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PLoS One
PLoS One
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PLOS ONE
1932-6203
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10.1371/journal.pone.0309746
PONE-D-23-40761
Study Protocol
Biology and Life Sciences
Nutrition
Diet
Food
Medicine and Health Sciences
Nutrition
Diet
Food
Research and Analysis Methods
Database and Informatics Methods
Database Searching
Medicine and Health Sciences
Women's Health
Obstetrics and Gynecology
Biology and Life Sciences
Nutrition
Diet
Medicine and Health Sciences
Nutrition
Diet
Research and Analysis Methods
Research Assessment
Systematic Reviews
Biology and Life Sciences
Nutrition
Diet
Beverages
Medicine and Health Sciences
Nutrition
Diet
Beverages
Medicine and Health Sciences
Epidemiology
Medical Risk Factors
Medicine and Health Sciences
Women's Health
Maternal Health
Birth
Labor and Delivery
Medicine and Health Sciences
Women's Health
Obstetrics and Gynecology
Birth
Labor and Delivery
Food and fluid intake during labor in maternity wards: A scoping review protocol
Food and fluid intake during the labor process: A scoping review protocol
https://orcid.org/0000-0001-7873-1653
Soares Brenda Kelly Pontes Conceptualization Methodology Writing – original draft Writing – review & editing 1 *
Carneiro Byanca Rodrigues Conceptualization Methodology Writing – original draft Writing – review & editing 2
Feitoza Ilana Bruna de Lima Conceptualization Methodology Writing – original draft Writing – review & editing 3 4 5
de Medeiros Anna Cecilia Queiroz Conceptualization Formal analysis Methodology Supervision Writing – original draft Writing – review & editing 6
Magalhães Adriana Gomes Conceptualization Formal analysis Methodology Supervision Writing – original draft Writing – review & editing 7
1 Master’s Student from the Graduate Program in Collective Health (PPGSACOL/UFRN), Nurse from the Faculty of Health Sciences of Trairi (FACISA/UFRN), Santa Cruz, Rio Grande do Norte, Brazil
2 Master’s Student in the Graduate Program in Sciences Applied to Women’s Health (PPgCASM), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
3 Nutritionist Specialized in Maternal and Child Health from the Multiprofessional Residency Program, Ana Bezerra University Hospital (HUAB), Santa Cruz, Rio Grande do Norte, Brazil
4 Nutritionist Specialized in Maternal and Child Health from the Multiprofessional Residency Program, Ana Bezerra University Hospital (HUAB), Natal, Rio Grande do Norte, Brazil
5 Master’s Student from the Graduate Program in Collective Health (PPGSACOL/UFRN). Nurse from the Faculty of Health Sciences of Trairi (FACISA/UFRN), Santa Cruz, Rio Grande do Norte, Brazil
6 Doctor in Psychobiology from the Federal University of Rio Grande do Norte (UFRN), Nutritionist from the Federal University of Rio Grande do Norte (UFRN), Santa Cruz, Rio Grande do Norte, Brazil
7 Doctor in Physiotherapy from the Federal University of Rio Grande do Norte (UFRN), Physiotherapist from the Federal University of Paraíba (UFPB), Natal, Rio Grande do Norte, Brazil
Mishra Anshuman Editor
Institute of Advanced Materials, IAAM, SWEDEN
Competing Interests: The authors have declared that no competing interests exist.

* E-mail: brendaa.pontes@gmail.com
18 9 2024
2024
19 9 e03097465 1 2024
17 8 2024
© 2024 Soares et al
2024
Soares et al
https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

During the 1940s, aspiration of stomach contents was recognized as a serious problem during labor, which is why fluid and food restriction was adopted for women who would undergo general anesthesia. Currently, the practice of generalized food restriction is a routine that is being discontinued. This review aims to map the evidence on the effects of the intake of foods, supplements and drinks in women on labor outcomes. To that end, documents investigating this topic in pregnant women admitted for uncomplicated deliveries in maternity wards, published from 2013 onwards, will be assessed. This interval was defined based on the publication by Singata et al., who carried out a systematic review on the benefits and harms of oral fluid intake or food restriction during labor. The scoping review methods of the JBI and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA) were followed. Firstly, a preliminary search was carried out to identify the existence of similar scoping reviews or protocols, as well as the keywords and MeSH descriptors in the titles and abstracts, with a view to developing a complete search strategy. Subsequently, a search will be carried out in the Cochrane Library, Medline/PubMed, Embase, SCOPUS and Web of Science databases. The search strategy will be adapted for each of these databases. Finally, a reverse search will be carried out using the references of the included studies. The obtained documents will be imported into Rayyan for duplicate detection and removal. Two independent reviewers will read the titles and abstracts, observing the inclusion and exclusion criteria. The data extraction from each included study will be carried out independently by two reviewers, using the extraction form created for this purpose. In order to report results, we will follow the PRISMA checklist and report descriptive statistics and a narrative summary.

http://dx.doi.org/10.13039/501100002322 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 001 https://orcid.org/0000-0001-7873-1653
Soares Brenda Kelly Pontes This work was carried out with the financial support of the Coordination for the Improvement of Higher Education Personnel (CAPES) (Master’s Scholarship). The funders had no role in the design of the study, the collection and analysis of data, the decision to publish or the preparation of the manuscript. Data AvailabilityNo datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.
Data Availability

No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.
==== Body
pmcIntroduction

In the 1940s, Mendelson recognized the aspiration of stomach contents as a serious problem during labor that could lead to develop severe lung disease or even death. As a result, a restriction on food and fluid intake was implemented [1].

Nonetheless, this should not be a general guideline, since the risk would be limited to parturient women who progress to cesarean delivery and require general anesthesia, since these women may present gastric aspiration [2]. However, since Mendelson’s historical study [1], obstetrics and gynecology have advanced considerably [3]. A study coordinated by the American Society for Obstetric Anesthesia and Perinatology did not identify any case of aspiration of gastric contents related to general anesthesia in more than 5,000 cesarean deliveries, which suggests that this complication is not as common as previously suspected [4].

