Epidural during labor doesn't increase child's autism risk, study finds

Epidural use during delivery does not increase future autism risk for children, a new study has found. Photo by Sanjas/Pixabay
Epidural use during delivery does not increase future autism risk for children, a new study has found. Photo by Sanjas/Pixabay

April 19 (UPI) -- Babies born to women who use epidurals for pain during childbirth do not carry increased risk for autism, according to an analysis published Monday by JAMA Pediatrics.

Among children exposed to epidurals during labor, just over 2% were later diagnosed with autism spectrum disorder, the data showed.


Meanwhile, just under 2% of children not exposed to the drugs were later diagnosed with the disorder, the researchers said.

"We did not find evidence for any genuine link between having an epidural and putting your baby at increased risk of autism spectrum disorder," study co-author Dr. Alexander Butwick said in a press release.

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The finding should help reassure both physicians and pregnant women about the safety of epidurals, said Butwick, an associate professor of anesthesiology, perioperative and pain medicine at Stanford University in Palo Alto, Calif.


During labor, an epidural, or anesthetic drug, is administered via catheter into the space around the spinal cord to relieve pain from contractions, while allowing women to stay alert and push during birth.

The drugs, which are used by about 75% of women in labor in the United States, can provide anesthesia to laboring women who require unplanned, and often urgent, Caesarean sections, and they pose a lower risk to the mother and baby than general anesthesia, the researchers said.

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Last October, a study found that epidural exposure during delivery increased newborns' risk for autism, a developmental disorder that affects learning and communication, by 37%.

However, the study was widely criticized for failing to account for many socioeconomic, genetic and medical risk factors for autism that could be more common among women who choose to use epidurals, Butwick and his colleagues said.

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"The epidural is the gold standard in labor pain management," Elizabeth Wall-Wieler, another co-author of the JAMA Pediatrics papers, said in a press release.

"The vast majority of evidence around epidurals, including that from our new study, shows that they are the most effective means of providing pain relief to women during labor and that serious complications are rare," Wall-Wieler, an assistant professor of community health sciences at the University of Manitoba in Canada.


For their study, Butwick, Wall-Wieler and their colleagues examined epidural use during childbirth and later diagnoses of autism in Manitoba, Canada, among 123,175 children born between 2005 and 2016 and followed until 2019.

The research team was able to access information that linked together individuals' medical records, prescriptions, other health-related data, socioeconomic information and information about children's academic achievements.

All of the children in the study were born via vaginal delivery and were single births, according to the researchers.

Of the children included in the research, just over 38% of them were exposed to epidural anesthesia during labor, the researchers said.

Among children exposed to epidurals during labor, 2.1% later were diagnosed with autism spectrum disorder, compared with 1.7% of children not exposed to epidurals, the data showed.

After considering other factors that may influence autism risk -- including mothers' pre-pregnancy medical history, medical conditions during pregnancy and mothers' smoking, alcohol and recreational drug use -- no statistically significant difference in autism risk exists between children whose mothers received epidurals and those who did not, the researchers said.

"An epidural remains a well-established and effective means of providing pain relief during labor, with several benefits associated with it," Butwick said.


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