Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review

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As a preliminary exploration for future discussion and development, we undertook a scoping review to identify the types, frequency, and extent of EDI characteristics that were measured and reported in randomised controlled trials (RCTs) of intrapartum interventions specifically. Methods Joanna Briggs Institute methodological guidance for scoping reviews guided the conduct of the review. The population were women of any parity and risk category who were enrolled in intrapartum RCTs in any birth setting or geographical location. The concept was measured and reported EDI characteristics. CINAHL, MEDLINE, PsycINFO, EMBASE, and CENTRAL were searched from January 2019 to March 2024. Data were extracted using a pre-designed form. The findings were summarised and narratively reported supported by illustrative tables and graphs. Results Two-hundred and forty-seven RCTs from 49 countries were included. Eleven EDI characteristics were measured or reported in at least one RCT, although frequency varied. Religion, for example, featured in three RCTs only, whereas Age featured in 222 RCTs. How the EDI characteristics featured also varied. Race/Ethnicity, for example, was described in 21 different ways in 25 RCTs. Similarly, Education was reported in 62 different ways across 96 RCTs. Ninety RCTs limited inclusion to nulliparous participants only, six RCTs required participants to have a minimum educational level, 127 RCTs had inclusion age cut-offs although 23 different variations of this were noted and 15 RCTs excluded participants on the grounds of disability. Conclusions This scoping review highlights EDI characteristic measurement and reporting deficits in intrapartum RCTs. There is a critical need for improvements in designing, conducting, and reporting RCTs to incorporate EDI. By adopting more extensive EDI practices a greater understanding of healthcare treatments and innovations leading to enhanced maternal health equity could be achieved. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/7-78/v2", "name": "Equality, Diversity and Inclusion characteristics measured or reported..." } } ] } Home Browse Equality, Diversity and Inclusion characteristics measured or reported... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Hannon S, Smith A, Gilmore J and Smith V. Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.12688/hrbopenres.14012.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Systematic Review Revised Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] Susan Hannon 1 , Aoife Smith 2 , John Gilmore https://orcid.org/0000-0002-3943-0724 3 , Valerie Smith https://orcid.org/0000-0003-2249-6038 3 Susan Hannon 1 , Aoife Smith 2 , John Gilmore https://orcid.org/0000-0002-3943-0724 3 , Valerie Smith https://orcid.org/0000-0003-2249-6038 3 PUBLISHED 07 Mar 2025 Author details Author details 1 School of Nursing and Midwifery, The University of Dublin Trinity College, Dublin, Leinster, D02, Ireland 2 School of Agriculture and Food Science, University College Dublin School of Nursing Midwifery and Health Systems, Dublin, Leinster, D04, Ireland 3 School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Leinster, D04, Ireland Susan Hannon Roles: Data Curation, Formal Analysis, Project Administration, Writing – Review & Editing Aoife Smith Roles: Formal Analysis, Visualization, Writing – Review & Editing John Gilmore Roles: Data Curation, Validation, Writing – Review & Editing Valerie Smith Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Supervision, Validation, Writing – Original Draft Preparation OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the HRB-TMRN gateway. Abstract Background Equality, diversity and inclusion (EDI) has gained discursive momentum across multiple arenas, including in maternal health research. As a preliminary exploration for future discussion and development, we undertook a scoping review to identify the types, frequency, and extent of EDI characteristics that were measured and reported in randomised controlled trials (RCTs) of intrapartum interventions specifically. Methods Joanna Briggs Institute methodological guidance for scoping reviews guided the conduct of the review. The population were women of any parity and risk category who were enrolled in intrapartum RCTs in any birth setting or geographical location. The concept was measured and reported EDI characteristics. CINAHL, MEDLINE, PsycINFO, EMBASE, and CENTRAL were searched from January 2019 to March 2024. Data were extracted using a pre-designed form. The findings were summarised and narratively reported supported by illustrative tables and graphs. Results Two-hundred and forty-seven RCTs from 49 countries were included. Eleven EDI characteristics were measured or reported in at least one RCT, although frequency varied. Religion, for example, featured in three RCTs only, whereas Age featured in 222 RCTs. How the EDI characteristics featured also varied. Race/Ethnicity, for example, was described in 21 different ways in 25 RCTs. Similarly, Education was reported in 62 different ways across 96 RCTs. Ninety RCTs limited inclusion to nulliparous participants only, six RCTs required participants to have a minimum educational level, 127 RCTs had inclusion age cut-offs although 23 different variations of this were noted and 15 RCTs excluded participants on the grounds of disability. Conclusions This scoping review highlights EDI characteristic measurement and reporting deficits in intrapartum RCTs. There is a critical need for improvements in designing, conducting, and reporting RCTs to incorporate EDI. By adopting more extensive EDI practices a greater understanding of healthcare treatments and innovations leading to enhanced maternal health equity could be achieved. READ ALL READ LESS Keywords Intrapartum, Labour, Childbirth, Equality, Diversity, Inclusion, Randomised trials Corresponding Author(s) Valerie Smith ( [email protected] ) Close Corresponding author: Valerie Smith Competing interests: No competing interests were disclosed. Grant information: This project was part funded by the Health Research Board-Trials Methodology Research Network Ireland (grant ref: HRB-TMRN-2021-001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Hannon S et al . 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 work is properly cited. How to cite: Hannon S, Smith A, Gilmore J and Smith V. Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.12688/hrbopenres.14012.2 ) First published: 24 Dec 2024, 7 :78 ( https://doi.org/10.12688/hrbopenres.14012.1 ) Latest published: 07 Mar 2025, 7 :78 ( https://doi.org/10.12688/hrbopenres.14012.2 ) Revised Amendments from Version 1 We have updated the original version in response to the reviewer's comments. This included moving the original Figure 3 to Extended File 4 (available at https://osf.io/7qmd2/), relabeling the remaining Figures and revising these to include numbers and %, and adding an additional few sentences of text in the Discussion to further clarify two points (paragraphs 2 and 3). We have updated the original version in response to the reviewer's comments. This included moving the original Figure 3 to Extended File 4 (available at https://osf.io/7qmd2/), relabeling the remaining Figures and revising these to include numbers and %, and adding an additional few sentences of text in the Discussion to further clarify two points (paragraphs 2 and 3). See the authors' detailed response to the review by Jennifer Vanderlaan See the authors' detailed response to the review by Lisa Gold READ REVIEWER RESPONSES Introduction Equality, diversity and inclusion (EDI) has increasingly gained discursive attention across multiple arenas, for example, in education, employment, and in healthcare practice and research. EDI as an overarching concept exists in multiple phraseology formats in policy and across societal sectors, encompassing individual discrete components (see Table 1 ) although associated and interrelated, for which a communal consensus definition is lacking 1 . Viewing EDI ontologically and axiologically may bring some clarity whereby the ethical and moral issues of social, structural and systemic inequalities and lack of representation of marginalised or underserved populations is considered 2 , 3 , and potentially addressed by meaningfully applied EDI practices 4 . Table 1. EDI component definitions 23 . Component NIHR Definition Applied to the Scoping Review Equality Ensuring that everyone is given equal access to resources and opportunities to utilise their skills and talents. Equal opportunities and access for all eligible persons to participate in intrapartum RCTs Diversity Being reflective of the wider community. Having a diverse community, with people from a broad range of backgrounds represented in all areas and at all levels. Representation of people from a range of backgrounds in intrapartum RCTs Inclusion An approach where groups or individuals with different backgrounds are welcomed, culturally and socially accepted, and treated equally. Engaging with each person as an individual. A sense of belonging that is respectful of people for who they are. RCT environments are supportive towards participation by all those eligible, that is, strategies to support participation by those, for example, with low literacy or disability (unless prohibitive due to the treatment being studied) In healthcare, socio-ecological factors, ethnicity, age, sex, and physical health factors are known to play a role in the experience of ill health, ability to access healthcare, treatment response, and short and long-term outcomes 5 – 10 . Pragmatically, this knowledge provides motivation for insisting on EDI in healthcare research. Randomised controlled trials (RCTs) are considered the gold standard for evaluating cause and effect relationships between treatments and health outcomes 11 . The results of RCTs should have relevance to all populations that may potentially benefit from the treatments being studied. This requires participation and representation of individuals of diverse backgrounds to ensure that RCT findings are generalisable, that the treatments or interventions are suitable for the populations to which they will be applied, and that illness impact and progression and treatment effectiveness may be understood and contextualised by differences related to potential diversity 12 – 14 . Historically, however, populations who represented those most affected by a disease or health condition or for which interventions were most needed were not always recruited to RCTs thus limiting the translation of findings to real-world settings 15 . Underrepresentation in RCTs has implications too for the ethical conduct of research, whereby the principles of beneficence, non-maleficence, justice and veracity may be undermined. The enrolment and participation of fewer women in RCTs, as an illustrative example, renders sex-based differences in disease aetiology, epidemiology, pathogenesis, and treatment effects to remain hidden or undiscovered 16 – 18 . Women who are pregnant or lactating are also frequently excluded from medical RCT participation due to prohibitive regulatory barriers 19 , 20 . These exclusions have real-world implications whereby the impact of a treatment or intervention remains unknown for these populations with a consequential lack of access to health interventions that may be effectively experienced by the wider population. The COVID-19 pandemic provides a further, albeit contrasting example. In the early phases of the pandemic, it became known that racial and ethnic minority populations were being disproportionately affected by the virus. By being inclusive of all populations, vaccine trial researchers were able to demonstrate the efficacy of