Malin G L, Bugg G J, Thornton J, Taylor M A, Grauwen N, Devlieger R, Kardel K R, Kubli M, Tranmer J E, Jones N W
School of Medicine, University of Nottingham, Nottingham, UK.
Department of Obstetrics, Queen's Medical Centre, Nottingham University Hospitals NHS Trust UK, Nottingham, UK.
BJOG. 2016 Mar;123(4):510-7. doi: 10.1111/1471-0528.13728.
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.
To assess the effect of oral carbohydrate supplementation on labour outcomes.
MEDLINE (1966-2014), Embase, the Cochrane Library and clinical trial registries.
Randomised controlled trials (RCT) of women randomised to receive oral carbohydrate in labour (<6 cm dilated), versus placebo or standard care.
Authors were contacted to provide data. Individual patient data meta-analyses were performed to calculate pooled risk ratios (RR) and 95% confidence intervals (CI).
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).
AUTHORS' CONCLUSION: Oral carbohydrate supplements in small quantities did not alter labour outcome.
Oral carbohydrate does not affect labour. But the difference between intervention and control equals 10 teaspoons sugar.
分娩是一段体力消耗巨大的时期。碳水化合物摄入对改善结局的重要性已在运动医学和普通外科中得到认可。
评估口服补充碳水化合物对分娩结局的影响。
检索MEDLINE（1966 - 2014年）、Embase、Cochrane图书馆及临床试验注册库。
将分娩时（宫颈扩张<6厘米）随机接受口服碳水化合物的女性与接受安慰剂或标准护理的女性进行比较的随机对照试验（RCT）。
联系作者获取数据。进行个体患者数据荟萃分析以计算合并风险比（RR）和95%置信区间（CI）。
八项RCT符合纳入标准。六位作者回复，四位提供了数据（n = 691）。三项研究使用等渗饮料（一项为安慰剂对照，两项与标准护理比较），一项使用关于碳水化合物摄入的建议手册。干预组与对照组之间的能量摄入平均差异较小[三项研究，195千卡（kcal），95% CI 118 - 273]。剖宫产风险（RR 1.15，95% CI 0.83 - 1.61）、器械助产（RR 1.26，95% CI 0.96 - 1.66）或缩宫素加强宫缩（RR 0.99，95% CI 0.86 - 1.13）无差异。产程长度相似（平均差异 - 3.15分钟，95% CI - 35.14至41.95）。将分析限于初产妇不影响结果。口服碳水化合物未增加呕吐风险（RR 1.09，95% CI 0.78 - 1.52）或1分钟阿氏评分<7的风险（RR 1.23，95% CI 0.82 - 1.83）。
少量口服碳水化合物补充剂不会改变分娩结局。
口服碳水化合物不影响分娩。但干预组与对照组的差异相当于10茶匙糖。
