Epidurals and Autism

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A recent study published in JAMA Pediatrics examines the association between epidural analgesia during labor and the risk of autism spectrum disorders (ASD) in offspring. Researchers looked at a multiethnic population-based clinical birth cohort of 147,895 children who were delivered vaginally between 1/1/2008 and 12/31/2015. Children were followed up to the age of 1 year or until: clinical diagnosis of ASD, last date of health plan enrollment, death, or the end of the study. Autism spectrum disorders were diagnosed in 1.9% of the children delivered using epidural analgesia versus 1.3% of the children delivered vaginally without it. After adjusting for potential cofounders, this is a 37% relative increase in risk which is significant. The results of this study suggest that maternal labor epidural analgesia (LEA) may be associated with increased risk for children developing ASD.

While further research is warranted to confirm the study findings, the potential implications are significant. Epidural analgesia is a central neve block technique achieved by injecting a local anesthetic close to the nerves that transmit pain. This is done so through a catheter in the lower back that continuously delivers medication throughout labor. Epidurals are a widely accepted practice used to ease the pain of childbirth for women. An article published in Stanford Medicine examined 17 million deliveries nationwide from 2009-2014, which found that epidurals or other spinal anesthesia were used in 71% of births, a 10% increase from 2008.

The growing numbers of epidural analgesia during birth is concerning given the findings of Chunyuan Qiu, MD, MS, Jane C. Lin, MS, and Jiaxiao M. Shi, PhD in JAMA Pediatrics. While there are many suspected links, there is no known single cause for autism spectrum disorder. If epidurals do indeed increase the risk of a child developing ASD, it would impact many women’s decision regarding pain management during childbirth. Abramson, Brown & Dugan specialize in medical malpractice law and have extensive experience in birth injury related cases. If you or someone you know has been affected by medical malpractice, contact us today.

Holly Haines
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