Abstract
Evidence Mounts Refuting an Association Between Epidural Use and Neurodevelopmental Adverse Outcomes in Children
Highlights
A recent population-based study of 147 895 live births in Kaiser Permanente Southern California hospitals reported that epidural pain relief is associated with a 37% increased risk of autism spectrum disorder in offspring.4 residual confounding likely explains these findings, as a subsequent population-based study of 123 175 live births in Manitoba, Canada, did not confirm this association after accounting for a larger set of confounders.5 there is a need for more research that addresses selection and confounding bias to clarify the presence and extent of an association
Kearns et al6 used data from 435 281 mother-offspring pairs in Scotland to explore whether associations exist between epidural pain relief and a number of childhood development indicators and adverse neonatal outcomes
In confounder-adjusted analyses, epidural pain relief was associated with a small increased risk of neonatal resuscitation and neonatal intensive care unit admission but was not associated with an increased risk of an offspring Apgar score less than 7 or 4 at 5 minutes
Summary
A recent population-based study of 147 895 live births in Kaiser Permanente Southern California hospitals reported that epidural pain relief is associated with a 37% increased risk of autism spectrum disorder in offspring.4 residual confounding likely explains these findings, as a subsequent population-based study of 123 175 live births in Manitoba, Canada, did not confirm this association after accounting for a larger set of confounders.5 there is a need for more research that addresses selection and confounding bias to clarify the presence and extent of an association. Kearns et al6 used data from 435 281 mother-offspring pairs in Scotland to explore whether associations exist between epidural pain relief and a number of childhood development indicators and adverse neonatal outcomes. Findings from the associations between epidural pain relief and neonatal outcomes were less clear.
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