Considering the advances in obstetric practices and anesthetic techniques for labor, with the current predominance of the use of local anesthesia rather than general anesthesia, it is important to re-assess the need for food and fluid restriction and fasting in the preoperative period [2, 5].

Currently, the practice of generalized food restriction is a routine that is being discontinued. A normal-risk labor is one in which there are no obstetric complications that could increase risks for the mother and the fetus. In these cases, labor generally progresses without incidents that require more specialized assistance or invasive interventions [6]. Studies point out that the intake of foods and fluids during usual-risk labor should be encouraged, respecting the tolerance and acceptance of parturient women, since oral intake is not related to a worsening of obstetric outcomes [5, 7, 8].

In this perspective, the systematic review by Signata et al. [5], which included five studies conducted between 1999 and 2009, which concluded that there is no proven benefit or harm in restricting women at low risk of complications from drinking or eating during labor, was a milestone in this regard [5]. Another review by Ciardulli et al. [9] also described the benefits and harms of consuming foods and fluids during labor. The researchers concluded that less restrictive policies can lead to a decrease in labor time [9].

In view of the results presented in the literature, which have led to changes in policies and guidelines on the topic, more scientific evidence has been produced, providing new subsidies to assess the effects of food and fluid intake during labor. Thus, the opportunity was identified to carry out a comprehensive search of publications on the topic, with a view to mapping and systematizing knowledge about the influence of food, supplement and fluid intake on labor outcomes.

Accordingly, it was decided to carry out a scoping review. In accordance with the recommendations of the JBI Methodological Guidelines [10], where the first step in terms of preparing a scoping review involves creating a protocol that describes the entire process of developing the review.

Therefore, this paper aims to present and describe the development process and the structure of a scoping review on the effect of food, dietary supplements and beverages for women in labor. The guiding hypothesis is that the intake of foods, dietary supplements and drinks has a positive impact on the usual-risk labor outcomes.

Methodology

The proposed review will be conducted in accordance with the JBI recommendations for scoping reviews [10], using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA) checklist to conduct review mapping [11]. This study was registered on the Open Science Framework (OSF) platform (generating the DOI): http://dx.doi.org/10.17605/OSF.IO/SBRV9).

The authors created a figure summarizing the structure of the scope review adopted for this study (Fig 1).

10.1371/journal.pone.0309746.g001 Fig 1 Framework on the methodological plan for this scoping review.

Review question

What are the effects of the intake of foods, dietary supplements and drinks on the usual-risk labor outcomes?

Inclusion and exclusion criteria

In this scoping review, studies will be included if their population consists of parturients, nulliparous and/or multiparous women, admitted for normal-risk labor. The concept will include studies that report the consumption of food, dietary supplements, and beverages by parturients and their influence on labor outcomes. The context will be childbirth in hospitals or maternity wards.

Studies published in languages other than English, Portuguese and Spanish will not be included as they fall outside the expertise of the team’s researchers.

Studies that only evaluate the intake of food, dietary supplements, and beverages without relating them to labor outcomes will be excluded; studies such as experience reports, theoretical essays, and conference abstracts will also be excluded. Additionally, studies published before 2013 will be excluded, as this period was already covered in the review by Singata et al. [5], which is considered a milestone for changes in recommendations on the intake of food, liquids, and dietary supplements during labor.

Source types

All types of primary research methods published in peer-reviewed journals will be included (qualitative, quantitative, mixed methods, experimental and quasi-experimental, analytical and descriptive observational, cross-sectional and documentary studies). Additionally, secondary research, including bibliographic reviews, such as scoping reviews, literature reviews or systematic reviews. It also encompasses relevant gray literature (dissertations, technical notes, manuals, conference consensus, texts and expert opinion articles) will be included. Moreover, articles that are available as full text, in open access mode or via the Federated Academic Community (CAFe, as per its Portuguese acronym), will be considered. The proposed review will look for worldwide evidence of relevance, without limitation as to geographical location or language.

Search strategy

In the first step, a preliminary search was carried out to identify articles on the topic in the databases belonging to Medline/PubMed, Open Science Framework (OSF), Figshare, JBI, Cochrane Library, Science Direct and the Scientific Electronic Library Online (SciELO), in March 2023. The controlled Medical Subject Headings (MeSH) descriptors used for the preliminary search were: eating; labor, obstetric and food intake. The search resulted in the finding of two systematic reviews related to the topic: Singata et al. in 2013 and Ciardulli et al. in 2017. The systematic review carried out by Singata et al. [5] was used as a reference by the World Health Organization (WHO) to draw up “Recommendations for augmentation of labour” [6].

The WHO Guideline [6] indicated that foods and fluids should not be restricted during usual-risk labor. This recommendation was adopted by several countries [12–15], resulting in new studies [16–19] assessing labor in this new scenario, where food and fluid intake was allowed, providing more information on this topic. Thus, since no review or protocol was identified regarding this new context, the current review seeks to map the outcomes and information regarding the intake of food, dietary supplements and drinks during labor in women at low obstetric risk.

Next, still in the first step, with the help of librarians, a preliminary survey of the literature was carried out to identify keywords, terms used in titles and abstracts, as well as indexing terms. This information was used to develop the complete search strategy, displayed in Table 1, which used controlled vocabulary: Descritores em Ciências da Saúde (DECs, as per its Portuguese acronym) and MeSH.

10.1371/journal.pone.0309746.t001 Table 1 Description of the search strategy to be used in the review databases.

