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Peanut ball during labor to reduce pain and anxiety: A single-blind randomized clinical trial
Itzel Osorto Zelaya1, Olvin René Reyes Soto1, Gabriela Patricia Medina Ventura1
1Postgraduate Program in Gynecology and Obstetrics, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.
Introduction:
Pain and anxiety are common during labor. Evidence on non-pharmacological tools like the peanut ball from public hospital settings in Honduras is limited. This study evaluated its efficacy in reducing pain and anxiety.
Methods:
A parallel-group, randomized, single-blind clinical trial was conducted at Hospital Escuela, Honduras, February to July 2025. Nulliparous women in active labor (cervical dilation ≥4 cm) were assigned to an intervention group (standard care + intermittent peanut ball use, n=83) or to a control group (standard care alone, n=80). Primary outcomes were pain and anxiety (Visual Analog Scales). Secondary outcomes included labor duration and oxytocin use. Pre-planned subgroup (no oxytocin) and adjusted analyses were performed.
Results:
No significant between-group differences were found in pain (p=0.45), anxiety (p=0.62), or maternal well-being. The active phase duration was shorter in the intervention group, mean=162 minutes (SD=78), compared with the control, mean=252 minutes (SD=138) (mean difference= -90.0 min, 95% CI: -172.37-7.7; p=0.03). This effect persisted in the subgroup without oxytocin (p=0.012) and after adjustment. Oxytocin use was higher in the intervention group (67.5% vs 38.8%; risk ratio, RR=1.74; 95% CI: 1.25-2.42; p=0.001). Cesarean birth and other outcomes were similar.
Conclusions:
The peanut ball shortened active labor but did not reduce maternal pain, anxiety, or oxytocin use within our setting.
Clinical Trial Registration:
The study is registered on the official website of ClinicalTrials.gov.
Identifier:
NCT06811584.
