Maternal Epidural During Birth Linked to Later Autism in Kids

WEDNESDAY, Oct. 14, 2020 — Exposure to maternal epidural analgesia during vaginal delivery may increase the later risk for autism spectrum disorders (ASD) for children, according to a study published online Oct. 12 in JAMA Pediatrics.

Chunyuan Qiu, M.D., from Kaiser Permanente Baldwin Park Medical Center in California, and colleagues evaluated the association between maternal labor epidural analgesia (LEA) exposure and risk for ASDs in offspring using data from 147,895 singleton children.

The researchers found that 74.2 percent were exposed to maternal LEA. ASDs were diagnosed in 1.9 percent of children in the LEA group and 1.3 percent of children in the non-LEA group. When adjusting for birth year, medical center, maternal age at delivery, parity, race/ethnicity, educational level, household income, history of comorbidity, diabetes during pregnancy, smoking during pregnancy, preeclampsia or eclampsia, prepregnancy body mass index, gestational weight gain, gestational age at delivery, and birth weight, there was elevated risk for ASD with LEA versus no exposure (hazard ratio [HR], 1.37). Risk increased with length of LEA exposure (LEA exposure less than four hours: HR, 1.33; LEA exposure of four to eight hours: HR, 1.35; and LEA exposure of more than eight hours: HR, 1.46) compared with no exposure.

“Short duration of LEA exposure may be associated with long-term neurodevelopmental disorders in offspring,” the authors write.

In a joint statement, the Society for Obstetric Anesthesia and Perinatology (SOAP) and four other medical societies said the study “does not provide credible scientific evidence that labor epidurals for pain relief cause autism.” “Neuraxial analgesia is the gold standard for labor pain relief,” said Ruth Landau, M.D., president of SOAP. “We should not stop providing labor epidurals, and if anything, epidurals improve maternal and neonatal outcomes.”

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