title: Does oral carbohydrate supplementation improve labour outcome? A systematic review and individual patient data meta-analysis.
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.
  
  
  OBJECTIVE
  To assess the effect of oral carbohydrate supplementation on labour outcomes.
  
  
  METHODS
  MEDLINE (1966-2014), Embase, the Cochrane Library and clinical trial registries.
  
  
  METHODS
  Randomised controlled trials (RCT) of women randomised to receive oral carbohydrate in labour (<6 cm dilated), versus placebo or standard care.
  
  
  METHODS
  Authors were contacted to provide data. Individual patient data meta-analyses were performed to calculate pooled risk ratios (RR) and 95% confidence intervals (CI).
  
  
  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 <7 (RR 1.23, 95% CI 0.82-1.83).
  
  
  CONCLUSIONS
  Oral carbohydrate supplements in small quantities did not alter labour outcome.
  
  
  CONCLUSIONS
  Oral carbohydrate does not affect labour. But the difference between intervention and control equals 10 teaspoons sugar.
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: G L
authors.initials: GL
authors.lastname: Malin
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.|Department of Obstetrics, Queen's Medical Centre, Nottingham University Hospitals NHS Trust UK, Nottingham, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Bugg
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Thornton
authors.affiliation: School of Life Sciences, University of Nottingham, Nottingham, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Taylor
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals KU, Leuven, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Grauwen
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals KU, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Devlieger
authors.affiliation: Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: K R
authors.initials: KR
authors.lastname: Kardel
authors.affiliation: Department of Anaesthetics, Ashford and St Peters Hospital NHS Trust UK, Ashford, UK.
authors.forename: M
authors.initials: M
authors.lastname: Kubli
authors.affiliation: School of Nursing and Department of Health Sciences, Queen's University, Kingston, ON, Canada.
authors.forename: J E
authors.initials: JE
authors.lastname: Tranmer
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: N W
authors.initials: NW
authors.lastname: Jones
mesh_terms: D000284:Administration, Oral; D000328:Adult; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000378:metabolism*; D019587:Dietary Supplements; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000378:metabolism / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic
chemical_list: D004040:Dietary Carbohydrates
keywords: Carbohydrates; individual patient data meta-analysis; labour outcome