Effect of postoperative coffee consumption on gastrointestinal function after cesarean section, a systematic review and meta-analysis of randomized controlled trials

Existing research on the impact of coffee consumption on post-cesarean section gastrointestinal function has yielded inconclusive results. Therefore, this systematic review and meta-analysis aim to evaluate the effects of postoperative coffee consumption on the recovery of gastrointestinal function in women undergoing cesarean delivery. Randomized controlled trials comparing the effects of coffee consumption and other care methods after planned cesarean section on the recovery of gastrointestinal function were included. Studies including women who underwent planned cesarean delivery were eligible, whereas those involving emergency cesarean sections, non-randomized designs, or participants with coffee intolerance were excluded. Pertinent studies were searched in PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, Chinese National Knowledge Infrastructure (CNKI), Wan Fang and VIP Database, spanning from their inception dates until December 2025. Cochrane Risk of bias instrument was used to assess the quality of included studies. The data analysis was conducted using the Review Manager (Rev Man) version 5.3 software. Subgroup analysis was presented if heterogeneity was observed among the studies. Egger’s regression test was used to evaluated the publication bias. A total of 6 RCTs (n =555 participants) conducted in Iran and Turkey published between 2017 and 2024 were included in the analysis. The sample sizes in the coffee and control groups ranged from 18 to 95 participants, with ages similar in both groups, spanning from 27 to 31 years old. The intervention involved both caffeinated and decaffeinated coffee, which was administered three times daily following surgery, with access restricted at other times. In most studies, the volume of coffee consumed was standardized at 100 ml. The minimum postoperative duration before the first intervention beverage was 2 hours, while the maximum interval was 8 hours. The control groups in most studies consisted of either water or routine care. Estimates from the meta-analysis revealed that coffee consumption reduced the time to first flatus by 2.75h (95%CI: -5.05- -0.46), defecation by 3.20h (-6.08- -0.32), and bowel sound by 0.68h (-1.11- -0.25). The subgroup analysis indicated that this effect was observed particularly in women who began coffee consumption two hours after cesarean delivery, in contrast to those who initiated coffee intake eight hours. The findings of this systematic review and meta-analysis indicate that early coffee consumption may enhance the recovery of the gastrointestinal function following cesarean section. The number of studies included in this meta-analysis was small and the quality of evidence was low, so results should be interpreted with some caution. The protocol for this review was registered with PROSPERO: CRD42024586382.