• Anesthesia and analgesia · Jun 2020

    Randomized Controlled Trial Multicenter Study

    Effect of Oral Carbohydrate Intake During Labor on the Rate of Instrumental Vaginal Delivery: A Multicenter, Randomized Controlled Trial.

    Oral carbohydrate consumption during labour did not alter the rate of instrumental delivery or cesarean section, vomiting incidence, nor self-reported hunger, thirst, fatigue, stress or overall well-being.

    pearl
    • Thérèse Simonet, Clément Gakuba, Isabelle Desmeulles, Julien Corouge, Gael Beucher, Rémi Morello, Jean-Louis Gérard, Anne Sophie Ducloy-Bouthors, Michel Dreyfus, and Jean-Luc Hanouz.
    • From the Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Caen, France.
    • Anesth. Analg. 2020 Jun 1; 130 (6): 1670-1677.

    BackgroundCarbohydrate intake during physical exercise improves muscle performance and decreases fatigue. We hypothesized that carbohydrate intake during labor, which is a period of significant physical activity, can decrease the instrumental vaginal delivery rate.MethodsIn a multicenter, prospective, randomized, controlled trial, healthy adult pregnant women presenting with spontaneous labor were assigned to a "Carbohydrate" group (advised to drink 200 mL of apple or grape juice without pulp every 3 hours) or a "Fasting" group (water only). The primary outcome was the instrumental vaginal delivery rate. Secondary outcomes included duration of labor, rate of cesarean delivery, evaluation of maternal hunger, thirst, stress, fatigue, and overall feeling during labor by numeric rating scale (0 worst rating to 10 best rating), rate of vomiting, and hospital length of stay. Statistical analysis was performed on an intention-to-treat basis. The primary outcome was tested with the "Fasting" group as the reference group. The P values for secondary outcomes were adjusted for multiple comparisons. The differences between groups are reported with 99% confidence interval (CI).ResultsA total of 3984 women were analyzed (2014 in the Carbohydrate group and 1970 in the Fasting group). There was no difference in the rate of instrumental delivery between the Carbohydrate (21.0%) and the Fasting (22.4%) groups (difference, -1.4%; 99% CI, -4.9 to 2.2). No differences were found between the Carbohydrate and the Fasting groups for the duration of labor (difference, -7 minutes; 99% CI, -25 to 11), the rate of cesarean delivery (difference, -0.3%; 99% CI, -2.4 to 3.0), the rate of vomiting (difference, 2.8%; 99% CI, 0.2-5.7), the degree of self-reported fatigue (difference, 1; 99% CI, 0-2), self-reported hunger (difference, 0; 99% CI, -1 to 1), thirst (difference, 0; 99% CI, -1 to 1), stress (difference, 0; 99% CI, -1 to 1), overall feeling (difference, 0; 99% CI, 0-0), and the length of hospitalization (difference, 0; 99% CI, -1 to 0).ConclusionsCarbohydrate intake during labor did not modify the rate of instrumental vaginal delivery.

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    pearl
    1

    Oral carbohydrate consumption during labour did not alter the rate of instrumental delivery or cesarean section, vomiting incidence, nor self-reported hunger, thirst, fatigue, stress or overall well-being.

    Daniel Jolley  Daniel Jolley
     
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