Epidural Anesthesia Linked To Infection Risk For Baby After Delivery: Study

Pregnant women receiving epidural anesthesia during delivery could face more than double the risk of their newborn being born with an infection, according to the findings of a new study.

Chinese researchers indicate 4.4% of newborns whose mothers received epidural anesthesia were born with infections, compared to only 1.8% of children born to women who did not receive the injections. The findings were published last week in JAMA Network Open.

Epidural anesthesia is used to block severe pain during childbirth and for surgery in the lower belly and legs. It is an injection of an analgesic into the epidural space around the spinal cord. In rare cases, it can cause temporary or permanent loss of feeling in the lower body if the needle strikes a nerve.

However, in this latest study, researchers at the Shanghai Jiao Tong University School of Medicine looked at whether epidural anesthesia provided during labor was also linked to neonatal infections. They conducted a cohort study of 37,786 pregnant women undergoing vaginal delivery at a hospital in Shanghai between January 2013 and October 2018.

The researchers looked for cases of neonatal infection, including sepsis, pneumonia, necrotizing enterocolitis (NEC) and uncharacterized infections.

According to the findings, the risk of infection was nearly two and a half times higher among women who received an epidural, with the risk of sepsis increasing three and a half times and the risk of uncharacterized infection increasing more than two-fold as well. The researchers also found increased risks of maternal intrapartum fever and histologic chorioamnionitis.

In sepsis cases, the most common pathogen was Staphylococci. However, the study also found there was no significant association between the epidural injections and increased risks of pneumonia or NEC.

“This cohort study found that use of epidural analgesia in full nulliparous women undergoing vaginal delivery was associated with an increased risk of neonatal infection, pending further investigation,” the researchers concluded. “These findings support efforts to further improve safety and quality of labor and delivery care for parturient women.”

The researchers noted that the overall rate of infection was still low, even in women receiving epidural injections, and noted some infection cases could have other causes, such as maternal fever, chorioamnionitis, more vaginal examinations and the use of oxytocin or instruments used during delivery.