Crossing #1	Crossing #2	Crossing #1 AND #2	
Labor OR “Labor, Obstetric” OR “Obstetric Labor”	“Organism Hydration Status” OR “Organism Hydration Status” OR “Organism Water Content” OR “Beverages” OR “Food and Beverages” OR Eating OR “Dietary Intake” OR “Food Intake”	(Labor OR “Labor, Obstetric” OR “Obstetric Labor”) AND (“Organism Hydration Status” OR “Organism Hydration Status” OR “Organism Water Content” OR “Beverages” OR “Food and Beverages” OR Eating OR “Dietary Intake” OR “Food Intake”)	

Next, a search was carried out in the databases indexed in the CAPES Journals Portal, from remote access via the Federated Academic Community (CAFe, as per its Portuguese acronym), by the Federal University of Rio Grande do Norte (UFRN, as per its Portuguese acronym), in the following databases: Medline/PubMed and Web of Science. The aim of this search was to test the developed search strategy. This search strategy was adapted to suit the syntax of each database, as displayed in Table 2.

10.1371/journal.pone.0309746.t002 Table 2 Preliminary search in the Medline/PubMed and Web of Science databases.

Database	Nº	Crossing	Result	Filters	
PubMed/ MEDLINE
Date of search:
August 1, 2023	1	Labor[tiab] OR “Labor, Obstetric”[Mh] OR “Obstetric Labor”[tiab]	41,129	Title and abstract/ Years 2013–2024	
2	“Organism Hydration Status”[Mh] OR “Organism Hydration Status”[tiab] OR “Organism Water Content”[tiab] OR “Beverages”[Mh] OR “Food and Beverages”[tiab] OR Eating[Mh] OR “Dietary Intake”[tiab] OR “Food Intake”[tiab]	129,974	Title and abstract/ Years 2013–2024	
3	1 AND 2	327	Title and abstract/ Years 2013–2024	
Web of Science
Date of search:
September 27, 2023	1	Labor OR “Labor, Obstetric” OR “Obstetric Labor”	188,502	Topics / Year 2013–2024	
2	“Organism Hydration Status” OR “Organism Hydration Status” OR “Organism Water Content” OR “Beverages” OR “Food and Beverages” OR Eating OR “Dietary Intake” OR “Food Intake”	169,250	Topics / Year 2013–2024	
3	1 AND 2	615	Topics / Year 2013–2023	

The second step will involve searching for publications in the following electronic databases: Cochrane Library, Medline/PubMed, Embase, SCOPUS; and Web of Science. A search will also be carried out in the gray literature: Google/Google Scholar and the Digital Library of Theses and Dissertations (Biblioteca Digital de Tese e Dissertações, [BDTD, as per its Portuguese acronym]) of the Brazilian Institute of Information in Science and Technology (IBICT, as per its Portuguese acronym). The authors of the included studies may be contacted for additional information.

In the third step, a reverse search will be carried out. This will be done by analyzing the references of the studies included from the searches in the second step, and will allow for the inclusion of materials pertinent to the study, which were not identified in the previous step.

Study selection

The documents obtained from the database searches will be imported into Rayyan (https://rayyan.ai/users/sign_in), a systematic review platform available on the web. After this, two independent reviewers will select the articles by reading the titles and abstracts, observing the inclusion and exclusion criteria. When it is not possible to determine eligibility from the title and abstract, the study will be assessed in its full text. Duplicate documents will then be deleted.

The selected studies will be independently reviewed by two researchers to verify compliance with the inclusion criteria and reduce the risk of bias. The eligible studies will be read in full and the data extraction process will continue. The number of articles to be excluded will be explained in the results of the full review. Finally, the references of the included articles will be analyzed to identify additional articles for possible inclusion in the review.

Possible divergences in the inclusion of studies will be resolved through discussion between the two researchers or with the inclusion of a third reviewer. If necessary, the authors of the scoping review will be available to respond to requests for missing or additional data relating to the protocol. The team of authors of the current study is made up of health professionals (nutritionists, nurses and physiotherapists) who have experience in childbirth care.

Data extraction

Data will be extracted from the included articles by two independent reviewers using an extraction tool developed by the authors. The data will include study and population characteristics, as well as key findings relevant to the research question. Table 3 displays the preliminary data extraction form. This tool will be modified and revised as necessary. The modifications that occur will be detailed in the full scoping review.

10.1371/journal.pone.0309746.t003 Table 3 Data extraction instrument.

DETAILS AND CHARACTERISTICS OF THE EVIDENCE SOURCE	Title	
Author (s)	
DOI	
Country	
Year	
Language	
Title of the Journal	
Type of evidence source	
Aim	
Study design (control/intervention group)	
Included studies	
Population	
Inclusion criteria	
Exclusion criteria	
ANALYZED VARIABLES	Food restriction or fasting	
Recommended or analyzed foods, supplements or fluids	
Form of food supply	
Type of hydration and quantity	
Oxytocin usage	
Other intravenous medications	
Food preference	
Food aversion	
Stages of labor taken into consideration	
Obstetric conditions considered for assessment	
Type of delivery/Assessed conditions of delivery	
Neonatal conditions considered for assessment	
LABOR OUTCOME	Regurgitation or vomiting	
Time of labor	
Type of labor	
Woman’s satisfaction	
Mendelson’s syndrome	
Other unexpected findings	

A pilot test of the form was carried out with five studies from PubMed/MEDLINE by two researchers, with a view to assessing the reliability and consistency of the data extraction for possible adjustments and improvements.

The following information will be extracted from the studies: aim, location, year, language, method, characteristics of the participants, as well as important variables for describing the results, such as: foods, supplements and drinks used by the parturient women, whether there was food or fluid restriction and obstetric and neonatal outcomes.

Analyzing and presenting the results

The extracted data will be tabulated in an electronic spreadsheet and a quantitative descriptive statistical analysis will be carried out. The results concerning the search and selection of scientific literature will be presented in accordance with the PRISMA guidelines (Fig 2) [11], including the preparation of a flowchart, as recommended. Characterization information will also be presented, such as: number of studies included in each database, years of publication, countries, languages, as well as study design and outcomes, among others. These results will be introduced in the form of charts, tables and figures, in order to display the extracted data, accompanied by a narrative synthesis to help interpret the data and describe how the findings relate to the research aim and question.

