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.

Abstract

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
• DOI: https://doi.org/10.1111/1471-0528.13728
• Public URL: https://nottingham-repository.worktribe.com/output/1113906
• Publisher URL: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.13728
• PMID: 26914893