Effects of epidural analgesia exposure during parturition on autism spectrum disorder in newborns: A systematic review and meta-analysis based on cohort study

Abstract

BackgroundLabor epidural analgesia (LEA) is one of the most effective and widely used approaches for pain relief during parturition. we conducted this meta-analysis to evaluate the association between LEA exposure during parturition and ASD in newborns.MethodsPubMed, Cochrane Library, EMBASE and Web of Science database were searched from inception to January 2, 2022 to identify related articles. Literature screening was carried out strictly according to the inclusion and exclusion criteria, and data were extracted and imported into STATA 15.0 software for meta-analysis.ResultsA total of 5 studies with 1763454 participants were included. A statistically significant correlation was observed between LEA and changed ASD (RR = 1.20, 95%CI (1.17, 1.24)), and the correlation between LEA and ASD were analyzed by univariate HR (ES = 1.34, 95%CI(1.27,1.40), P < 0.05) and Multivariate HR (ES = 1.13, 95%CI (1.05,1.21), P < 0.05).LimitationFirst, few studies were included, and most patients were from the United States. Second, the included studies were observational cohort designs, which cannot avoid selection and measurement bias. Third, the results of the included studies were heterogeneous, and a more detailed subgroup analysis was not possible.ConclusionThere is a correlation between LEA during parturition and the risk of ASD in newborns. The Newborn whose mother received LEA during her birth-giving might be more likely to develop ASD.

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“…Other studies based on robust epidemiological data and sibling matching analysis claim no significant association between LEA and ASD [81][82][83]. However, in a meta-analysis by Wang et al, it has been mentioned that LEA during birth can associate offspring with more chances of developing ASD [84]. In conclusion, additional studies will be needed to assess the possible risks of LEA.…”

Decoding labour epidural analgesia and autism

“…Meta-analyses conducted on this topic present an intriguing picture. [13][14][15][16] On one hand, they reveal an association between neuraxial labour analgesia and autism when no confounding variables are considered. However, a critical turning point emerges when confounders are pondered, resulting in a very weak association.…”

“…It is, therefore, crucial to approach the findings of Qiu et al 1 and related meta-analyses [13][14][15][16] with caution. The presence of an association without confounders does not imply causation.…”

“…Meta-analyses conducted on this topic present an intriguing picture 13–16 . On one hand, they reveal an association between neuraxial labour analgesia and autism when no confounding variables are considered.…”