10.1371/journal.pone.0309746.g002 Fig 2 Flowchart of the study selection process (adapted) [11].

Limitations

A possible limitation of the study is the fact that this scoping review will only focus on studies done in English, Portuguese and Spanish; hence may miss other important research conducted in other languages. Also, that there was no assessment of the quality (or risk of bias) of the included studies. Nonetheless, this is an optional requirement for conducting a scoping review, according to the protocols used to guide this study [10, 11].

Another possible limitation refers to the application of the inclusion criteria, as well as the delimitation of the databases to be investigated. This can lead to the loss of relevant reports or studies. Nonetheless, these criteria are necessary for refining and assessing the scientific literature, as well as helping retrieve studies with better methodological quality.

Discussion

Recommendations on the availability and provision of food and fluids for women during labor have constantly evolved. The current trend is to recommend offering foods and drinks during low obstetric risk labor [13, 14, 20].

These recommendations have been supported mainly by two significant systematic reviews. The first [5] aimed to determine the benefits and harms of restricting fluids or foods orally during labor, highlighting in its results that the evidence showed no benefits or harms for restricting fluids and foods for women at low risk of complications during labor. The second [9], with the aim of assessing the benefits and harms of food intake during labor, concluded that women with a single and low-risk pregnancy, who were able to eat more freely during labor, had a shorter duration of labor.

Nonetheless, with the change in scenario resulting from the updated recommendations on childbirth-related behaviors, new studies and research have been published assessing the effect of food and fluid intake at this time of life [17–20]. Thus, there is an emerging need to map this new body of evidence on the influence of the consumption of foods, supplements and fluids by parturient women on obstetric and neonatal outcomes.

A scoping review is a type of study which, among its purposes, seeks to synthesize and assess the breadth of the literature on the extent, coverage and nature of the evidence on a topic or issue [11]. Accordingly, it seems pertinent and necessary to conduct a scoping review on the topic, with a view to helping clarify this issue.

In this way, it is expected that the results of this review can contribute to guiding future research, as well as identifying gaps and convergences in the current body of literature. Thus, it would be possible to provide support for clinical practice, aiming to improve health care and women’s satisfaction, making childbirth a positive experience.

Therefore, this protocol is the starting point for carrying out the review itself, and any changes to this protocol will be reported in the final scoping review.

We would like to thank the librarian Gláucio Tavares and the librarian Joyanne Medeiros from the Federal University of Rio Grande do Norte/ Faculty of Health Sciences of Trairi (FACISA/UFRN, as per its Portuguese acronym) for their contributions to the development of this protocol and the preparation of the search strategy. We are grateful for all their guidance.

10.1371/journal.pone.0309746.r001
Author response to previous submission
Submission Version0
5 Jan 2024

Attachment Submitted filename: PRISMA-P-checklist (1).docx.pdf

10.1371/journal.pone.0309746.r002
Decision Letter 0
Mishra Anshuman Academic Editor
© 2024 Anshuman Mishra
2024
Anshuman Mishra
https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submission Version0
27 Feb 2024

PONE-D-23-40761FOOD AND LIQUID INTAKE DURING THE LABOR PROCESS: A SCOPE REVIEWPLOS ONE

Dear Dr. Soares,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Additional Editor Comments:

Study entitled- #Food and liquid intake during the labor process: a scope review

by Brenda Kelly et al, 2024 discussed the the effects of consuming food, supplements, and beverages in laboring women, during labor and delivery.

Summary-

In this study a limited search was conducted in the databases of Medline/PubMed, Open Science Framework (OSF), Figshare, Joanna Briggs Institute (JBI), Cochrane Library, Science Direct, and the Scientific Electronic Library Online (SciELO) in March 2023. A new search was conducted in EBSCO in September 2023. An expanded search will be conducted in the databases: Cochrane Library, Medline/PubMed, Embase, SCOPUS,and Web of Science. Removal of duplicates, independent inclusion and exclusion criteria was used here. This study adopts a scoping review design, which aims to systematically identify and 91 map key concepts, types of evidence, and gaps related to the topic of interest, which are 92 available in the main data sources. In order to research, select, and synthesize existing information. Study define characteristics of the study and population, findings.

Decision- Major

A scoping review is useful to map the literature on evolving or emerging topics and to identify gaps however conclusion is missing.

The methodological approach is fine however team involved with the stages is not defined in terms of expertise or theme purposes.

A independent screening by reviewer give calibration exercise properly, however require additional clarification regarding selecting the papers.

Once the data have been extracted from all papers, numerical, statistical and thematic analyses are conducted, however analysis part is missing therefore not giving clear conclusions.

The findings can be presented in a table or chart to showcase the most salient aspects of the scoping review.

Major to minor findings with clear objective for conducting the scoping review is missing. It should be noted that categories (collections of similar data in one place) and themes (patterns across the dataset) give more representative aspects of the article.

Graphics, tables with justified additional references may give more better draft for worldwide viewers.

Future prospect and clear conlsuion is missing.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Partly

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: No

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

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(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors while mentioning that thy are following JBI Scoping Review methodology do not use the same in the manuscript. For example: the title reads as scope review and not scoping review protocol. The authors are suggested to read JBI protocols on scoping review and redo the entire manuscript accordingly.

Reviewer #2: REVIEW COMMENTS

General comment: The reviewer recommends the use of a professional language editor to address ambuiguity and grammatical errors in some areas of the manuscript.

Introduction

Lines 54-56: “In the 1940s, Mendelson recognized that the aspiration of stomach contents was a serious problem during labor, which could lead to the development of severe lung disease or death in the parturient”.

Comment: This report wasn’t cited. Mendelson’s study should be cited.

Lines 59-60: “However, this should not be a general guideline, as the risk would be limited to some particular situations”

Comment: The reviewer suggests the authors highlight some situations in which this could pose a risk so as to enhance flow while reading.