COVID-19 vaccine across ethnic and minority groups, thus offering a safe and effective intervention irrespective of racial or ethnic origin 21 , although some trials were criticised for their lack of inclusivity of diverse ethnic and marginalised populations 22 . Health disparities feature prominently in maternity care. Recent data from the UK highlights considerable disparities in maternal health outcomes in women of diverse ethnicity, for example, the mortality rate from pregnancy to 6-weeks postpartum in Black, Asian, and women of mixed ethnicity was reported as being four, almost two, and three times that of White women, respectively 24 . Black, Asian and minority ethnic (BAME) women are also more likely to experience a stillbirth 25 , pre-eclampsia 26 , severe maternal morbidity 27 , and have an increased risk for preterm birth 28 . Despite this awareness, Black women remain underrepresented in maternal health research, and women of other ethnic minorities, such as women who are Asian, American Indian or Alaskan native, Hispanic, Aboriginal/Torres Strait Islander, or Native Hawaiian and other Pacific Islanders are even less represented 29 . Further confounding under-representation is the extent to which results based on participants differ from those of all eligible participants, and the implications of this for clinical practice. This was particularly highlighted following publication of the ARRIVE trial, a RCT that evaluated elective induction of labour (IOL) during gestational week 39 compared to expectant management at ≥40+5 weeks in low-risk nulliparous women with a singleton fetus in the vertex position 30 . The RCT, which involved 41 hospitals in the United States (US), demonstrated a 20% non-significant reduction in the primary outcome (composite of severe neonatal complications or mortality) and a significant reduction in caesarean birth in the IOL group (18.6% versus 22.2% respectively, p<0.01). A subsequent statement published by the Society for Maternal-Fetal Medicine (SMFM) recommended that “ It is reasonable to offer elective induction of labor to low-risk, nulliparous women at or beyond 39 weeks and 0 days of gestation” and that “ women can be reassured that both elective IOL and expectant management are reasonable options at 39 weeks of gestation ” 31 . Concerns related to ARRIVE’s applicability and transferability to other settings, however, were cited across several subsequent publications 32 – 34 . These concerns included an overall caesarean birth rate in ARRIVE that was considerably lower than the US national average, a higher proportion of African-American participants than that of the wider US birthing population (23% versus 15% respectively), proportionately fewer women ≥35 years of age than usual; 4% in ARRIVE versus 18% in US, and 60% and 10% in Europe in the categories of 30–39 and ≥40 years, respectively 34 , 35 , and a higher proportion of women with a pre-pregnancy Body Mass Index >30; 53% in ARRIVE versus 14% in European maternity populations 34 . Guidance for trialist on inclusive practices to help address and overcome issues associated with selection bias and population under-representation in RCTs are available 23 , 36 , and will likely further develop as focused momentum continues. The INCLUDE Ethnicity Framework, for example, ‘aims to help trial teams think specifically about which ethnic groups should be included in their trial’ , while acknowledging that ethnicity is complex, and may depend on aspects such as the ‘ geographic location of the trial, and the disease or condition targeted’ 37 . The Framework includes four key questions for trialists to consider when thinking about who participants should be, and how to facilitate their involvement 36 . While such guidance has broad applicability, there is a need also to consider EDI characteristics beyond and in addition to ethnicity, and to consider EDI characteristics specifically in the context of RCTs involving discrete populations such as those who are pregnant or postpartum. For this reason, to add to the discourse on EDI in RCT research and as a preliminary exploration for potential future developments, we conducted a scoping review to identify the types, frequency, and extent of EDI characteristics that were measured and reported in published RCTs of intrapartum interventions. For purposes of this review, we considered EDI under the definitions offered by the UK’s National Institute for Health and Care Research (NIHR) EDI Strategy 2022–2027 23 , interrelated at the component level and in the context of participation in intrapartum RCTs ( Table 1 ). Twelve EDI characteristics of interest were identified for this review by drawing on the Protected Characteristic in the UK Equality Act 2010 38 , the NIHR EDI Strategy 23 , and the Diversity and Inclusion Survey Question Guidance 39 ( Table 2 ). Table 2. EDI characteristics of interest. Characteristic Source(s) Race/Ethnicity 1 , 2 , 3 Age 1 , 2 , 3 Relationship status (marriage/civil partnership, single mothers) 1 , 2 Language 2 Education level (includes literacy) 2 , 3 Religion 1 , 2 , 3 Socio-economic status 2 , 3 Rural/Urban population 2 Sexual Orientation 1 , 2 , 3 Gender 1 , 3 Co-morbidities 3 Disability ( physical, ID, n eurodiversity ) 1 , 2 , 3 1=Protected Characteristic in the UK Equality Act 2010 2=NIHR Equality, Diversity and Inclusion Toolkit 3=Daisy Question Guidance Review objectives The objectives of the scoping review were to: 1. Identify and describe the types (which ones) of EDI characteristics being measured and reported in intrapartum RCTs. 2. Identify and describe the frequency (how often) that EDI characteristics are being measured and reported in intrapartum RCTs. 3. Identify and describe the extent of measurement and reporting, that is, at what stage(s) of intrapartum RCTs are EDI characteristics embedded, for example, as part of the inclusion or exclusion criteria, as a baseline characteristic, or as an outcome in analysis. Methods The protocol for this scoping review was registered prospectively in Open Science Framework (OSF) ( https://osf.io/7qmd2/ ). The Joanna Briggs Institute (JBI) methodological guidance for scoping reviews was used to guide the conduct of the review 40 . For reporting the review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) 41 (Extended File 1: https://osf.io/7qmd2/ ). Inclusion criteria The Population, Concept, Context (PCC) framework for scoping reviews 40 was used to frame the review’s inclusion criteria. Population: Women of any parity and risk category enrolled in RCTs of any design (parallel, cluster, cross-over) during intrapartum care. We chose to limit the review to the intrapartum period primarily to provide clinical homogeneity in the maternity stage in which the RCTs were occurring, while also maintaining manageable scope in conducting the review. The intrapartum period, for purposes of the review, was defined using the National Institute for Health and Care Excellence (NICE) definition for established first stage of labour through to the end of the third stage of labour, that is regular uterine contractions and progressive dilatation of the cervix from 4cms dilated until birth of the baby and expulsion of the placenta and membranes 42 . RCTs that enrolled women and commenced the intervention before established labour, for example, antenatally or in early labour (women with a cervical dilatation of 3cm or less), even if the intervention continued through to established labour, were excluded. Similarly, if it was unclear whether women were in established labour at the point of enrolment, these RCTs were excluded. RCTs that enrolled women in late second stage of labour with an intervention that was applied before birth of the placenta and membranes even if the outcomes were measured postpartum or were specific to the neonate, were included. Concept: EDI characteristics ( Table 2 ) as measured and reported in the included RCTs. Context: The context was completed and reported (published) RCTs of any design that evaluated an intrapartum intervention in any birth environment (i.e., hospital, midwifery-led units, home), in any geographical location. Trials of designs other than randomised, for example, quasi-experimental or clinical non-randomised trials of interventions, were excluded. Search and selection strategy To retrieve relevant RCTs the electronic databases of CINAHL (EBSCO), MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 2019 to March 2024. We limited our search to the past five years to maintain contemporaneous scope in the conduct of the review. As part of our search strategy, we adopted the Cochrane Highly Sensitive Search Strategy 43 for identifying RCTs and adjusted this to conform to each database’s search format. The search terms and combinations of these are presented in Extended File 2 ( https://osf.io/7qmd2/ ). Retrieved citations were downloaded initially to EndNote (Version 20.5, Clarivate Analytics) where duplicate records were removed. As we were interested in completed and reported (published) RCTs, grey literature searching was limited to a search of trial registries based only on the trial registry number provided in the included RCT reports. Language restrictions were not applied to the search strategy; however, due to a lack of translation services, only RCTs published in English were included. Searching without language restrictions, however, enabled us to evaluate the potential for language bias as a possible limitation in the review. Retrieved records, following de-duplication in Endnote, were uploaded to Covidence for screening. To ensure inter-rater reliability between reviewers, two reviewers initially screened 10% of retrieved records (by title and abstract) against the review’s inclusion and exclusion criteria, using the AMSTAR-2 recommendation of at least 80% agreement as an acceptable congruency cut-off 44 . Agreement was >90%, and one reviewer thus screened the remaining title and abstracts, excluding those that were clearly ineligible, and forwarding the remainder for full-text screening. Two reviewers independently screened all records at full text level. Any uncertainties or disagreements were resolved through discussion and consensus. Quality appraisal As the aim of the scoping review was to identify and describe the types, frequency and extent of EDI characteristics, individual RCT quality was not of particular concern. In this regard, a methodological quality appraisal of the included RCTs was not performed which is in line with JBI guidance for the conduct of scoping reviews 40 . Data extraction Data were extracted using a purposively designed data extraction form (DEF) constructed in Microsoft Excel (Extended File 3: https://osf.io/7qmd2/ ). The DEF was piloted by pairs of reviewers independently on 20 of the included records to assess the form’s suitability, and to cross-check accuracy and congruency in extracting the data. As data extraction congruency was almost 100%, discussions following the pilot centred on clarifications rather than revisions. The remaining records, following the pilot, were divided amongst the same three reviewers, and each reviewer extracted the data from their allocated records. Prior to and in preparation for data charting, one reviewer assessed all extracted data in the DEF for consistency in how the extracted data were recorded, and standardised any data as required; for example, if one extractor had used the full term for a clinical condition from one RCT (e.g., umbilical cord clamping) and a second had recorded an abbreviated term for the same condition from another RCT (e.g., UCC), this was standardised to the same format for both RCTs. Information extracted to the DEF included the RCT reference details, registration details, dates RCT was conducted, country of origin, RCT design, aim, setting, clinical