Effects of different oral intake management during labor on maternal and neonatal outcomes: A protocol for a systematic review and network meta-analysis

by Zheng Nian, Yonghong Wang, Chuanya Huang, Xin Chen

Fasting or restricting oral intake during labor may adversely affect maternal and neonatal outcomes. Although several interventions regarding oral intake during labor have been proposed, the optimal strategy for clinical practice remains controversial. This study aims to conduct a network meta-analysis to identify the most effective intervention for managing maternal oral intake during labor.

A comprehensive search will be conducted in the following electronic databases: Web of Science, PubMed, Embase, Ovid, Cochrane Library, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, the Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and VIP Database, from database inception until January 2026. All randomized controlled trials (RCTs) evaluating oral intake interventions during labor will be included. The primary outcomes include vaginal delivery rate, operative vaginal delivery, caesarean section, 10‐minute Apgar score, and neonatal hypoglycemia. Secondary outcomes include maternal and neonatal outcomes. Maternal outcomes include duration of labor, ketoacidosis, maternal hypoglycemia, postpartum hemorrhage, vomiting rate, Mendelson’s syndrome, maternal thirst and hunger sensations, and maternal satisfaction. Neonatal outcomes include fetal distress, neonatal jaundice, umbilical cord blood pH  Ethics and dissemination

This review will not involve individual patient data and therefore does not require ethical approval. The findings of this systematic review and network meta-analysis will be disseminated through publication in a peer-reviewed journal and presentation at relevant academic conferences.

CRD42025630953.

Concurrent Trajectories of Depressive Symptoms and Insomnia and Influencing Factors in Adolescents

ABSTRACT

Objective

To explore the concurrent trajectories of depressive symptoms and insomnia among adolescents and to analyse the individual, familial and social predictors of the concurrent trajectories.

Study Design

This study tracked depressive symptoms and insomnia in eight secondary schools annually from 2021 to 2023. We also collected data on individual, familial and social factors that may influence these conditions. Group-based multi-trajectory (GBMT) modelling was used to categorise adolescents into depressive–insomnia severity subgroups.

Result

This study included 2822 adolescents, who were categorised into four groups, including the no symptom group, mild symptom group, symptom relief group and symptom increase group. Compared with the no symptom group, predictors of the mild symptom group were gender (OR = 1.30), academic performance (OR = 1.57), subjective well-being (OR = 0.78), anxiety (OR = 1.14), economic status (OR = 1.23) and relationship with teachers (OR = 1.46). Predictors of the symptom relief group were personality (OR = 1.75), academic performance (OR = 2.28), subjective well-being (OR = 0.69) and anxiety (OR = 1.25). Predictors of the symptom-increasing group were personality (OR = 2.45), academic performance (OR = 1.96), subjective well-being (OR = 0.69), anxiety (OR = 1.20), maternal education level (OR = 1.58), family function (OR = 0.93), parental relationship (OR = 2.07) and relationship with teachers (OR = 1.54).

Conclusion

This study provided a comprehensive understanding of the concurrent trajectories of depressive symptoms and insomnia among adolescents, revealing distinct subgroups and identifying predictors across individual, familial and social levels.

Implications for Patient Care

This study emphasises the importance of a multi-faceted approach involving family, school and society to promote adolescent mental health and also highlights the need for conducting precise interventions according to adolescents' features.

Impact

The identification of four distinct symptom trajectories and their predictors advances the understanding of adolescent mental health development, informing precision prevention strategies.

Reporting Method

STROBE checklist.

Patient or Public Contribution

None.

Identification of pathogenic variants for the development of ultra-long axial length in myopic children

by YanYing Zhu, XueYan Li, YueXin Chen, HaiYan Xie, YuKun Liu, XiaoChen Xu, Jing Wang

Axial elongation is a key factor in myopia progression, yet its genetic basis remains incompletely understood. This study aims to identify pathogenic genetic variants associated with excessively elongated axial length in children.

This study included 56 children with axial lengths exceeding the normal range for their age group, and whole-exome sequencing (WES) was performed on their oral mucosal samples. Clinical evaluations included axial length measurement, refraction testing, and fundus photography to assess the degree of myopia and retinal changes. Co-segregation analysis was conducted in selected families (F#1, F#2, F#5) to validate the familial inheritance patterns of the variants.

Fifteen children carried variants in genes including BBS2, OPN1LW, P4HA2, FBN1, LOXL3, FZD4, USH2A, COL2A1, and BFSP2, with five novel variants identified: BBS2 (c.700C > T), P4HA2 (c.1382C > G), FBN1 (c.7130T > C), LOXL3 (c.1580delC), and FZD4 (c.1315G > A). Notably, a rare compound heterozygous BBS2 variant (c.700C > T/c.534 + 1G > T) was found in a non-syndromic child, and the P4HA2 (c.419A > G) variant in family F#5 exhibited a phenotype distinct from previous studies.

This study identified five novel variants sites and discovered two cases with phenotypes distinct from previous studies, thereby expanding the genetic variant spectrum associated with myopia and providing new targets for genetic screening and intervention.