In-text citation 2 is missing in the second paragraph of the introduction. In addition, authors should be consistent in the in-text citation format. The authors should look at the use of periods at the end of sentences before and after the superscript bearing the citation number (see citations in the first, second and third paragraphs of the introduction).

Methods

Inclusion criteria

The reviewers suggest the authors should state and clarify in the selection criteria if the study selection process will include literatures on both nulliparous and multiparous women as this may have influenced the reported outcomes in the selected literatures.

The authors should indicate if the literature search will include only full text articles.

Reviewer #3: ELABORATION ON QUESTIONS

1. This manuscript describes the plan/protocol for a scoping review on a specific topic.

2. My answer to Question 2 is "partly" because a) there are not hypotheses and b) the search strategy for the review is expected to evolve and/or be refined during the course of the review (lines 131-132).

3. In part because of the potential evolution of the search strategy for this review, what is specified in this article is insufficient for another investigator to replicate exactly the search and the ensuing review. The first step is described sufficiently to permit this. Judgments will be required concerning inclusion of literature in the review and data extracted.

4. I cannot see that the authors stated specifically that the data they extract will be available when the study is complete.

5. The manuscript is intelligible and the quality of the English far exceeds the quality of any manuscript that I would prepare in Portuguese. Nevertheless, there are a few places at which some refinement of the English would improve the manuscript. (Examples: Delete the word "similarly" from line 115; delete "the period of" from line 121; substitute "found" or "shown" for "proven" in line 130.)

OTHER COMMENTS

It is not clear from the title of this manuscript that this is a plan for a scoping review, not the review itself.

The conclusion of Singata et al. on line 69 should probably refer to no proven benefits or harms, not just to no proven harms.

The term "scoping review" should be used consistently (rather than "scope").

On lines 113-114, the statement that there is no limitation of years seems inconsistent with the limitation of the search to 2013 and later.

Possibly something more specific might be said about the planned analysis and presentation of the data.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Denny John

Reviewer #2: Yes: Dr Jeneviv Nene John

Reviewer #3: Yes: ALBERT F SMITH

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

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10.1371/journal.pone.0309746.r003
Author response to Decision Letter 0
Submission Version1
25 Apr 2024

Dear publisher,

We hereby submit the corrected and revised manuscript entitled “Food and fluid intake during the labor process: a scope review”, which has been renamed as “Food and fluid intake during the labor process: a scoping review protocol”, authored by Brenda Kelly Pontes Soares, Ilana Bruna de Lima Feitoza, Byanca Rodrigues Carneiro, Anna Cecilia Queiroz de Medeiros and Adriana Gomes Magalhães, for your consideration.

First of all, we appreciate the interest in our article and would like to thank the reviewers of this study, who provided very pertinent comments, thus contributing to the improvement of our manuscript. After analyzing the considerations and questions, as well as the errors and suggestions pointed out in the opinion sent to us, the article has undergone some changes, which are indicated below.

Thanks in advance for your attention.

Master’s student Brenda Kelly Pontes Soares.

ANSWERS TO THE PUBLISHER’S QUESTIONS

The Editor suggested the highlighted revisions below:

QUESTION 1) Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found.

ANSWER: In order to meet the reviewer’s request, the manuscript was adjusted to the template provided by PLOS ONE, including the main sections, such as the abstract, introduction (page 2, line 53), methodology (page 3, line 87), results (page 8, line 204), limitations (page 8, line 2015) and discussion (page 8, line 224). Moreover, the text formatting was adjusted, and the language was revised.

QUESTION 2) Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf.

ANSWER: Under the section “Funding”, the following text was included in the manuscript: “The funders had no role in the design of the study, the collection and analysis of data, the decision to publish or the preparation of the manuscript” (page 9, lines 260-261).

QUESTION 3) When completing the data availability statement of the submission form, you indicated that you will make your data available on acceptance. We strongly recommend all authors decide on a data sharing plan before acceptance, as the process can be lengthy and hold up publication timelines. Please note that, though access restrictions are acceptable now, your entire data will need to be made freely accessible if your manuscript is accepted for publication. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If you are unable to adhere to our open data policy, please kindly revise your statement to explain your reasoning and we will seek the editor's input on an exemption. Please be assured that, once you have provided your new statement, the assessment of your exemption will not hold up the peer review process.

ANSWER: This is a study protocol, the result of which is the protocol itself. It was registered on the Open Science Framework (OSF) platform and generated the DOI: http://dx.doi.org/10.17605/OSF.IO/SBRV9, for free access in its entirety (page 3, lines 91-93).

QUESTION 4) A scoping review is useful to map the literature on evolving or emerging topics and to identify gaps however conclusion is missing.

ANSWER: In order to reply to this comment, in the last two paragraphs of the section “Discussion” (page 8, lines 224-248), considerations were added about the importance of carrying out the study.

QUESTION 5) The methodological approach is fine however team involved with the stages is not defined in terms of expertise or theme purposes.

ANSWER: We appreciate your comments and the opportunity to clarify the points raised. Regarding the expertise of the team involved in the steps of the study, the following was inserted in the study: “The team of authors of the current study is made up of health professionals (nutritionists, nurses and physiotherapists) who have experience in childbirth care” (page 6, lines 184-186):

Brenda Kelly Pontes Soares: Nurse trained in the Federal University of Rio Grande do Norte (UFRN) since 2022. She is currently a master’s student in the Graduate Program in Collective Health (PPgSACOL) from the Federal University of Rio Grande do Norte.

Ilana Bruna de Lima Feitoza: Nurse working in prenatal care and with experience in the delivery room. She is currently a master’s student in the Graduate Program in Collective Health (PPgSACOL) from the Federal University of Rio Grande do Norte.