condition, ethical approval information, total participants included in the analysis, and whether each of the EDI characteristics ( Table 2 ) were measured or reported as part of sample characteristics, inclusion/exclusion criteria, or data analyses. We also extracted information related to gravida/parity representing pregnancy and maternity in the UK Equality Act 2010 38 . Data charting and presentation of the findings As recommended for scoping reviews, rather than providing a statistical or formal thematic synthesis of data, summary findings narratively supported by illustrative charting using tables and graphs, were presented. One reviewer undertook the charting processes, and a second reviewer aligned this charting with associated narrative summaries to address the review objectives. Results Search and selection results The search strategy retrieved 27,719 records, of which 10,543 were duplicates or marked ineligible in Covidence by the RCT automated filter and were removed. Title and abstract screening of 17,176 records was thus undertaken by one member of the review team and 16,452 records were excluded as ineligible. Of the remaining 724 records, we could not obtain the full text for 16 of these. The full texts of 708 records were thus screened, of which 461 were excluded with reasons documented ( Figure 1 ). This provided 247 eligible RCTs that were included in the review. Figure 1 , publicly available for download and use via the Equator Network ( https://www.equator-network.org,/reporting-guidelines/prisma/ ) illustrates the search and screening process. Figure 1. Search and Selection PRISMA Flow Diagram 45 . Characteristics of included trials The country of origins of the included RCTs represented a global spread ( Figure 2 ). The largest number of RCTs originated in Iran (n=49), followed by India (n=39), Turkey (n=26), Brazil (n=12), China (n=12) and Pakistan (n=11). A further nineteen countries each contributed one RCT to the dataset. Six countries each contributed two RCTs, five countries three RCTs, Australia contributed four RCTs, Spain and Sweden contributed five RCTs each, France nine RCTs, Egypt 10 RCTs, and for seven RCTs, the country of origin was unknown. Figure 2. Country of origin of the included RCTs (n=240). RCT design was described in all 247 included RCTs, albeit in 63 different ways. Extended File 4, Table S4.1 ( https://osf.io/7qmd2/ ) illustrates this variation across the 247 RCTs. Forty-seven broad intrapartum topics or conditions of interest were identified in the 247 RCTs. Extended File 4, Figure S41, https://osf.io/7qmd2/ ) illustrates the top 10 most frequently occurring topics/conditions and the numbers of RCTs that reported on these. Objectives 1 and 2: types and frequencies of EDI characteristics Of the 247 RCTs, five did not report any of the 12 EDI characteristics. Eleven of the 12 EDI characteristics were measured or reported in at least one RCT. The characteristic of Sexual Orientation did not feature in any RCT. The frequency of EDI characteristic measurement and reporting was varied. Religion, for example, featured in three RCTs only, whereas Age was measured and reported in 222 RCTs. Figure 3 illustrates the number of RCTs that measured or reported the 12 EDI characteristic. Figure 3. Number of RCTs that measured or reported each EDI characteristic. Descriptions of the EDI characteristics also varied extensively. For example, Race/Ethnicity was described in 21 different ways ( Table 3 ). For maternal Age, although five main reporting descriptors were identified ( Figure 4 ), within the Age categories descriptor, 31 different categorisations were noted (Extended File 4, Table S4.2, https://osf.io/7qmd2/ ). Similarly, for Education, which featured in 96 RCTs, this characteristic was measured and reported in 62 different ways (Extended File 4, Table S4.3, https://osf.io/7qmd2/ ). For descriptions of the remaining EDI characteristics, see Extended File 4, Tables S4.4 to S4.6 ( https://osf.io/7qmd2/ ). Table 3. Race/Ethnicity Descriptors. Race/Ethnicity Descriptors Description Tribe (Yoruba, Igbo, Hausa, Other) Caucasian only Caucasian, Other Caucasian, Black, Asian, Brown-skinned Dutch, non-Dutch Most women self-declared as White European, Southeast Asian, South Asian, Other Region of birth: France, Africa, Asia, Other Nordic, European, African, Middle Eastern, South American, Asian Spanish, non-Spanish Colour - White, Black, Yellow, Brown Malay, Chinese, Indian, Others Born in France, Other Black, White, or none of the above White, not White Mother’s birthplace: Spain, Latin America, Eastern Europe, Western Europe, Africa, Oceania, elsewhere White, Southeast Asian, South Asian, Other Caucasian, not white Hispanic or Latino, American Indian or Alaskan Native, Asian, Black or African American, White, Other Black or African American, White, Hispanic or Latina White, African, Other Figure 4. Proportion of RCTs (n=222) reporting each Age broad descriptor. Objective 3: stage(s) of RCTs that EDI characteristics were embedded Three stages of a RCT for EDI measurement and reporting were explored in this scoping review. These were as a baseline sample characteristic, as an inclusion or exclusion criterion, or as part of analyses. Table 4 illustrates the findings for the 11 EDI characteristics that were embedded in at least one stage of at least one included RCT. Table 4. Stage of trial that EDI characteristic (n=11) was measured or reported. EDI characteristic Sample characteristic n/247 (%) Inclusion or Exclusion criterion n/247 (%) Data analysis * n/n * (%) Race/Ethnicity 23 (9.3) 4 (1.6) 20/23 (86.9) Age 221 (89.5) 127 (51.4) 209/221 (94.6) Relationship status 29 (11.7) 2 (0.8) 25/29 (86.2) Language 1 (0.4) 18 (4.2) 1/1 (100) Education Level 91 (36.8) 6 (2.4) 82/91 (90.1) Religion 2 (0.8) 1 (0.4) 2/2 (100) Socio-Economic Status 74 (29.9) 2 (0.8) 70/74 (94.6) Rural/Urban Population 23 (9.3) 0 22/23 (95/6) Gender 153 (61.9) 196 (79.4) 5 * Co-morbidities 51 (20.6) 114 (46.2) 39/51 (76.5) Disability 0 15 (6.1) 0 * All data analyses were based on baseline sample characteristics (groups compared at baseline), hence the denominator used in the Data analysis column is the sample characteristic numerator, other than for gender where comparisons by group for infant gender were presented. With regards to inclusion/exclusion criteria, one RCT only had Religion (Muslim only) reported as an inclusion criterion. Six RCTs had a required minimum educational level (being literate, having minimal diploma literacy, minimum reading or writing literacy, educated to primary level or above, and ability to understand the intervention or the study information). Gender featured highly in sample inclusion/exclusion criteria, most frequently denoted as ‘women’ (n=193), ‘female women’ (n=1) and ‘pregnant females’ (n=2). Non-gender descriptions included ‘patients’, ‘parturient’, ‘participants’ or by parity or gravida, that is ‘Nulliparous’, ‘Primiparous’ or ‘Primigravida’. Fifteen RCTs excluded participants on the grounds of Disability ( Figure 5 ). For the EDI characteristics of Age, 127 reported cut-offs for age as an inclusion/exclusion criterion, although 23 different variations of this were identified ( Table 5 ). Figure 5. Disability (exclusion criteria) (total RCTs n=15). Table 5. Variation in Age inclusion/exclusion criterion. No. of trials Description (years) No. of trials Description (years) 34 18–35 2 18–34 27 18 2 19–45 22 ≥18 2 Any Age 7 18–40 1 19 4 18–45 1 19+ 4 20–40 1 15–45 3 19–35 1 18–42 3 20–30 1 18–47 3 20–35 1 18–49 2 16 1 20–27 2 16–40 Similarly, of the 18 trials that had Language as an inclusion or exclusion criterion, 12 variations of this were noted ( Table 6 ). Table 6.Inclusion/exclusion Language variations. No. of trials Description 3 Included if literate, proficient in, or able to communicate in the Turkish language 1 Included only if a Kurdish speaker 1 Included if can consent in English and is proficient in Swedish, English, Arabic, or Farsi 2 Must have English language 1 Must have French language 1 Must have English or Afrikaans 1 Must be Swedish speaking 1 Excluded if language barrier 3 Excluded if unable to communicate in the Dutch language 1 Excluded if unable to speak or understand French 1 Excluded if unable to communicate fluently in French 2 Excluded if poor communication skills in Norwegian or English Body Mass Index/obesity, hypertension and diabetes were the Co-morbidities most frequently reported in sample characteristics across the included RCTs, with 39, ten and seven RCTs respectively reporting on one or more of these conditions. Almost half of the RCTs (46.2%) had co-morbidities as an inclusion/exclusion criterion. While these co-morbidities varied extensively, most related to high-risk pregnancy and pre-existing medical conditions, such as cardiovascular, respiratory, neurological, renal or liver conditions. In 14 RCTs, a history of substance abuse/drug addiction featured as an exclusion criterion, and in 23 RCTs women with a previous or current history of mental health issues or psychiatric disorders were excluded. Gravida or parity were also described in the inclusion criteria of 106 RCTs. Notably, nulliparous or primiparous featured considerably, that is nulliparous, primigravida or primiparous women only were included in 85% of the 106 that noted Gravida/Parity in their inclusion or exclusion criteria. Discussion This is the first comprehensive exploration, known to the authors, of the types, frequency and extent of EDI characteristic measurement and reporting in intrapartum RCTs. Being cognisant of the importance of EDI in health research, we recognise also that participation in RCTs is complex and often context dependent. Nonetheless, we found considerable variation in measurement and reporting of our 12 pre-specified EDI characteristics in this scoping review. The first notable variation was in frequency of the number of trials that measured or reported each characteristic which ranged from three (Religion) to 226 (Gender), revealing that some EDI characteristics are receiving greater attention than others. Sexual Orientation as an EDI characteristic was entirely absent, yet research has shown disparities in pregnancy and birth outcomes based on Sexual Orientation data. Bisexual and lesbian women, for example, are more likely to experience miscarriage (Odds Ratio (OR) 1.77, 95% Confidence Interval (CI) 1.34 to 2.35), stillbirth (OR 2.85, 95% CI 1.40 to 5.83) and preterm birth (OR 1.84, 95% CI 1.11 to 3.04) than heterosexual women 46 . Given that some of the included RCTs were conducted in countries where homosexuality remains criminalised (e.g., Iran, Pakistan), non-measurement or reporting might be understandable in these RCTs, but not for those outside of such jurisdictions. Gender, alternatively, featured in almost 80% of the included RCTs albeit using the term women, with no assurances of sex and gender separation. Pezaro and colleagues argue that gender-inclusive language is a safety and communication-critical issue is maternity care and suggest that use of the term women is exclusive, suggesting alternatively that pregnant people, pregnant populations and other non-genderised terms should be used 47 . Arguable, this returns to a blurring of population characteristics; for example, one may assume female sex, but ‘pregnant people’ may include cis-gender, trans-gender, or gender nonconforming individuals, therefore, again concealing important EDI information. Nonetheless, the argument here points to the assumptions made around gender identity care, and the use of the term women without specifically gathering gender or sex segregated data. Beyond terminology, collecting sexual orientation and gender identity (SOGI) data, is considered necessary for monitoring and addressing health disparities, yet several prohibitive