Effect of food intake during labour on obstetric outcome: randomised controlled trial

Abstract

Objective To investigate the effect of feeding during labour on obstetric and neonatal outcomes. Design Prospective randomised controlled trial. Setting Birth centre in London teaching hospital. Participants 2426 nulliparous, non-diabetic women at term, with a singleton cephalic presenting fetus and in labour with a cervical dilatation of less than 6 cm. Intervention Consumption of a light diet or water during labour. Main outcome measures The primary outcome measure was spontaneous vaginal delivery rate. Other outcomes measured included duration of labour, need for augmentation of labour, instrumental and caesarean delivery rates, incidence of vomiting, and neonatal outcome. Results The spontaneous vaginal delivery rate was the same in both groups (44%; relative risk 0.99, 95% confidence interval 0.90 to 1.08). No clinically important differences were found in the duration of labour (geometric mean: eating, 597 min v water, 612 min; ratio of geometric means 0.98, 95% confidence interval 0.93 to 1.03), the caesarean delivery rate (30% v 30%; relative risk 0.99, 0.87 to 1.12), or the incidence of vomiting (35% v 34%; relative risk 1.05, 0.9 to 1.2). Neonatal outcomes were also similar.

Effect of continuous support during labor on duration of labor and rate of cesarean delivery

“…Another study showed that food intake during labor did not increase the rate of maternal and fetal complications, or vomiting [13]. Duration of labor and number of operative deliveries were similar among women who were allowed to eat and those who only drank water during labor.…”

First Do No Harm: Interventions During Childbirth

“…The American College of Nurse-Midwives (2008) encourages the provision of nutrition to low-risk patients in labor to prevent ketosis and other problems associated with keeping a patient on a nothing by mouth (NPO) diet. Oral nutrition during labor does not influence either obstetric or neonatal outcomes (O'Sullivan, Liu, Hart, Seed, & Shennan, 2009). Another intervention as common as limiting oral intake from the woman is frequent vaginal examinations.…”

What’s new in obstetric anesthesia: the 2011 Gerard W. Ostheimer lecture

“…57,58 To date, five randomized controlled trials have evaluated labor outcomes following liquid or solid oral intake in lowrisk laboring women. [59][60][61][62][63] A Cochrane review of these studies (pooled n = 3130) found that there was no difference in the rate of cesarean delivery (average risk ratio 0.89, 95% CI: 0.63-1.25), operative deliveries (average risk ratio 0.98, 95% CI: 0.88-1.10), or Apgar scores < 7 at 5-min (average risk ratio 1.43, 95% CI: 0.77-2.68) between parturients allowed oral intake and those who had oral fluid restrictions. 64 The review did not identify evidence of harm from allowing oral intake, and therefore concluded that eating/drinking should be allowed during labor.…”