Should we restrict food intake during labor? A randomized controlled trial

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Nutrition

Background:

• Historically, food intake during labor was restricted due to concerns about aspiration and its impact on labor progress.
• Current evidence is limited, necessitating further investigation into the safety and efficacy of allowing food consumption during labor.

Purpose of the Study:

• To determine if consuming food during labor influences labor outcomes in healthy, low-risk pregnancies.
• To compare the incidence of adverse composite outcomes between laboring patients who eat freely versus those restricted to clear fluids.

Main Methods:

• A randomized controlled trial involving 129 healthy pregnant patients (37-41 weeks gestation) after epidural anesthesia.
• Patients were randomized to either consume food freely or adhere to a clear fluids-only diet during labor.
• The primary composite outcome included unplanned cesarean delivery, general anesthesia, asphyxia, postpartum fever, and prolonged postpartum admission.

Main Results:

• No significant difference in the primary composite outcome was observed between the food-consuming group (n=71) and the clear fluids-only group (n=58).
• Labor progression, need for oxytocin, fetal heart rate tracings, and maternal/neonatal outcomes were comparable between the groups.
• No cases of aspiration or need for general anesthesia occurred in either group.

Conclusions:

• Consuming food during labor in healthy, low-risk pregnancies does not appear to adversely affect labor progression or key maternal and neonatal outcomes.
• The findings support a more liberal approach to oral intake during labor, emphasizing patient autonomy while acknowledging individual risk factors.