Absence of oral intake during labour: frequency and determinants in a national population-based study

Fasting during labour has adverse maternal and neonatal effects, and oral intake has many potential benefits. We aimed to describe the frequency and determinants of absence of oral intake during labour using population-based data.

Women from the 2021 French National Perinatal Survey who laboured and responded to the question 'Did you drink or eat during labour, i.e., in the delivery room?' were included. We investigated factors associated with absence of oral intake, using multivariable analyses stratified by use of neuraxial analgesia.

Among 10 192 labouring women, 41.0% (95% confidence interval 40.0%-41.9%) had no oral intake, 52.4% (51.4%-53.4%) only drank, and 6.6% (6.1%-7.1%) ate. Among women with neuraxial analgesia, factors associated with absence of oral intake included low education level (1.17, 1.01-1.35), Sub-Saharan African origin (1.58, 1.19-2.09), and absence of a dedicated maternity anaesthesiologist (1.46, 1.20-1.76). Among women without neuraxial analgesia, factors included maternal age <30 yr (1.47, 1.09-1.98), overweight (1.49, 1.09-2.03), and multiparity (1.35, 1.00-1.85). Factors associated with both groups were prior Caesarean delivery, social deprivation, absence of a close relative at birth, absence of a room dedicated to physiologic birth and delivery in a private maternity unit.

Women with sociodemographic vulnerabilities had reduced oral intake during labour. Implementation of oral intake guidelines should be improved, particularly in private maternity units and those without a dedicated maternity anaesthesiologist or rooms dedicated to physiologic birth.