Epidural Analgesia During Labor Or Delivery May Increase Autism Risk For Children: Study

The findings of a new study suggest that side effects of an epidural during labor and delivery may increase the risk of autism in the child, but researchers admit that the evidence is slim.

In a report published last week in the Journal of the American Medical Association (JAMA), Canadian researchers evaluated data on 388,254 children born via vaginal delivery in British Columbia, Canada between April 2000 and December 2014, and compared whether children exposed to epidural analgesia during birth were more likely to develop autism.

Children born to mothers who had an epidural analgesia had a small increased risk of developing autism spectrum disorder (ASD), which was obtained from the British Columbia Autism Assessment Network and the British Columbia Ministry of Education data.

Overall, roughly 111,000 children were exposed to epidural during delivery, while 276,000 children were not. A total of 5,200 children were diagnosed with autism. Among children exposed to epidural, 1,700 were diagnosed with autism. Roughly 3,400 were diagnosed with autism among children whose mothers did not have epidurals. Therefore, about 1.5% of children exposed to epidurals during delivery were later diagnosed with autism, compared to about 1.3% of children born to mothers who did not have epidurals.

Researchers highlight that the data found an increased risk, but the risk was small. Because of this, the data did not provide significant or definitive evidence of a link between exposure to epidural and autism.

Epidural analgesia is a form of pain relief used during delivery that blocks severe pain in the lower body. It is done using an injection into the epidural space around the spinal cord, leading to blocked pain and at times loss of feeling in the lower limbs to help women endure the pain of childbirth.

Prior research has found that side effects of epidurals may increase the infection risk to the baby after delivery. Infants face double the risk of being born with an infection if their mother had an epidural during labor.

Autism spectrum disorder is a group of neurodevelopmental disorders that are characterized by social impairments, delays in communication and behavioral challenges.

Those with autism may experience more difficulty communicating, interacting, and learning than other children. They may have behavior issues and need assistance with day-to-day activities. Roughly one in 59 children in the US are diagnosed with ASD and the incidence has increased nearly 150% since 2000.

Prior research has linked epidurals to increased risk of autism later in life. A study published last year indicated the risk of ASD increased by nearly 40% if the mother was given an epidural.

“In this population-based study, maternal epidural analgesia use during labor and delivery was associated with a small increase in the risk of autism spectrum disorder in offspring that met the threshold for statistical significance,” researchers of the latest study wrote. “However, given the likelihood of residual confounding that may account for the results, these findings do not provide strong supporting evidence for this association.”