barriers to this have been identified: these include lack of awareness of sexual orientation and gender diversity, lack of institutional support, infrastructure workflow, discomfort from the clinician perspective, discomfort from the participant perspective and lack of training 48 . Poor integration of SOGI data across electronic health records has also been highlighted as a major barrier to EDI for sexual minorities in clinical research, as well as a risk for misgendering, inappropriate questioning or inappropriate medical intervention 49 . The review also found minimal reporting of Race/Ethnicity in sample characteristics (9% of 247 RCTs), emulating that found in other studies 50 , 51 , and an absence of outcome evaluation by Race/Ethnicity in sub-group analyses. This was surprising given that many EDI guidelines or toolkits place emphasise on this characteristic ( Table 2 ), and there is evidence for disparate health adversity across racial and ethnic groups 23 – 25 . Considering the recent momentum and focus on EDI in RCTs, however, it remains to observe if this finding will alter in future prospective RCTs. Socio-Economic Status which is complex and influenced by multiple factors, including education, occupation, income, and social support, was also absent in sub-group outcome analyses although almost 30% of the 247 RCTs measured and reported this as a sample characteristic. Data minimisation, that is collecting necessary data only from participants, is generally expected as part of research ethical approval processes 52 , yet our findings show that despite collecting these data in 30% of the dataset, none used these data to produce new knowledge, raising ethical concerns of contravening the principle of data minimisation. Furthermore, collecting but not fully utilising diversity data perpetuates the notion that EDI practices are existing as ‘tick box’ activity rather than serving a meaningful function in RCTs. Additionally, collecting and reporting EDI characteristic data as sample characteristic or inclusion/exclusion data is far less tangible and informative for healthcare planning and provision when other analyses for variance are not carried out. Consideration also needs to be given to analyses that account for participants who carry more than one EDI characteristic. Countering this, we acknowledge that reporting EDI data in sample characteristics but not in sub-group analyses could relate to maintaining statistical power in RCTs. In this regard, EDI-based subgroup analyses might be more appropriately addressed in meta-analyses of data from multiple RCTs data. For this to occur, however, consistent EDI categorization is required; a variation challenge which was identified in this scoping review. Living in rural versus urban settings also impacts maternal health. A US nation-wide analysis, for example, found that the maternal mortality rate in rural settings was almost double that of urban locations (Relative Risk 1.93; 95% CI 1.71 to 2.17) 53 . Addressing health disparities is crucial for improving maternal and societal health and ensuring equitable, tailored access to resources. The lack of consideration for measuring health outcomes and reporting these in sub-group analyses based on EDI characteristics points to a lack of consideration for potential differential treatment effectiveness. Consequently, this prohibits a comprehensive and appropriate translation of RCT evidence across jurisdictions and context-specific maternity healthcare settings and hinders adequate health policy and practice developments. It further leads to gaps in understanding how different populations respond to treatments and may render clinicians who might hope to adopt or utilise RCT findings challenged in being confidently enabled to do so. These findings may also reflect broader issues of inequality in research participation, further perpetuating health disparities because of inadequate explorations and ongoing unknowns. The EDI characteristic of Age featured prominently in this scoping review. Problematic, however, is the variation in how this was measured and reported, primarily in sample characteristics. This applies to other EDI characteristics also, including Language, Socio-Economic status, Family/Relationship status, Race/Ethnicity, and Education. At an individual RCT level, this might not appear overly problematic, however the challenge arises when trying to synthesise the evidence from RCTs in a systematic review. Methodology for standardising outcome measures in effectiveness trials is well established through the Core Outcome Measures in Effectiveness Trials (COMET) initiative 54 . A core outcome set represents a minimum set of outcomes that should be measured and reported in all RCTs on a specific health condition. Although many RCTs compare population characteristics at baseline, little attention has been given thus far to standardising a minimum set of EDI characteristics for use in RCTs, including how to measure and report these. Future research is required to address this gap. Recent decades have witnessed a trend towards increasing maternal age in pregnancy and childbirth. For example, the birth rate among women aged 35–39 has increased in the past 40 years by 272% and for women aged 40–44 years by 318% 55 . This growing trend impacts individuals and health systems, especially as advanced maternal age, defined historically as >35 years, can lead to increased risks for complications, including hypertension-related conditions, gestational diabetes, preterm birth, fetal growth restriction, and stillbirth 56 . In this scoping review, few trials explicitly included women >35 years of age although the upper age limit in some trials was not defined ( Table 5 ). Most trials that reported Age as an inclusion/exclusion criterion used 35 years or below as the upper-level cut-off, with no rationale provided for doing so. This trends against the obligation of equitable recruitment in trials and fails to take account of changing patterns in maternal age in pregnancy and the possible implications of this when evaluating intrapartum treatments or interventions. The NIHR component of inclusivity, as applied in this scoping review, necessitates trialists giving due consideration to environments that are supportive towards participation by all who are eligible. We found 15 RCTs that excluded participants on the grounds of Disability. In seven of these RCTs it may appear reasonable to exclude participants based on specific disabilities, for example, the intervention being evaluated engaged virtual reality, showing images or playing music to women during labour, thus excluding participants with visual and hearing impairments. In two RCTs, however, women with hearing or visual impairment were excluded with no apparent indication for this; that is the interventions centred on warm compresses to the perineum during childbirth 57 and acupressure 58 . In a third RCT which evaluated umbilical cord milking, the inclusion criteria necessitated women to be able to communicate verbally, a necessity not explicitly related to the intervention under evaluation 59 . Similarly, mental health or psychiatric conditions appeared as exclusion criteria in three RCTs, with no clear rationale presented for this 60 – 62 . Research has shown that for women with physical disabilities access to, and experiences of, maternity care is suboptimal 63 . Trialists, as with all maternity care providers, need to have disability knowledge and awareness and make available, where possible, support services to ensure accessibility and inclusivity for all women in all trials. Language and Education levels also featured as inclusion/exclusion criteria is some trials, although, positively, the numbers of RCTs that excluded participants based on these EDI characteristics were comparatively few (4% and 2% respectively). Nonetheless, in the absence of legitimate reasons, exclusions based on Language and Education contravene inclusive practices, especially when evidence for alternative methods to aid inclusivity (e.g., use of metaphors, plain language, face-to-face discussions with researchers, etc.) are available 64 , 65 . Lastly, the considerable proportion of RCTs (n=90, 36%) limiting inclusion to participants who were pregnant or birthing for the first time without clinical rationale is noteworthy in the context of EDI. Health in pregnancy is influenced by many factors, including that of parity 66 . Restricting RCT participation solely to nulliparous women may thus not accurately reflect the effect of treatments in all birthing women. Not only does this limit the applicability of the findings, but such restrictions could lead to biases in RCT outcomes as the results will not account for physiological and psychological differences between nulliparous and parous women 66 . This may further impact and perpetuate disparities in maternal health as important insights that could improve treatments and health outcomes for all women could be missed. Strengths and limitations The strengths of this review include the extensive dataset of 247 RCTs that informed the exploration of 12 pre-specified EDI characteristics and by including intrapartum RCTs only, which enhanced clinical homogeneity and provided scope to successfully undertake the review within a reasonable timeframe was achieved. We acknowledge that including English language published RCTs sourced from electronic database searching only may have reduced the expanse of EDI characteristic exploration; nonetheless, as the purpose of the review was preliminary exploration with the aim of establishing a baseline for discussion and future developments, having a broader dataset based on grey literature and unpublished RCTs would unlikely change or add to the quality or depth of information revealed in the review. We also acknowledge, although discovering a high level of Gender reporting across the included RCTs, this may be related to our assumption of Gender reporting when participants were described as women when, in reality, this could be related to either or both sex and gender. Lastly, we acknowledge that traditional practice in reviews of this type involve independent data extraction of each included record by at least two reviewers independently. We overcame this limitation by undertaking a data extraction pilot process with congruency across extractors achieving 100% on 20 records, and by one reviewer assessing the entire dataset for consistency and standardisation prior to data charting and presentation. Conclusion This scoping review highlights deficits in intrapartum RCTs with respect to measuring and reporting EDI characteristics. There is a critical need for improvements and adaptation of EDI guidelines and toolkits, as well as cultural competence practices in designing, conducting, and reporting intrapartum RCTs. While specific to the healthcare population receiving intrapartum care, the review’s findings are likely to resonate and have applicability to RCTs in other discrete populations. Integrating EDI in RCTs not only meets the obligation of ethical research conduct, but it also serves to enhance the quality and applicability of the findings derived from the RCTs. By adopting more extensive EDI practices, including standardisation of what and how EDI characteristics should be measured and reported, a greater understanding of healthcare treatments, practices, and innovations leading to better benefit and enhanced maternal health equity for all could be achieved. Ethics and consent Ethical approval and consent were not required. Data availability Underlying data No data are associated with this article. Extended data Repository name: Open Science Framework (OSF), DOI: 10.17605/OSF.IO/7QMD2 (citation 67 ) The project contains the following underlying data: Extended File 1: PRISMA-ScR – complete