Sports Drink vs Water for Pregnant Women in Labor

Age: 18 - 65

Sex: Female

Trial Phase: Academic

Sponsor: Beth Israel Deaconess Medical Center

Must not be taking: Narcotics, Magnesium sulfate

Disqualifiers: Preeclampsia, Diabetes, Multiple gestations, others

Compensation: Varies

Number of Visits: 1

Duration: 60 minutes

108 Participants Needed

Trial Summary

What is the purpose of this trial?

To determine the half time of the emptying of the stomach of women in early labor with and without epidural pain relief when drinking either water or a carbohydrate-based sports drink.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes those who have received narcotics within 12 hours or are receiving magnesium sulfate.

What data supports the effectiveness of the treatment Sports Drink vs Water for Pregnant Women in Labor?

Research shows that drinks containing carbohydrates and electrolytes, like sports drinks, can help maintain hydration and physical performance during exercise, which may suggest they could be beneficial for hydration during labor as well. ^{1 2 3 4 5}

Is it safe for humans to consume sports drinks?

Sports drinks, which are often used to maintain hydration and improve performance, are generally considered safe for human consumption. However, they can add extra calories to the diet, which may not be necessary for typical physical activities, especially in adolescents. ^{1 3 6 7 8}

How does drinking sports drinks during labor differ from other treatments for hydration?

Drinking sports drinks during labor is unique because it provides carbohydrates, which can improve muscle performance and reduce fatigue, unlike plain water that may lead to water intoxication if consumed excessively. This approach is inspired by sports medicine, where carbohydrate intake is known to enhance physical performance. ^{9 10 11 12 13}

Eligibility Criteria

This trial is for pregnant women who are at least 36 weeks along, have a single baby, and are either being induced or in early labor with less than 6cm dilation. They should be relatively healthy as judged by anesthesiology standards.

Inclusion Criteria

Singleton gestation

Induction of labor or early labor (cervical dilation < 6cm)

I have a mild to severe systemic disease.

Exclusion Criteria

Recent food ingestion (<3 hours)

Having received narcotics within 12 hours

I have diabetes.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants in early labor will ingest either 100 ml of water or a carbohydrate sports drink, and gastric emptying will be measured using ultrasound over 60 minutes.

60 minutes

1 visit (in-person)

Follow-up

Participants are monitored for hunger levels using a visual analogue scale for up to two hours after ingestion.

2 hours

Treatment Details

Interventions

• Sports drink
• Water

Trial Overview The study aims to compare how fast the stomach empties when drinking water versus a carbohydrate-based sports drink during early labor, with and without epidural pain relief.

Participant Groups

Group I: Early labor, analgesia: Sports drink Active Control 1 Intervention

Subject will ingest 100 ml of a carbohydrate sports drink

Group II: Early labor, no analgesia: Sports drink Active Control 1 Intervention

Subject will ingest 100 ml of a carbohydrate sports drink

Group III: Early labor, analgesia: Water Placebo Group 1 Intervention

Subject will ingest 100 ml of water

Group IV: Early Labor, no analgesia: Water Placebo Group 1 Intervention

Subject will ingest 100 ml of water

Who Is Running the Clinical Trial?

Beth Israel Deaconess Medical Center

Lead Sponsor

Trials

872

Recruited

12,930,000+

Findings from Research

Coconut water, whether pure or from concentrate, is as effective as traditional carbohydrate-electrolyte sports drinks in promoting rehydration and supporting exercise performance after dehydration, based on a study with 12 exercise-trained men.

Participants reported feeling more bloated and experienced greater stomach upset after consuming coconut water compared to other beverages, indicating potential discomfort despite similar hydration outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men. Kalman, DS., Feldman, S., Krieger, DR., et al.[2021]

Rehydration solutions that contain water, carbohydrates, and electrolytes are most effective for recovering from dehydration, as they enhance the absorption of fluids and nutrients.

Properly balanced rehydration beverages not only restore electrolyte balance and carbohydrates but also improve physical endurance and reduce stress during recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Dehydration and rehydration of the human body. Physiopathologic and clinical considerations]. Formenti, A., Vittadini, G.[2006]

In a study involving 50 adult triathletes and runners, a commercially available 6% carbohydrate-electrolyte sports beverage (CCE) was found to be the most palatable and consumed the most during exercise compared to diluted orange juice (DOJ), homemade sports beverage (HCE), and water (W).

The results suggest that beverage palatability significantly influences voluntary intake during exercise, with CCE being preferred over other options, which could impact hydration and energy replenishment strategies for athletes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Palatability and voluntary intake of sports beverages, diluted orange juice, and water during exercise. Passe, DH., Horn, M., Stofan, J., et al.[2019]

In a study involving 14 middle-aged men, hydration with plain water or sports drinks did not improve work capacity during 90 minutes of indoor cycling compared to no liquid intake, indicating that hydration does not affect performance in this context.

Body temperature was found to be the most sensitive indicator of hydration status during exercise, with significant increases in body temperature, heart rate, and mean blood pressure observed when no liquids were consumed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute physiological response to indoor cycling with and without hydration; case and self-control study. Ramos-Jiménez, A., Hernández-Torres, RP., Wall-Medrano, A., et al.[2013]

In a study with seven trained cyclists exercising in heat for 120 minutes, rehydrating with commercial sports drinks (Gatorade and Powerade) significantly preserved leg power and force compared to not drinking anything (DEH), while water and a low-sodium drink did not provide the same benefits.

Cyclists who did not hydrate lost more body mass and had higher body temperatures, indicating that rehydration is crucial for maintaining performance in hot conditions, but the sodium content in sports drinks plays a key role in their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anaerobic performance when rehydrating with water or commercially available sports drinks during prolonged exercise in the heat. Coso, JD., Estevez, E., Baquero, RA., et al.[2016]

Nearly 60% of adolescents regularly consume sports drinks, which were originally designed for elite athletes to enhance performance and prevent dehydration, heat stroke, and muscle cramps.

