of bias assessed using RoB2 and evidence quality evaluated by GRADEpro GDT.
Main Results:
- Eight studies with 1352 women indicated that peanut ball use shortened the first stage of labor by 52.98 minutes in women with epidural analgesia (p=0.003).
- A significant reduction in cesarean section risk was observed (RR=0.74; 95% CI: 0.60-0.91, p=0.0004).
- Maternal satisfaction was significantly higher in the peanut ball group compared to controls (p<0.0001).
Conclusions:
- Peanut balls effectively reduce the duration of the first stage of labor and lower cesarean delivery rates among women receiving epidural analgesia.
- The use of peanut balls is associated with increased maternal satisfaction.
- While effective and non-invasive, potential limitations include the risk of bias in some included studies.
Introduction:
Peanut balls, a specific type of positioning aid used during labor, have gained attention for their potential to enhance maternal comfort and facilitate fetal positioning. This meta-analysis aims to evaluate the effect of peanut balls on the duration of the first stage of labor, the rate of cesarean section, and maternal satisfaction.
Methods:
A comprehensive literature search was carried out employing electronic databases such as PubMed, Web of Science, and the Cochrane Library. The search included articles published from inception to 11 October 2023 with no language restrictions. Randomized controlled trials or quasi-experimental studies were considered for inclusion if they met the following criteria: participants were pregnant women in labor; intervention involved using a peanut ball during labor; and primary outcome included duration of labor, and the rate of cesarean section and maternal satisfaction were secondary outcomes. The risk of bias in the included studies was assessed using the Risk of Bias 2 (RoB2) tool. Results were synthesized using Review Manager software (RevMan version 5.1), employing both fixed-effect and random-effects models as appropriate, and results were presented as risk ratios for dichotomous outcomes and mean differences and standardized mean differences for continuous outcomes. The quality of the evidence was assessed using GRADEpro GDT (Guideline Development Tool).
Results:
Eight studies including 1352 laboring women met the criteria to be included in the systematic review and meta-analysis. The results of the meta-analysis showed that the women with epidural analgesia who used the peanut ball, experienced a shortened duration of the first stage of labor by 52.98 min, which was statistically significant (p=0.003). Heterogeneity evidence was not found among the included studies (χ2=6.83, p=0.15, I2=41%). It was also shown that the risk ratio of cesarean section in women who used peanut balls during childbirth was significantly lower than the control group (RR=0.74; 95% CI: 0.60-0.91, p=0.0004) (χ2=5.72, p=0.45, I2=0%). Compared to the control group, the women in the peanut ball group were found to have a higher satisfaction level, which was statistically significant (p<0.0001).
Conclusions:
The peanut birth ball reduces the first stage of labor duration, and lowers cesarean rates in women with epidural analgesia. While effective and non-invasive, the findings are limited by the risk of bias in some included studies.