Byanca Rodrigues Carneiro: Nutritionist with a Specialization in Maternal and Child Health (5760 hours) and experience in childbirth and postpartum care. She is currently a master’s student in the Graduate Program in Sciences Applied to Women’s Health (PPgCASM) from the Federal University of Rio Grande do Norte.

Anna Cecília Queiroz de Medeiros: Nutritionist, lecturer in the Residency Program in Maternal and Child Health.

Adriana Gomes Magalhães: Physiotherapist, lecturer in the Residency Program in Maternal and Child Health since 2012, with experience in delivery room care.

QUESTION 6) A independent screening by reviewer give calibration exercise properly, however require additional clarification regarding selecting the papers.

ANSWER: As advised, additional information has been included on the Rayyan platform (https://rayyan.ai/users/sign_in), which will be used to import the studies. The selection will be made by two independent reviewers based on the titles and abstracts, meeting the eligibility criteria. Duplicates will then be excluded (page 6, lines 169-186). Eligible studies will be read in full, and data extracted using the form described in “Chart 3 – Data Extraction Instrument” (pages 6 and 7, lines 188-202). The number of articles to be excluded will be explained in the results of the full review (page 6, lines 178-179).

QUESTION 7) Once the data have been extracted from all papers, numerical, statistical and thematic analyses are conducted, however analysis part is missing therefore not giving clear conclusions. The findings can be presented in a table or chart to showcase the most salient aspects of the scoping review.

ANSWER: In order to meet the reviewer’s request, the section “Analyzing and presenting the results” has been improved, which can be found on (page 8, lines 204-213).

QUESTION 8) Major to minor findings with clear objective for conducting the scoping review is missing. It should be noted that categories (collections of similar data in one place) and themes (patterns across the dataset) give more representative aspects of the article.

ANSWER: In order to clarify this point, the introduction and justification of the study were rewritten (pages 2 and 3, lines 53-85).

QUESTION 9) Graphics, tables with justified additional references may give more better draft for worldwide viewers.

ANSWER: In order to meet this request, the section “Analyzing and presenting the results” states that the results will be introduced in the form of tables, charts and figures. This text can be found on page 8, lines 204-213.

RESPOSTA AO REVISOR #1.

O revisor #1 sugeriu as reformulações destacadas abaixo:

QUESTION 1) The authors while mentioning that thy are following JBI Scoping Review methodology do not use the same in the manuscript. For example: the title reads as scope review and not scoping review protocol. The authors are suggested to read JBI protocols on scoping review and redo the entire manuscript accordingly.

ANSWER: As advised by the present reviewer, the scoping review protocol was adjusted to meet the recommendations of the Joanna Briggs Institute (JBI), as well as (where appropriate) the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist (PRISMA-ScR). Moreover, the scoping review protocols published by the Plos One journal in 2024 were consulted, in order to meet the journal’s formatting requirements (page 3, lines 87-93).

RESPOSTA AO REVISOR #2.

O revisor #2 sugeriu as reformulações destacadas abaixo:

QUESTION 1) General comment: The reviewer recommends the use of a professional language editor to address ambuiguity and grammatical errors in some areas of the manuscript.

ANSWER: The text has been proofread and grammatically corrected by a specialized professional, in addition to having received formatting adjustments.

QUESTION 2) Introduction: Lines 54-56: “In the 1940s, Mendelson recognized that the aspiration of stomach contents was a serious problem during labor, which could lead to the development of severe lung disease or death in the parturient”. Comment: This report wasn’t cited. Mendelson’s study should be cited.

ANSWER: In order to meet the reviewer’s request, the reference to Mendelson’s study was included in the first paragraph of the introduction, which can be found on page 2, on lines 54-56.

QUESTION 3) Lines 59-60: “However, this should not be a general guideline, as the risk would be limited to some particular situations” Comment: The reviewer suggests the authors highlight some situations in which this could pose a risk so as to enhance flow while reading.

ANSWER: The following excerpt has been reworded and included in the second paragraph of the introduction: “Nonetheless, this should not be a general guideline, since the risk would be limited to parturient women who progress to cesarean delivery and require general anesthesia, since these women may present gastric aspiration” (page 2, lines 57-59).

QUESTION 4) In-text citation 2 is missing in the second paragraph of the introduction. In addition, authors should be consistent in the in-text citation format. The authors should look at the use of periods at the end of sentences before and after the superscript bearing the citation number (see citations in the first, second and third paragraphs of the introduction).

ANSWER: The quotations were adjusted, and the use of periods in the first, second and third paragraphs of the introduction (page 2, lines 54-66) was complied with, as requested.

QUESTION 5) Methods: Inclusion criteria The reviewers suggest the authors should state and clarify in the selection criteria if the study selection process will include literatures on both nulliparous and multiparous women as this may have influenced the reported outcomes in the selected literatures.

ANSWER: This point was further clarified in the selection criteria for the studies (page 3, lines 100-101): “Studies that explicitly state that the analyzed population is made up of parturient women, nulliparous and/or multiparous, admitted for usual-risk labor will be considered”.

QUESTION 6) The authors should indicate if the literature search will include only full text articles.

ANSWER: The following excerpt was included in the first paragraph of the section “Source types”: “Moreover, articles that are available as full text will be considered” (page 3, lines 113-115).

RESPOSTA AO REVISOR #3.

O revisor #3 sugeriu as reformulações destacadas abaixo:

QUESTION 1) My answer to Question 2 is "partly" because a) there are not hypotheses and b) the search strategy for the review is expected to evolve and/or be refined during the course of the review (lines 131-132).

ANSWER: In order to meet the suggestions made by reviewer 3, the research hypothesis was explained on página X, linhas de X a X: “The guiding hypothesis is that the intake of foods, dietary supplements and drinks has a positive impact on the usual-risk labor outcomes” (page 3, lines84-85).

QUESTION 2) In part because of the potential evolution of the search strategy for this review, what is specified in this article is insufficient for another investigator to replicate exactly the search and the ensuing review. The first step is described sufficiently to permit this. Judgments will be required concerning inclusion of literature in the review and data extracted.