There is a need for better education and counseling on the appropriate use of sports drinks, as current marketing often misleads consumers about their health benefits and the level of physical activity required for their proper use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Approaches to Reduce Sports Drink Consumption Among Adolescents. White, ND.[2020]

A 6.5% isomaltulose-electrolyte beverage significantly improved postexercise hydration by increasing plasma volume compared to a 2% solution or water, as shown in a study with 10 young healthy men after exercise-induced dehydration.

Despite enhancing hydration, the 6.5% isomaltulose beverage did not affect physiological heat loss responses, indicating it can be effective for rehydration without compromising the body's ability to cool itself during heat stress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of isomaltulose ingestion on postexercise hydration state and heat loss responses in young men. Amano, T., Sugiyama, Y., Okumura, J., et al.[2020]

A study of over 15,000 high school students showed that while overall daily consumption of sports drinks has decreased, 57.6% reported consuming them at least weekly, indicating their continued popularity among teens.

Concerns arise as daily consumption of sports drinks increased among teenagers who watch more than 2 hours of television per day, highlighting a potential link between sedentary behavior and unhealthy beverage choices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adolescent Consumption of Sports Drinks. Cordrey, K., Keim, SA., Milanaik, R., et al.[2021]

In a study of 60 women in early labor, those who consumed isotonic sport drinks showed reduced maternal ketosis compared to those who only drank water, indicating a potential benefit for metabolic stability during labor.

Both groups had similar gastric residual volumes and rates of vomiting, suggesting that isotonic drinks can be safely consumed during labor without increasing the risk of complications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evaluation of isotonic "sport drinks" during labor. Kubli, M., Scrutton, MJ., Seed, PT., et al.[2022]

A systematic review of 8 randomized controlled trials involving 691 women found that oral carbohydrate supplementation during labor did not significantly change outcomes such as the risk of cesarean section or length of labor.

The study showed that small amounts of oral carbohydrates did not increase the risk of complications like vomiting or low Apgar scores, indicating that they are safe to use during labor without affecting the overall labor process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does oral carbohydrate supplementation improve labour outcome? A systematic review and individual patient data meta-analysis. Malin, GL., Bugg, GJ., Thornton, J., et al.[2018]

In a study involving 3984 healthy pregnant women, carbohydrate intake during labor (through juice every 3 hours) did not significantly reduce the rate of instrumental vaginal deliveries compared to fasting (water only).

There were no notable differences in secondary outcomes such as duration of labor, cesarean delivery rates, or maternal self-reported experiences of hunger, thirst, stress, or fatigue between the carbohydrate and fasting groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Oral Carbohydrate Intake During Labor on the Rate of Instrumental Vaginal Delivery: A Multicenter, Randomized Controlled Trial. Simonet, T., Gakuba, C., Desmeulles, I., et al.[2020]

A study of 142 pregnant women showed that total fluid intake (TFI) increased throughout pregnancy, but a significant majority (over 85%) did not meet the recommended fluid intake levels in all three trimesters, indicating a widespread issue with hydration during pregnancy.

The research found a moderate negative correlation between urine osmolality and TFI, suggesting that higher fluid intake is associated with better hydration status, highlighting the need for improved fluid intake strategies and health education for pregnant women.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Amount of Fluid Intake among Pregnant Women in China Increases with Pregnancy Progression: A Prospective Cohort Study. Song, Y., Zhang, F., Wang, X., et al.[2023]

Excessive water intake during labor can lead to life-threatening hyponatraemia in both mothers and newborns, as demonstrated in a case involving four term infants and one mother.

The study emphasizes the need for awareness and guidelines in delivery units to prevent and manage perinatal water intoxication, which can present symptoms similar to pre-eclampsia or dehydration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perinatal water intoxication due to excessive oral intake during labour. Johansson, S., Lindow, S., Kapadia, H., et al.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Comparison of coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men. [2021]

2. Italy pubmed.ncbi.nlm.nih.gov

[Dehydration and rehydration of the human body. Physiopathologic and clinical considerations]. [2006]

3. United States pubmed.ncbi.nlm.nih.gov

Palatability and voluntary intake of sports beverages, diluted orange juice, and water during exercise. [2019]

4. Spain pubmed.ncbi.nlm.nih.gov

Acute physiological response to indoor cycling with and without hydration; case and self-control study. [2013]

5. Canada pubmed.ncbi.nlm.nih.gov

Anaerobic performance when rehydrating with water or commercially available sports drinks during prolonged exercise in the heat. [2016]

6. United States pubmed.ncbi.nlm.nih.gov

Approaches to Reduce Sports Drink Consumption Among Adolescents. [2020]

7. England pubmed.ncbi.nlm.nih.gov

Effects of isomaltulose ingestion on postexercise hydration state and heat loss responses in young men. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Adolescent Consumption of Sports Drinks. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

An evaluation of isotonic "sport drinks" during labor. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Does oral carbohydrate supplementation improve labour outcome? A systematic review and individual patient data meta-analysis. [2018]

11. United States pubmed.ncbi.nlm.nih.gov

Effect of Oral Carbohydrate Intake During Labor on the Rate of Instrumental Vaginal Delivery: A Multicenter, Randomized Controlled Trial. [2020]

12. Switzerland pubmed.ncbi.nlm.nih.gov

The Amount of Fluid Intake among Pregnant Women in China Increases with Pregnancy Progression: A Prospective Cohort Study. [2023]

13. Norway pubmed.ncbi.nlm.nih.gov

Perinatal water intoxication due to excessive oral intake during labour. [2019]