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Does oral carbohydrate supplementation improve labour outcome? A systematic review and individual patient data meta-analysis.

Malin, G.L.; Bugg, G.J.; Thornton, J.; Taylor, M.A.; Grauwen, N.; Devlieger, R.; Kardel, K.R.; Kubli, M.; Tranmer, J.E.; Jones, N.W.


G.L. Malin

G.J. Bugg

J. Thornton

N. Grauwen

R. Devlieger

K.R. Kardel

M. Kubli

J.E. Tranmer


Background: Labour is a period of significant physical activity. The importance of carbohydrate intake to improve outcome has been recognised in sports medicine and general surgery.
Objectives: To assess the effect of oral carbohydratesupplementation on labour outcomes.
Search strategy: MEDLINE (1966–2014), Embase, the CochraneLibrary and clinical trial registries.
Selection criteria: Randomised controlled trials (RCT) of womenrandomised to receive oral carbohydrate in labour (less than 6 cm dilated), versus placebo or standard care.
Data collection and analysis: Authors were contacted to provide data. Individual patient data meta-analyses were performed to calculate pooled risk ratios (RR) and 95% confidence intervals (CI).
Main results: Eight RCTs met the inclusion criteria. Six authors responded, four supplied data (n=691). Three studies used isotonic drinks (one placebo-controlled, two compared with standard care), and one an advice booklet regarding carbohydrate intake. The mean difference in energy intake between the intervention and control groups was small [three studies, 195 kilocalories (kcal), 95% CI 118–273]. There was no difference in the risk of caesarean section (RR 1.15, 95% CI 0.83–1.61), instrumental birth (RR 1.26, 95% CI 0.96–1.66) or syntocinon augmentation (RR 0.99, 95% CI 0.86–1.13). Length of labour was similar (mean difference 3.15 minutes, 95% CI 35.14 to 41.95). Restricting the analysis to primigravid women did not affect the result. Oral carbohydrates did not increase the risk of vomiting (RR 1.09, 95% CI 0.78=1.52) or 1-minute Apgar score less than 7 (RR 1.23, 95% CI 0.82–1.83).
Authors’ conclusion: Oral carbohydrate supplements in small quantities did not alter labour outcome.

Journal Article Type Article
Acceptance Date Sep 6, 2015
Online Publication Date Feb 23, 2016
Publication Date Mar 1, 2016
Deposit Date Apr 13, 2018
Journal BJOG: An International Journal of Obstetrics and Gynaecology
Print ISSN 1470-0328
Electronic ISSN 1471-0528
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 123
Issue 4
Pages 510-517
Public URL
Publisher URL
PMID 26914893