The findings of a new study raise potential concerns about the impact of epidurals used during childbirth, indicating that it may increase the risk a child will later be diagnosed with autism.
Researchers with Kaiser Permanente indicate they found an association between maternal labor epidural analgesia and autism spectrum disorders, according to a report published this week in the medical journal JAMA Pediatrics.
The population-based clinical birth study included data on more than 147,000 children delivered vaginally from 2008 to 2015 in a single healthcare system.
Children were followed up from the age of one year until the children had an autism diagnosis, they were no longer enrolled with the health plan, or the study ended.
Nearly 110,00 children were exposed to epidural analgesics, or narcotic painkillers delivered via an epidural during vaginal delivery. Roughly 38,000 children were not exposed to an epidural.
An epidural is a method of injecting different types of drugs and medications via the space around the spinal cord. During childbirth women are given painkillers or local anesthetics to numb or block the pain using an epidural. The technique was first used in 1921.
According to the findings, autism spectrum disorders were diagnosed in 2% of children who were delivered with epidural analgesia. This amounts to roughly 2,000 children. Comparatively, only about 1.3% of children who were not exposed to epidurals were diagnosed with autism later.
The difference represents about a 37% relative increase in risk of autism, the researchers determined. The risk was significant even after adjusting for other potential risk factors, like health conditions, obesity, and other factors.
The researchers also determined that the longer a woman was exposed to the epidural the higher the risk her child would develop autism. The risk ranged from 1.3 times higher for roughly four hours of exposure to a 1.46 times increased risk of autism for more than eight hours of exposure to the epidural.
Autism spectrum disorders are neurodevelopment disorders that cause social, communication, and behavioral changes. The severity of autism can range from minimal to extreme, affecting relationships, learning, and coping skills. Some research has linked exposure to Tylenol during pregnancy and exposure to common air pollution during pregnancy to increased risk of autism.
There are roughly 3 million cases of autism in the United States each year and the prevalence of diagnosis is becoming even more common than before. In fact, cases of autism have increased 150% since 2000.
While the safety of epidural use is well documented, long-term health effects in the child have not been fully investigated, the researchers said. Some drugs and chemicals easily cross the placenta during pregnancy, increasing the likelihood it may affect the fetus. Epidural painkillers may be one of those drugs that strongly affects baby during delivery.
“This study suggests that exposure to epidural analgesia for vaginal delivery may be associated with increased risk of autism in children; further research is warranted to confirm the study findings and understand the potential mechanisms,” the study’s authors wrote.