ANSWER: The section “Search strategy” has been reworded to make the research replicable. The steps of the scoping protocol have been added (pages 4-6, lines 120-167).

QUESTION 3) I cannot see that the authors stated specifically that the data they extract will be available when the study is complete.

ANSWER: Regarding the conclusion of the review, the following text has been included in the section “Discussion”, in the last paragraph: “Finally, when the study is completed, it is intended to be published in a peer-reviewed scientific journal.” (page 9, lines 247-248).

QUESTION 4) The manuscript is intelligible and the quality of the English far exceeds the quality of any manuscript that I would prepare in Portuguese. Nevertheless, there are a few places at which some refinement of the English would improve the manuscript. (Examples: Delete the word "similarly" from line 115; delete "the period of" from line 121; substitute "found" or "shown" for "proven" in line 130).

ANSWER: The text has been proofread and grammatically corrected by a specialized professional, in addition to having received formatting adjustments (page 2, line 68).

QUESTION 5) It is not clear from the title of this manuscript that this is a plan for a scoping review, not the review itself.

ANSWER: The title has been renamed to meet the request made by reviewer 3: “Food and fluid intake in the labor process: a scoping review protocol” (page 1, line 2).

QUESTION 6) The conclusion of Singata et al. on line 69 should probably refer to no proven benefits or harms, not just to no proven harms.

ANSWER: The writing was reworded according to what was requested by reviewer 3: “the systematic review by Signata et al. (3), which concluded that there is no proven benefit or harm in restricting women at low risk of complications from drinking or eating during labor” (page 2, lines 67-69).

QUESTION 7) The term "scoping review" should be used consistently (rather than "scope").

ANSWER: Spelling and grammar were checked. Therefore, all errors found have been corrected (page 2 and 3, lines 80 and 83).

QUESTION 8) On lines 113-114, the statement that there is no limitation of years seems inconsistent with the limitation of the search to 2013 and later.

ANSWER: Spelling and grammar were checked. Therefore, all errors found have been corrected (page 6, lines 161-164).

QUESTION 9) Possibly something more specific might be said about the planned analysis and presentation of the data.

ANSWER: In order to meet the reviewers’ requests, the section “Analyzing and presenting the results” has been reworded, which can be found on page 8, on lines 204-213.

Attachment Submitted filename: RESPONSES TO REVIEWERS.pdf

10.1371/journal.pone.0309746.r004
Decision Letter 1
Mishra Anshuman Academic Editor
© 2024 Anshuman Mishra
2024
Anshuman Mishra
https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submission Version1
25 Jun 2024

PONE-D-23-40761R1FOOD AND FLUID INTAKE DURING LABOR IN MATERNITY WARDS: A SCOPING REVIEW PROTOCOLPLOS ONE Dear Dr. Soares,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

In this protocol, additional characteristics should be defined for the importance of the study (references).

1. Implications for practice

2. Recommendations

3. Flow diagram for systematic protocol which included searches of databases, registers and other sources used.

Few studies (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104541/, https://onlinelibrary.wiley.com/doi/10.1111/birt.12773, https://www.obstetanesthesia.com/article/S0959-289X(21)00157-6/fulltext) may give some understanding.

Please submit your revised manuscript by Aug 09 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Anshuman Mishra, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Study entitled- #Food and fluid intake during the labor process: a scoping review protocol by Soares et al, 2024 discussed and addressed the reviewer's comments appropriately.

However, in this protocol, additional characteristics should be defined for the importance of the study (references).

1. Implications for practice

2. Recommendations

3. Flow diagram for systematic protocol which included searches of databases, registers and other sources used.

Few studies (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104541/, https://onlinelibrary.wiley.com/doi/10.1111/birt.12773, https://www.obstetanesthesia.com/article/S0959-289X(21)00157-6/fulltext) may give some understanding.

Decision- Minor

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #4: Yes

Reviewer #5: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #4: Yes

Reviewer #5: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #4: No

Reviewer #5: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #4: Yes

Reviewer #5: No

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #4: Yes

Reviewer #5: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #4: The authors have addressed most of the comments previously received, but there are still minor corrections to make, especially in the methodology. My comments have been uploaded in an attachment

Reviewer #5: The description of materials and methods is thorough. The justification for why such an analysis is needed is well-described in the introduction. I would add at least a brief "Data Availability Statement" describing that all of your underlying data and analysis will be made available at submission to PLOS, and will be available publicly for review. You should consider adding to your introduction a little more language about how aspiration risk during cesarian section with local anesthesia is considerably low, and how often general anesthesia is utilized for C/S. Otherwise overall this was very well written and thought-out. I look forward to reviewing your results.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #4: Yes: John Bekiita Byabagambi

Reviewer #5: Yes: Henry David MD

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Attachment Submitted filename: Plos_Reviewer Comments.docx

10.1371/journal.pone.0309746.r005
Author response to Decision Letter 1
Submission Version2
5 Aug 2024

FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE

GRADUATE PROGRAM IN HEALTH SCIENCE

Santa Cruz/RN, 31 de july de 2024.

Dear publisher,

We hereby submit the corrected and revised manuscript entitled “Food and fluid intake during the labor process: a scoping review protocol”, authored by Brenda Kelly Pontes Soares, Byanca Rodrigues Carneiro, Ilana Bruna de Lima Feitoza, Anna Cecilia Queiroz de Medeiros and Adriana Gomes Magalhães, for your consideration.

First of all, we appreciate the interest in our article and would like to thank the reviewers of this study, who provided very pertinent comments, contributing to the improvement of our manuscript. After analyzing the considerations and questions, the article has undergone some changes, which are indicated below.

Thanks in advance for your attention.

Brenda Kelly Pontes Soares.

