Association between fluid intake and labor: a cross-sectional study

Abstract

Introduction: Ingestion during labor is an issue that has attracted the attention of the scientific community in recent decades, with different practices in different countries [1]. However, the influence of fluid intake scientific evidence in labor is still not fully understood [2]. The aim of this study was to evaluate the association between the amount of fluid ingested during labor and the type of delivery, duration of labor, occurrence of nausea and vomiting and value of the Apgar Index at the 1st and 5th minutes of the newborn’s life.

Materials and methods: A cross-sectional study included 144 parturient from two Portuguese Hospitals (Hospital Garcia de Orta and Hospital Nossa Srª do Rosário). This study was authorized by Data Protection National Commission (CNPD), approved by Hospitals Committee and Ethics Committee of Cooperativa de Ensino Superior Egas Moniz, and carried out in accordance with the Helsinki Declaration of 1975 as revised in 2000. A written informed consent was obtained from each participant. All parturient included were at least 37 weeks of gestation, primiparous, with fetus in cephalic presentation, with onset of spontaneous labor, at the beginning of the active phase (>4 cm of dilatation). Were excluded women with associated pathologies, previous pregnancy, pregnancies of medium or high risk and, that develop problems along the labor, such as hyperthermia, hypotension, hypoglycemia, fetuses with cardiotocographic alterations and newborns with tight cervical loops at birth. The logistic regression model, correlation coefficient of Spearman and logistic regression discriminant analysis was applied to data analysis.

Results: Analysis revealed that the probability of occurrence of a dystocic birth does not depend on the amount of liquid ingested (ρ = 0.711). Additionally, there was a weak correlation between liquid ingestion and duration of labor (ρ = 0.269), but positive and significant (ρ = 0.001), it means, the higher the amount of water the longer the duration of labor; The results also reveal that the increased of fluid intake during labor increases the chance of nausea and vomiting 1.005 per mL of fluid ingested (ρ = 0.002). It was not observed a predictive effect of Apgar Index at 1st and 5th minutes of the newborn’s life (ρ = 0.196 and ρ = 0.612, respectively).

Discussion and conclusions: This study reinforces that the ingestion of fluid during labor does not have a predictive effect of dysthymia, or negative consequences for the newborn, which is according with other studies [1]. However, for this sample, the chance of occurrence of nausea and vomiting significantly increases with fluid ingestion during labor.