The effect of unrestricted oral carbohydrate intake on labor progress.
OBJECTIVE
To determine if unrestricted oral carbohydrate intake during labor reduced the incidence of dystocia in low-risk nulliparous women.


METHODS
A randomized clinical trial at a university-affiliated hospital in southeastern Ontario. Low-risk nulliparous women were randomized between 30 and 40 weeks gestation to either an intervention or usual care group.


METHODS
Women in the intervention group received, prenatally, guidelines about food and fluid intake during labor and were encouraged to eat and drink as they pleased during labor. Women in the usual care group received no prelabor information and were restricted to ice chips and water during labor in the hospital.


METHODS
The incidence of dystocia, defined as a cervical dilatation rate of less than 0.5 cm/hr for a period of 4 hrs after a cervical dilatation of 3 cm.


RESULTS
Three hundred twenty-eight women were randomized to the intervention (n = 163) or usual care (n = 165) groups. Women in the intervention group reported a significantly different pattern of oral intake during early labor in the hospital (chi(2) = 40.7, p < .001). The incidence of dystocia was 36% (n = 58) in the intervention group and 44% (n = 72) in the usual care group and was not significantly different (OR = 0.71, 95% CI = 0.46, 1.11). There were no significant differences in the other secondary outcomes or in the incidence of adverse maternal or neonatal complications.


CONCLUSIONS
Eating and drinking early in labor had no significant impact on the incidence of dystocia and/or adverse maternal or neonatal outcomes.
Tranmer
Joan E
JE
Nursing Research Unit, Kingston General Hospital, Kingston, Ontario, Canada K7L 2V7. tranmerj@KGH.KARI.NET
Hodnett
Ellen D
ED
Hannah
Mary E
ME
Stevens
Bonnie J
BJ
D000328:Adult; D016001:Confidence Intervals; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000378:metabolism; D004420:Dystocia / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000378:metabolism*; D009773:Obstetric Nursing / Q000592:standards*; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D039401:Prenatal Nutritional Physiological Phenomena; D013997:Time Factors
D004040:Dietary Carbohydrates