ANSWERS TO THE PUBLISHER’S QUESTIONS

The Editor suggested the highlighted revisions below:

QUESTION 1) Implications for practice and Recommendations

ANSWER: In order to meet the reviewer’s request, the possible contributions/implications for clinical practice that may arise from the results of this scoping review were inserted in the ‘Discussion’ section on (lines 262-267).

QUESTION 2) Flow diagram for systematic protocol which included searches of databases, registers and other sources used.

ANSWER: As stated in the protocol, the PRISMA flowchart will be used to present the results of the scoping review, which has been inserted in line 229-230. However, to address the reviewer's request, a figure summarizing the information about the structure of the scoping review has been developed (line 107).

RESPONSES TO THE REVIEWERS QUESTIONS:

RESPONSE TO REVIEWER #4.

Reviewer #4 suggested the following rewordings:

QUESTION 1) Abstract: Include a statement on how data extraction will be done.

ANSWER: The correction has been made. A statement on how data extraction will be conducted has been included (lines 47-48).

QUESTION 2) Introduction: The authors state that this review will build on the work done by Signata et al. Please add the review dates covered by the review of Signata et al. in line 67.

ANSWER: The review dates covered by the review of Signata et al. have been added (lines 77-78).

QUESTION 3) Introduction: Line 79: The Joanna Briggs Institute was renamed to JBI. Please use the updated name. The same comment applies to line 88.

ANSWER: The updated name has been added in line 37, 90, 99 and 141 as per the reviewer's suggestions.

QUESTION 4) Review question: The authors refer to “usual-risk labour.” Define this concept in the introduction to make it clear to readers.

ANSWER: The concept of "habitual risk work" has been defined in the introduction to provide greater clarity for the readers (lines 71-73).

QUESTION 5) Inclusion criteria: Will the reviewers have any exclusion criteria? If yes, please include. If not, please state that there is no exclusion criteria.

ANSWER: Yes, we will have exclusion criteria. We have included information about the exclusion of studies in the "Inclusion and Exclusion Criteria" section (lines 112-125).

QUESTION 6) Source Types: Line 116: The authors state that papers in all languages will be included. Please describe how studies in other languages will be searched for and how the findings will be reported.

ANSWER: No specific search strategy will be adopted for Portuguese and Spanish languages, as it is required to present a version of the abstract, title, and keywords in English in all the databases investigated.

QUESTION 7) Source Types: Line 117: Seems to state that there were exclusion criteria. Please clarify. Also, clarify if the sentence in lines 117 and 118 should be in past tense.

ANSWER: Information about the inclusion criteria has been clearly included in the "Inclusion and Exclusion Criteria" section (lines 112-125). Additionally, the sentence in lines 117 and 118 has been revised, and the verb has been corrected to the future indicative tense (lines 194-195).

QUESTION 8) Search strategy: Line 149: change the word “research” to “search.”

ANSWER: The writing has been revised according to the request from reviewer #4 (line 168).

QUESTION 9) Study selection: Line 152: Please clarify how these terms will be used to search papers in languages other than English.

ANSWER: No specific search strategy will be adopted for Portuguese and Spanish languages, as it is required to present a version of the abstract, title, and keywords in English in all the databases investigated.

QUESTION 10) Study selection: Line 173 states that there are exclusion criteria. Please state what it is.

ANSWER: Information about the inclusion criteria has been clearly included in the "Inclusion and Exclusion Criteria" section (lines lines 112-125).

QUESTION 11) Study selection: Line 179: Please clarify: Will the references to included articles be analysed for inclusion in the review, or are the authors meant to say that references to included articles will be analysed to identify additional articles for inclusion?

ANSWER: The authors intend to analyze the references of the included articles to identify additional articles for inclusion in the review. This information has been clarified in lines 194-195.

RESPONSE TO REVIEWER #5.

Reviewer #5 suggested the following rewordings:

QUESTION 1) The description of materials and methods is thorough. The justification for why such an analysis is needed is well-described in the introduction. I would add at least a brief "Data Availability Statement" describing that all of your underlying data and analysis will be made available at submission to PLOS, and will be available publicly for review. You should consider adding to your introduction a little more language about how aspiration risk during cesarian section with local anesthesia is considerably low, and how often general anesthesia is utilized for C/S.

ANSWER: To address the reviewers' comments, the "Data Availability Statement" section has been included (lines 269-272). Additionally, as guided by the current reviewer, more information about risk of aspiration has been added to the introduction (lines 61-65).

REFERENCES) Two new references have been added to address reviewer #5’s request, cited in lines 62 and 6, numbered 4 and 5 in the reference list. The PRISMA reference has been updated to the latest version, now numbered 11. These changes are highlighted in the reference list.

FINANCING) Study financing data was added in lines 2081 to 282.

Attachment Submitted filename: Response to Reviewers.docx

10.1371/journal.pone.0309746.r006
Decision Letter 2
Mishra Anshuman Academic Editor
© 2024 Anshuman Mishra
2024
Anshuman Mishra
https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submission Version2
19 Aug 2024

FOOD AND FLUID INTAKE DURING LABOR IN MATERNITY WARDS: A SCOPING REVIEW PROTOCOL

PONE-D-23-40761R2

Dear Dr. Soares,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Anshuman Mishra, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Article accepted with few small corrections mentioned as below-

1. Author writes the rebuttal against reviewers comments point wise to justify the significance and relevance of study.

Acceptance- Yes

Reviewers' comments:

10.1371/journal.pone.0309746.r007
Acceptance letter
Mishra Anshuman Academic Editor
© 2024 Anshuman Mishra
2024
Anshuman Mishra
https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
6 Sep 2024

PONE-D-23-40761R2

PLOS ONE

Dear Dr. Soares,

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team.

At this stage, our production department will prepare your paper for publication. This includes ensuring the following:

* All references, tables, and figures are properly cited

* All relevant supporting information is included in the manuscript submission,

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on behalf of

Dr. Anshuman Mishra

Academic Editor

PLOS ONE
==== Refs
References

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