checklist of items in reporting scoping reviews Extended File 2: Search Terms – complete list of search terms used in all databases Extended File 3: DEF (Data Extraction Form) – Excel File of all data extracted from the included records Extended File 4: Tables S4.1-S4.6 – document of supplementary tables referred to in the manuscript Supplementary tables: Table S4.1: Descriptions of Trial Designs Table S4.2: Maternal Age category descriptors Table S4.3: Education Leve (sample characteristics) Table S4.4: Relationship status (sample characteristics) Table S4.5: Socio-Economic status (sample characteristics) Table S4.6: Rural/Urban Population (sample characteristics) PRISMA Flow Diagram - flow chart of search and selection results License: CC-By Attribution 4.0 International Reporting guidelines The review is reported as per the Preferred Reporting Items for Reviews Systematic Reviews and Meta-Analyses extension for Scoping (PRISMA-ScR) reporting guideline (Extended File 1: 10.17605/OSF.IO/7QMD2 (citation 67 ) License: CC-By Attribution 4.0 International Authors’ contributions VS conceived the idea for the review. SH and VS drafted the protocol. SH registered the protocol with OSF. SH implemented the search strategy. SH and VS conducted screening and selection. SH, VS, and JG extracted the data. AS and VS collated and charted the results. VS drafted the main manuscript. All authors read and approved the final manuscript prior to submission. Faculty Opinions recommended References 1. Wolberg G, Nguyen A: Equity/equality, diversity and inclusion, and other EDI phrases and EDI policy frameworks: a scoping review. Trends High Educ. 2023; 2 (1): 168–237. Publisher Full Text 2. Burt MA, Haacker R, Montaño P, et al. : The ethics of diversity, equity, inclusion, and justice in the earth system sciences. Front Phys. 2022; 10 : 1085789. Publisher Full Text 3. Pratt B: Research for health justice: an ethical framework linking global health research to health equity. BMJ Glob Health. 2021; 6 (2): e002921. PubMed Abstract | Publisher Full Text | Free Full Text 4. Tessema M, Hulback T, Jones J, et al. : Diversity, equity, and inclusion: history, climate, benefits, challenges, and creative strategies. J Human Res Sustainability Studies. 2023; 11 (4): 780–794. Publisher Full Text 5. Gibson B, Schneier J, Talamonti D, et al. : The impact of inequality on mental health outcomes during the COVID-19 pandemic: a systematic review. Canadian Psychol. 2021; 62 (1): 101–126. Publisher Full Text 6. Hu Y: Intersecting ethnic and native-migrant inequalities in the economic impact of the COVID-19 pandemic in the UK. Res Soc Stratif Mobil. 2020; 68 : 100528. PubMed Abstract | Publisher Full Text | Free Full Text 7. Jordan RE, Adab P, Cheng KK: COVID-19: risk factors for severe disease and death. BMJ. 2020; 368 : m1198. PubMed Abstract | Publisher Full Text 8. Khunti K, Singh AK, Pareek M, et al. : Is ethnicity linked to incidence or outcomes of covid-19? BMJ. 2020; 369 : m1548. PubMed Abstract | Publisher Full Text 9. Siedner MJ, Kraemer JD, Meyer MJ, et al. : Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis. BMJ Open. 2020; 10 (10): e043763. PubMed Abstract | Publisher Full Text | Free Full Text 10. Zaher K, Basingab F, Alrahimi J, et al. : Gender differences in response to COVID-19 infection and vaccination. Biomedicines. 2023; 11 (6): 1677. PubMed Abstract | Publisher Full Text | Free Full Text 11. Hariton E, Locascio JJ: Randomised Controlled Trials - the gold standard for effectiveness research: study design: Randomised Controlled Trials. BJOG. 2018; 125 (13): 1716. PubMed Abstract | Publisher Full Text | Free Full Text 12. Esnaola NF, Ford ME: Racial differences and disparities in cancer care and outcomes: where's the rub? Surg Oncol Clin N Am. 2012; 21 (3): 417–37, viii. PubMed Abstract | Free Full Text 13. Oh SS, Galanter J, Thakur N, et al. : Diversity in clinical and biomedical research: a promise yet to be fulfilled. PLoS Med. 2015; 12 (12): e1001918. PubMed Abstract | Publisher Full Text | Free Full Text 14. Sandström N, Johansson M, Jekunen A, et al. : Socioeconomic status and lifestyle patterns in the most common cancer types-community-based research. BMC Public Health. 2023; 23 (1): 1722. PubMed Abstract | Publisher Full Text | Free Full Text 15. Witham M, Anderson E, Carroll C, et al. : Developing a roadmap to improve trial delivery for under-served groups: results from a UK multi-stakeholder process. Trials. 2020; 21 (1): 694. PubMed Abstract | Publisher Full Text | Free Full Text 16. Wizemann TM, Pardue ML, (Editors), Institute of Medicine: Exploring the biological contributions to human health: does sex matter? The National Academies Press (US), 2001. PubMed Abstract | Publisher Full Text 17. Liu KA, DiPietro Mager NA: Women’s involvement in clinical trials: historical perspective and future implications. Pharm Pract (Granada). 2016; 4 (1): 708. PubMed Abstract | Publisher Full Text | Free Full Text 18. Seydel C: The missing sex. Nat Biotechnol. 2021; 39 (3): 260–265. PubMed Abstract | Publisher Full Text 19. Blehar MC, Spong C, Grady C, et al. : Enrolling pregnant women: issues in clinical research. Womens Health Issues. 2013; 23 (1): e39–45. PubMed Abstract | Publisher Full Text | Free Full Text 20. Salloum M, Paviotti A, Bastiaens H, et al. : The inclusion of pregnant women in vaccine clinical trials: an overview of late-stage clinical trials’ records between 2018 and 2023. Vaccine. 2023; 41 (48): 7076–7083. PubMed Abstract | Publisher Full Text 21. National Institute on Minority Health and Health Disparities: Diversity and inclusion in clinical trials. Accessed 8 Sept 2024. Reference Source 22. Gardiner T, Cooke G, Fidler S, et al. : The under-representation of BAME patients in the COVID-19 Recovery trial at a major London NHS Trust. J Infect. 2021; 82 (4): 84–123. PubMed Abstract | Publisher Full Text | Free Full Text 23. Knight M, Bunch K, Patel R, (Eds.), et al. : Saving Lives, Improving Mothers’ Care Core Report - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018–20. Oxford: National Perinatal Epidemiology Unit, University of Oxford, 2022. Reference Source 24. Matthews RJ, Draper ES, Manktelow BN, et al. : Understanding ethnic inequalities in stillbirth rates: a UK population-based cohort study. BMJ Open. 2022; 12 (2): e057412. PubMed Abstract | Publisher Full Text | Free Full Text 25. Johnson JD, Louis JM: Does race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literature. Am J Obstet Gynecol. 2022; 226 (2s): s876–s885. PubMed Abstract | Publisher Full Text 26. Boghossian NS, Greenberg LT, Lorch SA, et al. : Racial and ethnic disparities in severe maternal morbidity from pregnancy through 1-year postpartum. Am J Obstet Gynecol MFM. 2024; 6 (8): 101412. PubMed Abstract | Publisher Full Text | Free Full Text 27. Li Y, Quigley MA, Macfarlane A, et al. : Ethnic differences in singleton preterm birth in England and Wales, 2006–12: analysis of national routinely collected data. Paediatr Perinat Epidemiol. 2019; 33 (6): 449–458. PubMed Abstract | Publisher Full Text | Free Full Text 28. Yamasato K, Chern I, Lee MJ: Racial/Ethnic representation in United States and Australian obstetric research. Maternal Child Health J. 2021; 25 (5): 841–848. PubMed Abstract | Publisher Full Text 29. National Institute for Health and Care Research (NIHR): Equality, diversity and inclusion strategy 2022–2027. Version 2, March 2023; Accessed 15 Sept 2024. Reference Source 30. Grobman WA, Rice MM, Reddy UM, et al. : Labor induction versus expectant management in low-risk nulliparous women. N Engl J Med. 2018; 379 (6): 513–523. PubMed Abstract | Publisher Full Text | Free Full Text 31. Society of Maternal-Fetal (SMFM) Publications Committee: SMFM statement on elective induction of labor in low-risk nulliparous women at term: the ARRIVE trial. Am J Obstet Gynecol. 2019; 221 (1): B2–B4. PubMed Abstract | Publisher Full Text 32. Carmichael SL, Snowden JM: The ARRIVE trial: interpretation from an epidemiologic perspective. J Midwifery Womens Health. 2019; 64 (5): 657–663. PubMed Abstract | Publisher Full Text | Free Full Text 33. James-Conterelli S, Kennedy HP: Does the ARRIVE trial merit changing obstetric practice? Some reflections four-year post release. Birth. 2023; 50 (2): 258–266. PubMed Abstract | Publisher Full Text 34. Facchinetti F, Menichini D, Perrone E: The ARRIVE trial will not “arrive” to Europe. J Matern Fetal Neonatal Med. 2022; 35 (22): 4229–4232. PubMed Abstract | Publisher Full Text 35. Martin JA, Hamilton BE, Osterman MJK, et al. : Births: final data for 2017. Natl Vital Stat Rep. 2018; 67 (8): 1–50. PubMed Abstract 36. Treweek S, Banister K, Bower P, et al. : Developing the INCLUDE ethnicity framework-a tool to help trialists design trials that better reflect the communities they serve. Trials. 2021; 22 (1): 337. PubMed Abstract | Publisher Full Text | Free Full Text 37. Trial Forge: The INCLUDE ethnicity framework. Accessed 27 Sept 2024. Reference Source 38. UK Government: Equality Act 2010. Accessed 15 Sept 2024. Reference Source 39. Wellcome Trust Diversity and inclusion survey (Daisy) question guidance. Accessed 15 Sept 2024. Reference Source 40. Peters MDJ, Marnie C, Tricco AC, et al. : Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020; 18 (10): 2119–2126. PubMed Abstract | Publisher Full Text 41. Tricco AC, Lillie E, Zarin W, et al. : PRISMA extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169 (7): 467–473. PubMed Abstract | Publisher Full Text 42. National Institute of Health and Care Excellence (NICE): Intrapartum care. NICE guideline [NG235], 2023. Reference Source 43. Higgins JPT, Thomas J, Chandler J, (Editors), et al. : Cochrane handbook for systematic reviews of interventions version 6.5. 2024. Reference Source 44. Shea BJ, Reeves BC, Wells G, et al. : AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358 : j4008. PubMed Abstract | Publisher Full Text | Free Full Text 45. Page MJ, McKenzie JE, Bossuyt PM, et al. : The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372 : n71. PubMed Abstract | Publisher Full Text | Free Full Text 46. Everett BG, Kominiarek MA, Mollborn S, et al. : Sexual orientation disparities in pregnancy and infant outcomes. Matern Child Health J. 2019; 23 (1): 72–81. PubMed Abstract | Publisher Full Text | Free Full Text 47. Pezaro S, Pendleton J, van der Waal R, et al. : Gender-inclusive language in midwifery and perinatal services: a guide and argument for justice. Birth. 2024. PubMed Abstract | Publisher Full Text 48. Kamen CS, Pratt-Chapman ML, Meersman SC, et al. : Sexual Orientation and Gender Identity data collection in oncology practice: findings of an ASCO survey. JCO Oncol Pract. 2022; 18 (8): e1297–e1305. PubMed Abstract | Publisher Full Text | Free Full Text 49. Gilmore J, Dainton M, McEvoy N: Sexual Orientation and Gender Identity (SOGI) and electronic health record data, a mechanism for gender-affirming care and evidence-based practice for sexual and gender minority healthcare - response to Ginaldi et al . Intensive Crit Care Nurs. 2024; 84 : 103709. PubMed Abstract | Publisher Full Text 50. Delma S, Langford K, Baylor JL, et al. : Race and ethnicity reporting in randomized controlled trials published in upper-extremity journals. J Hand Surg Am. 2023; 48 (4): 340–347. PubMed Abstract | Publisher Full Text 51. Wallace N, O’Keeffe S, Gardner H, et al. : Under recording and underreporting of participant ethnicity in clinical trials is persistent and is a threat to inclusivity and generalizability. J Clin Epidemiol. 2023; 162 : 81–89. PubMed Abstract | Publisher Full Text 52. General data protection regulation. 2018. Reference Source 53. Harrington KA, Cameron NA, Culler K, et al. : Rural-Urban disparities in adverse maternal outcomes in the United States, 2016–2019. Am J Public Health. 