The use of epidural analgesia for vaginal delivery in mothers may be associated with an increased risk of autism in children, according to a recent study published in the journal JAMA Pediatrics.
Epidural administration is a method of administration in which a drug is injected into the epidural space around the spinal cord. It is being used commonly and is known to improve outcomes for both neonates and mothers but the recent findings from the study are of concern in the context of long-term neurodevelopmental disorders in offspring.
Researchers at the Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California investigated the association between maternal labour epidural analgesia (LEA) exposure and risk of autism spectrum disorders (ASDs) in offspring using data from 147 895 singleton children born through vaginal delivery between January 1, 2008, and December 31, 2015. The data was derived based on electronic medical records from a single integrated health care system.
Among the cohort, 74.2% were exposed to maternal LEA and the relative risk of developing ASD was found 37% higher in this group after adjusting for potential confounders, said the researchers.
The study found that autism spectrum disorders were diagnosed in 1.9% of the children delivered vaginally with epidural analgesia compared to 1.3% of the children delivered vaginally without the exposure.
The children were followed up from the age of 1 year until the first incidence of a clinical diagnosis of ASD. The researchers noted that fever during labour was observed in 11.9% of mothers in the LEA group and 1.3% mothers in the non-LEA group.
The hazard risk associated with LEA exposure of fewer than 4 hours was 1.33, with LEA exposure of 4 to 8 hours was 1.35, and with LEA exposure of more than 8 hours was 1.46.
“This study suggests that maternal LEA may be associated with an increased risk of autism in children. Further research is warranted to confirm the study findings and understand the potential mechanisms,” concluded the authors.