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By Amy Norton<\/b>
HealthDay Reporter<\/i><\/p>\n
TUESDAY, Oct. 13, 2020 (HealthDay News)<\/p>\n
Children whose mothers were given an epidural during labor<\/a> may face a slightly heightened risk of autism<\/a>, a large, new study suggests.<\/p>\n Researchers found that the rate of autism<\/a> was a little higher among those kids, versus their peers whose mothers did not get epidural pain<\/a> relief during childbirth<\/a>: 1.9% versus 1.3%.<\/p>\n The reasons for the difference are not yet known. And experts stressed that the findings do not prove epidurals directly raise the odds of a future autism spectrum disorder<\/a> (ASD<\/a>) diagnosis.<\/p>\n “I don’t think people should be panicked,” said senior researcher Anny Xiang, of Kaiser Permanente Southern California’s Department of Research and Evaluation.<\/p>\n For one, she said, the rates of ASD<\/a> were low in both study groups.<\/p>\n Instead, the findings point to a need for more research to better understand what is going on, Xiang said.<\/p>\n Other experts agreed. Autism<\/a> is a complex brain-based disorder, and it’s thought that many factors — before, during and after birth — may influence the risk, said Dr. Rahul Gupta, chief medical and health officer for the March of Dimes.<\/p>\n “It’s quite unlikely that just the drugs<\/a> used in epidural would cause ASD,” he said.<\/p>\n Gupta pointed to a bigger-picture question: Women who did or did not have epidurals during delivery may have differed from each other in various ways that the study could not take into account: They may have had different exposures to infections, environmental toxins or medications during pregnancy<\/a>, for example.<\/p>\n Gupta noted that a large U.S. government study, called SEED, is digging into potential risk factors for autism<\/a>. It recently found an elevated risk among kids whose mothers were prescribed opioids painkillers shortly before they became pregnant<\/a>.<\/p>\n When it comes to medications in general, Gupta said, researchers need to learn more about the possible effects during pregnancy<\/a>.<\/p>\n Autism<\/a> is a brain disorder that affects social skills, communication and behavior control. It affects about 1 in 54 children in the United States, according to the U.S. Centers for Disease Control and Prevention<\/a>.<\/p>\n The disorder varies widely from one person to the next: Some children have milder problems with socializing and communicating, while others are profoundly affected — speaking little, if at all, and getting wrapped up in repetitive, obsessive behaviors.<\/p>\n Genes are thought to account for much of the risk of autism<\/a>, but experts have long believed that environmental factors also play a role.<\/p>\n Past studies have looked at mode of delivery: Some have found that children born by cesarean section or labor<\/a> induction have a higher risk of autism.<\/p>\n This latest study, published Oct. 12 in JAMA Pediatrics<\/a><\/i>, is the first to look at epidural use and autism risk.<\/p>\n Xiang’s team scoured electronic medical records for nearly 148,000 children born at Southern California hospitals between 2008 and 2015. All were delivered vaginally, and about three-quarters were exposed to epidural analgesia.<\/p>\n Children in that exposed group had a somewhat higher rate of ASD diagnosis. The researchers used the medical records to try to account for other factors — including the mother’s age and education level, and health issues such as diabetes<\/a>, obesity<\/a> and smoking<\/a>.<\/p>\n Even then, children exposed to epidural analgesia remained at 37% greater risk of ASD, compared to unexposed kids.<\/p>\n Xiang’s team also looked at one possible explanation: Epidurals can cause a fever<\/a> and, in theory, that might affect newborns. But there was no clear link between moms’ fevers<\/a> during labor<\/a> and the risk of autism.<\/p>\n
Several medical groups responded to the study, saying it “does not provide credible scientific evidence that labor<\/a> epidurals for pain<\/a> relief cause autism.”<\/p>\n The groups, including the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists, said women should not be scared away from opting for an epidural.<\/p>\n “Very low levels of these [epidural] drugs<\/a> are transferred to the infant, and there is no evidence that these very low levels of drug exposure cause any harm to an infant’s brain,” the groups said.<\/p>\n Thomas Frazier, chief science officer for the advocacy group Autism Speaks, called the study “high-quality,” and said it will hopefully spur more research.<\/p>\n Frazier agreed there may be other explanations for the connection between epidural use and higher ASD risk — such as infections or other prenatal<\/a> factors.<\/p>\n <\/p><\/div>\n References<\/p>\n
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\n SOURCES: Anny Xiang, Ph.D., senior research scientist, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif.; Rahul Gupta, M.D., M.P.H., chief medical and health officer, March of Dimes, Arlington, Va.; Thomas Frazier, Ph.D., chief science officer, Autism Speaks, New York City; JAMA Pediatrics<\/i>, Oct. 12, 2020, online
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