Coffee intake after cesarean section and postoperative gastrointestinal recovery: a systematic review and meta-analysis.

OBJECTIVE

To evaluate the effect of postoperative coffee intake on gastrointestinal recovery outcomes following cesarean delivery.

METHODS

A systematic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials was conducted from database inception to January 2026. Search terms included combinations of "caffeine", "coffee", "cesarean delivery". Eligible studies were randomized controlled trials (RCTs) enrolling adult women undergoing cesarean delivery and comparing postoperative caffeinated coffee intake with a control intervention. Continuous endpoints were compared using pooled weighted mean differences (WMDs), and binary outcomes with risk ratios (RR), with 95% confidence intervals (CIs). Statistical analysis was performed using R statistical software version 4.5.1 (R Foundation for Statistical Computing). Certainty of evidence was assessed using the GRADE framework. The review protocol was prospectively registered in PROSPERO (CRD420261289159).

RESULTS

Eight RCTs including 1,269 patients were included. Postoperative caffeinated coffee intake was compared with warm water, decaffeinated coffee, plain water, or standard postoperative care. Postoperative caffeine intake was associated with a shorter time to defecation (WMD -3.38 h; 95% CI -5.26 to -1.50; p = 0.0004), and time to first flatus (WMD -4.99 h; 95% CI -6.94 to -3.04; p < 0.0001). No significant difference was observed in time to first bowel movement (WMD -0.98 h; 95% CI -2.49 to 0.53; p = 0.2024). Caffeinated coffee intake was also associated with a reduced length of hospital stay (WMD -9.13 h; 95% CI -17.19 to -1.08; p = 0.0263). No differences were observed in tolerance of solid food intake or vomiting. Nausea occurred less frequently in the caffeinated coffee group (RR 0.67; 95% CI 0.46 to 0.97; p = 0.0359). Overall certainty of evidence ranged from low to very low.

CONCLUSION

Postoperative caffeinated coffee intake after cesarean delivery may potentially be a simple and low-cost adjunct to support postoperative gastrointestinal recovery following cesarean delivery. However, substantial heterogeneity and low certainty of evidence warrant cautious interpretation, and further well-designed RCTs are needed to confirm these findings.