2023; 113 (2): 224–227. PubMed Abstract | Publisher Full Text | Free Full Text 54. Williamson PR, Altman DG, Bagley H, et al. : The COMET handbook: version 1.0. Trials. 2017; 18 (Suppl 3): 280. PubMed Abstract | Publisher Full Text | Free Full Text 55. Hochler H, Lipschuetz M, Suissa-Cohen Y, et al. : The impact of advanced maternal age on pregnancy outcomes: a retrospective multicenter study. J Clin Med. 2023; 12 (17): 5696. PubMed Abstract | Publisher Full Text | Free Full Text 56. Attali E, Yogev Y: The impact of advanced maternal age on pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2021; 70 : 2–9. PubMed Abstract | Publisher Full Text 57. Modoor S, Fouly H, Rawas H: The effect of warm compresses on perineal tear and pain intensity during the second stage of labor: a randomized controlled trial. Belitung Nurs J. 2021; 7 (3): 210–218. PubMed Abstract | Publisher Full Text | Free Full Text 58. Topraghlou SB, Shafaie FS, Mirghafourvand M, et al. : Comparing the effects of acupressure at the hugo point and hyoscine on the duration of labor stages and fetal-neonatal outcomes in nulliparous women: a controlled randomized clinical trial. Int J Women's Health Repro Sci. 2019; 7 (3): 393–399. Publisher Full Text 59. Zhang Y, Tao M, Wang S, et al. : Effectiveness and safety of umbilical cord milking in premature infants: a randomized controlled trial. Medicine (Baltimore). 2023; 102 (47): e36121. PubMed Abstract | Publisher Full Text | Free Full Text 60. Le Ray C, Garabedian C, Chantry AA: Alternative to intensive management of the active phase of the second stage of labor: a multicenter randomized trial (Phase Active du Second STade trial) among nulliparous women with an epidural: a reply. Am J Obstet Gynecol. 2023; 229 (2): 182. PubMed Abstract | Publisher Full Text 61. Jameei-Moghaddam M, Goljaryan S, Charandabi SMA, et al. : Effect of plantar reflexology on labor pain and childbirth experience: a randomized controlled clinical trial. J Obstet Gynaecol Res. 2021; 47 (6): 2082–2092. PubMed Abstract | Publisher Full Text 62. Lee CH, Choi SS, Lee MK, et al. : Electric stimulation-guided epidural analgesia for vaginal delivery: a randomized prospective study. PLoS One. 2019; 14 (1): e0209967. PubMed Abstract | Publisher Full Text | Free Full Text 63. Blair A, Cao J, Wilson A, et al. : Access to, and experiences of, maternity care for women with physical disabilities: a scoping review. Midwifery. 2022; 107 : 103273. PubMed Abstract | Publisher Full Text 64. Krieger JL, Neil JM, Strekalova YA, et al. : Linguistic strategies for improving informed consent in clinical trials among low health literacy patients. J Natl Cancer Inst. 2016; 109 (3): djw233. PubMed Abstract | Publisher Full Text | Free Full Text 65. Davidson KM, Espie CJ, Lammie C: Conducting randomised controlled trials: finding better ways to explain research to people with anti-social personality disorder who have low literacy levels. Crim Behav Ment Health. 2011; 21 (4): 265–78. PubMed Abstract | Publisher Full Text 66. Reuwer P, Bruinse H, Franx A: Chapter 13 Nulliparous versus parous labor. In: Proactive support of labor. The challenge of normal childbirth . Cambridge University Press, 2015; 88–92. Publisher Full Text 67. Hannon S, Smith V: Scoping review protocol: reporting of Equality, Diversity and Inclusion (EDI) characteristics in randomized controlled trials of intrapartum interventions. Open Science Framework. 2024. http://www.doi.org/10.17605/OSF.IO/7QMD2 Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 24 Dec 2024 ADD YOUR COMMENT Comment Author details Author details 1 School of Nursing and Midwifery, The University of Dublin Trinity College, Dublin, Leinster, D02, Ireland 2 School of Agriculture and Food Science, University College Dublin School of Nursing Midwifery and Health Systems, Dublin, Leinster, D04, Ireland 3 School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Leinster, D04, Ireland Susan Hannon Roles: Data Curation, Formal Analysis, Project Administration, Writing – Review & Editing Aoife Smith Roles: Formal Analysis, Visualization, Writing – Review & Editing John Gilmore Roles: Data Curation, Validation, Writing – Review & Editing Valerie Smith Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Supervision, Validation, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information This project was part funded by the Health Research Board-Trials Methodology Research Network Ireland (grant ref: HRB-TMRN-2021-001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (2) version 2 Revised Published: 07 Mar 2025, 7:78 https://doi.org/10.12688/hrbopenres.14012.2 version 1 Published: 24 Dec 2024, 7:78 https://doi.org/10.12688/hrbopenres.14012.1 Copyright © 2025 Hannon S et al . 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 work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Hannon S, Smith A, Gilmore J and Smith V. Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.12688/hrbopenres.14012.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 24 Dec 2024 Views 0 Cite How to cite this report: Gold L. Reviewer Report For: Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.21956/hrbopenres.15378.r44825 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-78/v1#referee-response-44825 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 30 Jan 2025 Lisa Gold , Deakin University, Burwood, Victoria, Australia Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15378.r44825 This scoping review tells us that – in a sample of 247 intrapartum RCTs reported in the last 5 years – most (?all?) reported some EDI data but there are large gaps in EDI reporting. The most commonly-reported was age ... Continue reading READ ALL This scoping review tells us that – in a sample of 247 intrapartum RCTs reported in the last 5 years – most (?all?) reported some EDI data but there are large gaps in EDI reporting. The most commonly-reported was age (222 RCTs) – really a classic sample characteristic that also serves as an EDI characteristic – and the least commonly reported were sexual orientation (0 RCTs) and religion (3 RCTs). Why are we interested in EDI? The general point is that we need to know the characteristics of trial participants in order to interpret results. This requires EDI data to be reported in sample characteristics. The type of EDI data we are interested in will vary between countries, with the 12 EDI characteristics (Table 2) a logically-selected and comprehensive list that could easily be added to journal/organisational requirements for RCT reporting. A more specific point is that RCT evidence should come from population-representative samples, so a second reason to assess EDI data is to highlight inclusion issues in research. As we already know that pregnant women are a highly-excluded group in research, it is a very good choice in this study to assess EDI in the context where this group is by definition included (ie, intrapartum care). This scoping review addresses both points. A scoping review is appropriate at this early stage of research in this area. This scoping review is an excellent example of the approach, including pre-published protocol (OSF) and following established methods of conduct and reporting (JBI/PRISMA-ScR). The restriction to more recent evidence is entirely appropriate given the timing of increased awareness/focus on EDI and the review demonstrates a model approach to language of publication where research resources are limited (ie, no language restriction in search but exclude from review and discuss impact of this). What do we learn from this review? The results of the scoping review demonstrate variation across EDI characteristics in the extent of reporting, and variation of categorizations within EDI characteristics. Table 4 makes a good point that some EDI (disability) is reported only in the context of inclusion/exclusion criteria. The discussion highlights important considerations for EDI reporting. The section on (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power – at least that this may well be the reason that EDI data is reported in sample characteristics but not used in (sub-group) analysis. This would link nicely into the issue of variance of categorization, as EDI-based sub-group analysis could be addressed more appropriately in meta-analyses across RCTs, but that requires consistent EDI categorization, which is difficult when categorization is country-specific. Minor comments for presentation: Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also if possible keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Typos: P5 Quality Appraisal: extent not extend P8 There is one “RCTS” that should be have a small “S” Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Not applicable Are the conclusions drawn adequately supported by the results presented in the review? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Public Health, Health Economics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Gold L. Reviewer Report For: Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.21956/hrbopenres.15378.r44825 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-78/v1#referee-response-44825 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 07 Mar 2025 Valerie Smith , School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, D04, Ireland 07 Mar 2025 Author Response Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your ... Continue reading Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your comments as follows: We are grateful for the point you made about how the (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power in the Discussion section is valued. We have addressed this with the addition of the following text (Discussion section, end of paragraph 3): Response: Countering this, we acknowledge that reporting of EDI data in sample characteristics but not in sub-group analyses could relate to maintaining statistical power in RCTs, yet EDI-based analyses could be addressed in meta-analyses across RCTs. For this to occur, however, consistent EDI categorization is required; a variation challenge identified in this scoping review. Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Response: We have now reduced the details in the section on Characteristics of included trials including some of the text on country of origin, trial design, RCT start dates and duration periods, and the numbers included in the RCTs. Figure 3 has been removed from the manuscript and is now included in Extended File 4 (Figure S4.1). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Response : We have removed the text related to the gender of the infant from the main manuscript, although we have retained illustrative Figures 5-6 (now Figures 4 and 5) in the main paper. Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Response: We have added the following sentence to the start of this section: Of the 247 RCTs, five did not report any of the 12 EDI characteristics. We refrained though from creating a new graphic, as we feel Figure 2, Table 4 and Extended File X collectively help capture the depth of EDI reporting. Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also, if possible, keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Response: We have now added numbers into Figure 4 (now Figure 3) and added in Sexual Orientation. The list is in the same order as Table 2, only from the bottom up (Excel appears to default to this for this type of bar chart) Typo P5 Quality Appraisal: extent not extend Response: Thank you, type corrected Typo P8 There is one “RCTS” that should have a small “S” Response: Thank you, type corrected Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your comments as follows: We are grateful for the point you made about how the (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power in the Discussion section is valued. We have addressed this with the addition of the following text (Discussion section, end of paragraph 3): Response: Countering this, we acknowledge that reporting of EDI data in sample characteristics but not in sub-group analyses could relate to maintaining statistical power in RCTs, yet EDI-based analyses could be addressed in meta-analyses across RCTs. For this to occur, however, consistent EDI categorization is required; a variation challenge identified in this scoping review. Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Response: We have now reduced the details in the section on Characteristics of included trials including some of the text on country of origin, trial design, RCT start dates and duration periods, and the numbers included in the RCTs. Figure 3 has been removed from the manuscript and is now included in Extended File 4 (Figure S4.1). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Response : We have removed the text related to the gender of the infant from the main manuscript, although we have retained illustrative Figures 5-6 (now Figures 4 and 5) in the main paper. Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Response: We have added the following sentence to the start of this section: Of the 247 RCTs, five did not report any of the 12 EDI characteristics. We refrained though from creating a new graphic, as we feel Figure 2, Table 4 and Extended File X collectively help capture the depth of EDI reporting. Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also, if possible, keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Response: We have now added numbers into Figure 4 (now Figure 3) and added in Sexual Orientation. The list is in the same order as Table 2, only from the bottom up (Excel appears to default to this for this type of bar chart) Typo P5 Quality Appraisal: extent not extend Response: Thank you, type corrected Typo P8 There is one “RCTS” that should have a small “S” Response: Thank you, type corrected Competing Interests: No competing interests to declare Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 07 Mar 2025 Valerie Smith , School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, D04, Ireland 07 Mar 2025 Author Response Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your ... Continue reading Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your comments as follows: We are grateful for the point you made about how the (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power in the Discussion section is valued. We have addressed this with the addition of the following text (Discussion section, end of paragraph 3): Response: Countering this, we acknowledge that reporting of EDI data in sample characteristics but not in sub-group analyses could relate to maintaining statistical power in RCTs, yet EDI-based analyses could be addressed in meta-analyses across RCTs. For this to occur, however, consistent EDI categorization is required; a variation challenge identified in this scoping review. Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Response: We have now reduced the details in the section on Characteristics of included trials including some of the text on country of origin, trial design, RCT start dates and duration periods, and the numbers included in the RCTs. Figure 3 has been removed from the manuscript and is now included in Extended File 4 (Figure S4.1). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Response : We have removed the text related to the gender of the infant from the main manuscript, although we have retained illustrative Figures 5-6 (now Figures 4 and 5) in the main paper. Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Response: We have added the following sentence to the start of this section: Of the 247 RCTs, five did not report any of the 12 EDI characteristics. We refrained though from creating a new graphic, as we feel Figure 2, Table 4 and Extended File X collectively help capture the depth of EDI reporting. Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also, if possible, keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Response: We have now added numbers into Figure 4 (now Figure 3) and added in Sexual Orientation. The list is in the same order as Table 2, only from the bottom up (Excel appears to default to this for this type of bar chart) Typo P5 Quality Appraisal: extent not extend Response: Thank you, type corrected Typo P8 There is one “RCTS” that should have a small “S” Response: Thank you, type corrected Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your comments as follows: We are grateful for the point you made about how the (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power in the Discussion section is valued. We have addressed this with the addition of the following text (Discussion section, end of paragraph 3): Response: Countering this, we acknowledge that reporting of EDI data in sample characteristics but not in sub-group analyses could relate to maintaining statistical power in RCTs, yet EDI-based analyses could be addressed in meta-analyses across RCTs. For this to occur, however, consistent EDI categorization is required; a variation challenge identified in this scoping review. Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Response: We have now reduced the details in the section on Characteristics of included trials including some of the text on country of origin, trial design, RCT start dates and duration periods, and the numbers included in the RCTs. Figure 3 has been removed from the manuscript and is now included in Extended File 4 (Figure S4.1). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Response : We have removed the text related to the gender of the infant from the main manuscript, although we have retained illustrative Figures 5-6 (now Figures 4 and 5) in the main paper. Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Response: We have added the following sentence to the start of this section: Of the 247 RCTs, five did not report any of the 12 EDI characteristics. We refrained though from creating a new graphic, as we feel Figure 2, Table 4 and Extended File X collectively help capture the depth of EDI reporting. Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also, if possible, keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Response: We have now added numbers into Figure 4 (now Figure 3) and added in Sexual Orientation. The list is in the same order as Table 2, only from the bottom up (Excel appears to default to this for this type of bar chart) Typo P5 Quality Appraisal: extent not extend Response: Thank you, type corrected Typo P8 There is one “RCTS” that should have a small “S” Response: Thank you, type corrected Competing Interests: No competing interests to declare Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Vanderlaan J. Reviewer Report For: Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.21956/hrbopenres.15378.r44558 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-78/v1#referee-response-44558 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 10 Jan 2025 Jennifer Vanderlaan , University of Nevada Las Vegas, Las Vegas, USA Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15378.r44558 Thank you for the opportunity to read and review this manuscript. The manuscript presents a scoping review of randomized controlled trials of intrapartum interventions to determine the extent to which diversity, equity, and inclusion are incorporated into the studies. I ... Continue reading READ ALL Thank you for the opportunity to read and review this manuscript. The manuscript presents a scoping review of randomized controlled trials of intrapartum interventions to determine the extent to which diversity, equity, and inclusion are incorporated into the studies. I agree this is an important question, and the results highlight opportunities for researchers to improve the study of intrapartum interventions. As this is a scoping review, the authors do not present statistics. The study is presented according to the PRISMA guidelines. Overall I feel this article is unique and contributes to the general knowledge and recommend its publication. Below I query a few minor issues that could be clarified by the authors to assist the readers. The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Not applicable Are the conclusions drawn adequately supported by the results presented in the review? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Midwifery, Maternal Health Services I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Vanderlaan J. Reviewer Report For: Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.21956/hrbopenres.15378.r44558 ) The direct URL for this report is: https://hrbopenresearch.org/articles/7-78/v1#referee-response-44558 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 07 Mar 2025 Valerie Smith , School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, D04, Ireland 07 Mar 2025 Author Response Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your ... Continue reading Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your comments as follows: The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Response: AI was used only for capturing duplicates and not for screening; that is title and abstract screening, and full text screening were undertaken by the reviewer team. We have clarified this by altering the sentence to read: Title and abstract screening of 17,176 records was thus undertaken by a member of the review team and 16,452 records were excluded as ineligible. Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. For Figure 2, we have added (n=240) to the caption, based on the RCTs where country of origin was known. For Figures 5 and 6 (now Figures 4 and 5 based on comments from the second reviewer), we have similarly added the total n RCTs in the Figure captions and added the counts that each % relates to in the Figures. Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your comments as follows: The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Response: AI was used only for capturing duplicates and not for screening; that is title and abstract screening, and full text screening were undertaken by the reviewer team. We have clarified this by altering the sentence to read: Title and abstract screening of 17,176 records was thus undertaken by a member of the review team and 16,452 records were excluded as ineligible. Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. For Figure 2, we have added (n=240) to the caption, based on the RCTs where country of origin was known. For Figures 5 and 6 (now Figures 4 and 5 based on comments from the second reviewer), we have similarly added the total n RCTs in the Figure captions and added the counts that each % relates to in the Figures. Competing Interests: No competing interests to declare Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 07 Mar 2025 Valerie Smith , School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, D04, Ireland 07 Mar 2025 Author Response Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your ... Continue reading Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your comments as follows: The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Response: AI was used only for capturing duplicates and not for screening; that is title and abstract screening, and full text screening were undertaken by the reviewer team. We have clarified this by altering the sentence to read: Title and abstract screening of 17,176 records was thus undertaken by a member of the review team and 16,452 records were excluded as ineligible. Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. For Figure 2, we have added (n=240) to the caption, based on the RCTs where country of origin was known. For Figures 5 and 6 (now Figures 4 and 5 based on comments from the second reviewer), we have similarly added the total n RCTs in the Figure captions and added the counts that each % relates to in the Figures. Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your comments as follows: The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Response: AI was used only for capturing duplicates and not for screening; that is title and abstract screening, and full text screening were undertaken by the reviewer team. We have clarified this by altering the sentence to read: Title and abstract screening of 17,176 records was thus undertaken by a member of the review team and 16,452 records were excluded as ineligible. Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. For Figure 2, we have added (n=240) to the caption, based on the RCTs where country of origin was known. For Figures 5 and 6 (now Figures 4 and 5 based on comments from the second reviewer), we have similarly added the total n RCTs in the Figure captions and added the counts that each % relates to in the Figures. Competing Interests: No competing interests to declare Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 24 Dec 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 2 (revision) 07 Mar 25 Version 1 24 Dec 24 read read Jennifer Vanderlaan , University of Nevada Las Vegas, Las Vegas, USA Lisa Gold , Deakin University, Burwood, Australia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Gold L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 30 Jan 2025 | for Version 1 Lisa Gold , Deakin University, Burwood, Victoria, Australia 0 Views copyright © 2025 Gold L. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This scoping review tells us that – in a sample of 247 intrapartum RCTs reported in the last 5 years – most (?all?) reported some EDI data but there are large gaps in EDI reporting. The most commonly-reported was age (222 RCTs) – really a classic sample characteristic that also serves as an EDI characteristic – and the least commonly reported were sexual orientation (0 RCTs) and religion (3 RCTs). Why are we interested in EDI? The general point is that we need to know the characteristics of trial participants in order to interpret results. This requires EDI data to be reported in sample characteristics. The type of EDI data we are interested in will vary between countries, with the 12 EDI characteristics (Table 2) a logically-selected and comprehensive list that could easily be added to journal/organisational requirements for RCT reporting. A more specific point is that RCT evidence should come from population-representative samples, so a second reason to assess EDI data is to highlight inclusion issues in research. As we already know that pregnant women are a highly-excluded group in research, it is a very good choice in this study to assess EDI in the context where this group is by definition included (ie, intrapartum care). This scoping review addresses both points. A scoping review is appropriate at this early stage of research in this area. This scoping review is an excellent example of the approach, including pre-published protocol (OSF) and following established methods of conduct and reporting (JBI/PRISMA-ScR). The restriction to more recent evidence is entirely appropriate given the timing of increased awareness/focus on EDI and the review demonstrates a model approach to language of publication where research resources are limited (ie, no language restriction in search but exclude from review and discuss impact of this). What do we learn from this review? The results of the scoping review demonstrate variation across EDI characteristics in the extent of reporting, and variation of categorizations within EDI characteristics. Table 4 makes a good point that some EDI (disability) is reported only in the context of inclusion/exclusion criteria. The discussion highlights important considerations for EDI reporting. The section on (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power – at least that this may well be the reason that EDI data is reported in sample characteristics but not used in (sub-group) analysis. This would link nicely into the issue of variance of categorization, as EDI-based sub-group analysis could be addressed more appropriately in meta-analyses across RCTs, but that requires consistent EDI categorization, which is difficult when categorization is country-specific. Minor comments for presentation: Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also if possible keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Typos: P5 Quality Appraisal: extent not extend P8 There is one “RCTS” that should be have a small “S” Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Not applicable Are the conclusions drawn adequately supported by the results presented in the review? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Public Health, Health Economics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 07 Mar 2025 Valerie Smith, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, D04, Ireland Thank you very much for taking the time to review our work and for your thoughtful comments. These are much appreciated. We have edited the original version to address your comments as follows: We are grateful for the point you made about how the (non)use of EDI data in analysis should include cautions around the presentation of sub-group analysis that may be misinterpreted in the context of low statistical power in the Discussion section is valued. We have addressed this with the addition of the following text (Discussion section, end of paragraph 3): Response: Countering this, we acknowledge that reporting of EDI data in sample characteristics but not in sub-group analyses could relate to maintaining statistical power in RCTs, yet EDI-based analyses could be addressed in meta-analyses across RCTs. For this to occur, however, consistent EDI categorization is required; a variation challenge identified in this scoping review. Results: While the benefit of open-source publishing is that you can include more detail in a paper, there is quite a lot of detail presented on the RCT design that is not relevant to the EDI topic and could be edited (Characteristics of included trials) or moved to supplementary material (Figure 3). Response: We have now reduced the details in the section on Characteristics of included trials including some of the text on country of origin, trial design, RCT start dates and duration periods, and the numbers included in the RCTs. Figure 3 has been removed from the manuscript and is now included in Extended File 4 (Figure S4.1). Similarly, there could be less detail presented on the variation of reporting within gender (last paragraph p7) and Table 3 is enough to illustrate this variation in the main paper, with Tables 5-6 and Figures 5-6 moved to supplementary material? Response : We have removed the text related to the gender of the infant from the main manuscript, although we have retained illustrative Figures 5-6 (now Figures 4 and 5) in the main paper. Objectives 1 & 2: please add to first sentence the number (of 247 RCTs) that reported at least one EDI characteristic. Potentially you could also add a graphic of the distribution of the 247 RCTs across the number of EDI characteristics reported, to give a visual representation of the depth of EDI reporting? Response: We have added the following sentence to the start of this section: Of the 247 RCTs, five did not report any of the 12 EDI characteristics. We refrained though from creating a new graphic, as we feel Figure 2, Table 4 and Extended File X collectively help capture the depth of EDI reporting. Figure 4: Please add numbers to Figure 4 – it is a main result to show the number of trials reporting each of the 12 EDI characteristics. Also, if possible, keep it in the same order as Table 2 (and add sexual orientation back in, as n=0). Response: We have now added numbers into Figure 4 (now Figure 3) and added in Sexual Orientation. The list is in the same order as Table 2, only from the bottom up (Excel appears to default to this for this type of bar chart) Typo P5 Quality Appraisal: extent not extend Response: Thank you, type corrected Typo P8 There is one “RCTS” that should have a small “S” Response: Thank you, type corrected View more View less Competing Interests No competing interests to declare reply Respond Report a concern Gold L. Peer Review Report For: Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.21956/hrbopenres.15378.r44825) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/7-78/v1#referee-response-44825 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Vanderlaan J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 10 Jan 2025 | for Version 1 Jennifer Vanderlaan , University of Nevada Las Vegas, Las Vegas, USA 0 Views copyright © 2025 Vanderlaan J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for the opportunity to read and review this manuscript. The manuscript presents a scoping review of randomized controlled trials of intrapartum interventions to determine the extent to which diversity, equity, and inclusion are incorporated into the studies. I agree this is an important question, and the results highlight opportunities for researchers to improve the study of intrapartum interventions. As this is a scoping review, the authors do not present statistics. The study is presented according to the PRISMA guidelines. Overall I feel this article is unique and contributes to the general knowledge and recommend its publication. Below I query a few minor issues that could be clarified by the authors to assist the readers. The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Not applicable Are the conclusions drawn adequately supported by the results presented in the review? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Midwifery, Maternal Health Services I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 07 Mar 2025 Valerie Smith, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, D04, Ireland Thank you very much for taking the time to review our work and for your thoughtful comments which are much appreciated. We have edited the original version to address your comments as follows: The authors indicated that an automated filter was used to remove duplicates and ineligible during the initial article collection. Was AI also used during the Title and abstract screening? Response: AI was used only for capturing duplicates and not for screening; that is title and abstract screening, and full text screening were undertaken by the reviewer team. We have clarified this by altering the sentence to read: Title and abstract screening of 17,176 records was thus undertaken by a member of the review team and 16,452 records were excluded as ineligible. Some of the figures lack the information needed to interpret the figure. The caption for figure 2 does not include the total n. Figures 5 and 6 present only percentages without the count or total n to help the reader interpret the result. For Figure 2, we have added (n=240) to the caption, based on the RCTs where country of origin was known. For Figures 5 and 6 (now Figures 4 and 5 based on comments from the second reviewer), we have similarly added the total n RCTs in the Figure captions and added the counts that each % relates to in the Figures. View more View less Competing Interests No competing interests to declare reply Respond Report a concern Vanderlaan J. Peer Review Report For: Equality, Diversity and Inclusion characteristics measured or reported in randomised trials of intrapartum interventions: A Scoping Review [version 2; peer review: 2 approved] . HRB Open Res 2025, 7 :78 ( https://doi.org/10.21956/hrbopenres.15378.r44558) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/7-78/v1#referee-response-44558 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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