No link found for exposure to epidural labor analgesia and autism

Exposure to epidural labor analgesia (ELA) is not associated with offspring risk for autism spectrum disorder (ASD), according to a study published online April 19 in JAMA Pediatrics.

Elizabeth Wall-Wieler, Ph.D., from the University of Manitoba in Winnipeg, Canada, and colleagues conducted a longitudinal cohort study of vaginal deliveries of singleton live infants born from 2005 to 2016 to examine the correlation between ELA and offspring risk for ASD. Data were included for 123,175 offspring, of whom 38.2 percent were exposed to ELA.

The researchers found that 2.1 percent of those exposed to ELA and 1.7 percent of unexposed offspring were diagnosed with ASD during the follow-up period (hazard ratio, 1.25; 95 percent confidence interval, 1.15 to 1.36). ELA was not associated with an offspring risk for ASD after adjustment for maternal sociodemographic, prepregnancy, pregnancy, and perinatal covariates (inverse probability of treatment-weighted hazard ratio, 1.08; 95 percent confidence interval, 0.97 to 1.20). ELA was not associated with ASD in the within-siblings design adjusting for baseline covariates (inverse probability of treatment-weighted hazard ratio, 0.97; 95 percent confidence interval, 0.78 to 1.22).

“This finding is of clinical importance in the context of pregnant women and their obstetric and anesthesia care professionals who are considering ELA during labor,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.