Less restrictive food consumption during labor in nulliparous habitual risk patients and obstetric outcomes: A systematic review

Abstract

Objective

Childbirth is a natural process, and according to the World Health Organization, oral intake is recommended for patients at usual risk. However, due to rare cases of pulmonary aspiration (known as Mendelson's syndrome) during general anesthesia and the limited evidence supporting its benefits, this practice remains controversial. This systematic review summarizes evidence on interventions that recommend oral intake during labor compared to fasting, focusing on labor duration and perinatal complications.

Sources

A literature search across PubMed, EMBASE, Lilacs, and Scielo identified randomized clinical trials involving habitual-risk patients, nulliparous women receiving oral diet interventions during labor. The RoB 2.0 tool was used to assess bias.

Summary of the findings

Six studies (3,333 patients) were included, with three showing low risk of bias. Patients in the intervention group were allowed to eat, while the control group only had access to water, ice chips, and non-energy drinks. Food intake was found to correlate with significantly shorter labor duration in one study (P < 0.01), while no significant differences were observed in the others. No outcome variations (such as epidural anesthesia, lower Apgar scores, vomiting, or nausea) or cases of aspiration or Mendelson's syndrome were reported.

Conclusions

Only one study found a significant difference in labor duration when offering a diet during labor to patients at usual risk compared to fasting. No differences were observed in other perinatal outcomes between the intervention and control groups.