Category: Labor
Poster Session III
Controversy exists regarding the association between epidural analgesia during labor and the development of autism spectrum disorder (ASD) in the offspring, as the few existing investigations have reported mixed findings. The objective of this study was to evaluate the possibility of this association in our heterogenous population.
Study Design:
A population-based cohort study was conducted, that included vaginal deliveries occurring between the years 1991 to 2021 at a tertiary referral hospital. Incidence of offspring diagnosed with ASD was compared based on whether their mothers had or had not received epidural during labor. A Kaplan Meier survival curve compared cumulative morbidity. A Cox proportional hazards model was used to control for confounders.
Results: Out of 306,434 parturient in the study, 60,861 were administrated epidural analgesia during their labor. Epidural analgesia was more common among high-risk pregnancies groups (including diabetes mellitus and hypertensive disorders, intrauterine growth restriction and pregnancies complicated by oligohydramnios; p< 0.001). Overall, epidural analgesia during labor was associated with higher rate of ASD in the offspring (OR= 2.33, 95% CI 1.71-3.18, P< 0.001; Table). The Kaplan Meier survival curve demonstrated higher cumulative incidence of ASD in offspring of parturient receiving epidural analgesia (log-rank p< 0.001; Figure). This association, however, has lost significance when adjusting for confounders such as maternal age, gestational age, hypertensive disorders, diabetes mellitus and ethnicity, in a Cox proportional hazards model (adjusted HR=1.2, 95% CI 0.86-1.67, P=0.284; Table).
Conclusion: In our population, epidural analgesia is not independently associated with ASD in the offspring.
Omri Zamstein, MD
Soroka University Medical Center
Beer Sheva, Israel
Tamar Wainstock, PhD (she/her/hers)
Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel, Israel
Gali Pariente, MD
Acting director of Fetal Maternal Unit B Division of Obstetrics and Gynecology
Soroka University Medical Center
Klahim, HaDarom, Israel
Yair Binyamin, MD
Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Beer Sheva, HaDarom, Israel, Israel
Eyal Sheiner, MD,PhD
Head of department of Obstetrics and Gynecology B, Soroka University Medical Center
Soroka Medical Center
Omer, HaDarom, Israel