Early oral feeding within two hours for parturients compared with delayed oral feeding after cesarean section: a systematic review and meta-analysis.

Background: It is recommended that postpartum women undergo early oral feeding (EOF) after cesarean section (CS). However, the optimal early time for oral feeding after CS is unclear. We performed a meta-analysis to assess whether EOF within two hours is superior to delayed oral feeding (DOF) after CS.

Methods: The PubMed, Embase, Cochrane Library, and Google Scholar databases were searched from inception to February 2024 for randomized controlled trials comparing EOF versus DOF after CS. Primary outcomes included the time to normal bowel function. The secondary outcomes included postoperative complications, the time to ambulation after surgery, the time to removal of the catheter, the time to start of a regular diet, the length of hospital stay and patient satisfaction.

Results: Data from 8 studies involving a total of 2572 women were obtained. EOF within two hours was significantly associated with shorter durations of return bowel movement (WMD, - 2.41, 95% CI, - 3.80-- 1.02; p < 0.001; I² = 96%), passage flatus after surgery (WMD, - 3.55, 95% CI, - 6.36-- 0.75; p = 0.01; I² = 98%), ambulation after surgery (WMD, - 0.96, 95% CI, - 1.80-- 0.13; p = 0.02; I² = 53%), removal of catheters (WMD, - 15.18, 95% CI, - 25.61-- 4.74; p = 0.004; I² = 100%) and starting a regular diet (WMD, - 7.03, 95% CI, - 13.13-- 0.92; p = 0.02; I² = 99%) compared with DOF. EOF was not related to increased vomiting (RR, 1.08; 95% CI, 0.74-1.57; p = 0.69; I² = 0%), nausea (RR, 1.21; 95% CI, 0.83-1.77; p = 0.33; I² = 37%), abdominal distension (RR, 0.76; 95% CI, 0.31-1.89; p = 0.55; I² = 54%) or ileus (RR, 0.91; 95% CI, 0.40-2.06; p = 0.81; I² = 12%).

Conclusions: This meta-analysis provides evidence that EOF within two hours after CS has comparable safety with DOF, and can accelerate the recovery time for normal bowel function.

Trial registration: INPLASY202320055.