Researchers have revealed epidural use at birth does not increase the risk of autism in children. The findings quash a previous, highly criticised study released last year.
The new study led by researchers at the Stanford University and the University of Manitoba, has put to rest several of the questions raised by the 2020 study.
“We did not find evidence for any genuine link between having an epidural and putting your baby at increased risk of autism spectrum disorder,” the study’s senior author, Alexander Butwick, MD, said. “The study should help reassure both physicians and pregnant women about the favourable safety profile of epidurals.”
About 30 percent of Australian women use an epidural during labour. It involves an injection of local anaesthetic into the space around the spinal nerves in the lower back.
“The epidural is the gold standard in labour pain management,” study lead author, Elizabeth Wall-Wieler, PhD, said. “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.”
Previous study linked autism and epidurals
A study of births in California released in October last year, said epidural is linked to a 37 per cent greater risk of an autism diagnosis in children later on in life. But it met with heavy criticism for not taking into account the risk factors for autism that could be more common in women who choose epidurals.
It prompted experts to speak out against the findings, saying it was ‘biologically implausible’ for epidurals to up the risk of autism. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists also released a statement reassuring that use of epidurals is safe.
The new research looked at epidural use during childbirth and the later diagnosis of autism in Manitoba, Canada. It included 123,175 children who were born between 2005 and 2016 and followed until 2019.
“Manitoba has these wonderful, linked data sets that are population-wide,” Dr Butwick said. The research team accessed information that linked individuals’ medical records, prescriptions, other health-related data, socioeconomic information and information about children’s academic achievements.
All the children in the study were born via vaginal delivery and were single births. Of those studied, 38.2 percent of the children were exposed to an epidural during labour, the rest weren’t. Of children exposed to epidurals during labor, 2.1 percent were later diagnosed with autism spectrum disorder, compared with 1.7 percent of children not exposed to epidurals.
No link between epidurals and autism risk
The researchers then took into account the factors thought to potentially influence the risk of autism – many more than the previous study, including:
- socioeconomic factors (mothers’ education, marital status, neighbourhood socioeconomic level and receipt of welfare during pregnancy)
- mothers’ pre-pregnancy medical history (including diabetes, hypertension, anxiety and depression)
- medical conditions during pregnancy
- mothers’ smoking
- alcohol and recreational drug use
- mothers’ hospitalisation for mental illness during pregnancy
- mothers’ use of several types of prescription medications
- medical complications of delivery
- factors related to the mothers’ pregnancy and labour, including the length of the pregnancy
The researchers even analysed pairs of siblings where the mum had an epidural for one child but not the other. Once they crunched and compared the data, they found there was no difference in the autism risk for children whose mums had an epidural and those who didn’t. In short, they found no link between an epidural and increased risk of autism. “Our study has a stronger finding because we accounted for limitations the first study had,” Dr Butwick said.
Pregnant women are being reassured that epidurals remain a well-established and effective means of providing pain relief during labour.
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