Evidence map›Paper›PMID 38702238›Full record

ArticleBritish journal of anaesthesia2024

Behavioural and neuropsychological outcomes in children exposed in utero to maternal labour epidural analgesia.

Oliver G Isik, Shaqif Junaid, Ling Guo, Deven Lackraj, Ruth Landau, Caleb H Miles, Craig Pennell, Britta S von Ungern Sternberg, Andrew J O Whitehouse, Guohua Li and 1 more

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In one paragraph

Article in British journal of anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Oliver G IsikDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Shaqif JunaidDepartment of Anesthesiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Ling GuoDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Deven LackrajDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Ruth LandauDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Caleb H MilesDepartment of Biostatistics, Mailman School of Public Health, New York, NY, USA.
Craig PennellSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.
Britta S von Ungern SternbergDivision of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, WA, Australia; Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia; Perioperative Care Program, Perioperative Medicine Team, Telethon Kids Institute, Perth, WA, Australia.
Andrew J O WhitehouseTelethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Guohua LiDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Caleb IngDepartment of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. Electronic address: ci2119@cumc.columbia.edu.

Funding

Prenatal Exposure to Anesthesia and Subsequent Neurodevelopmental DisordersR01HS026493 · AHRQ · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ING, CALEB · 2018 to 2022
$1.6M
AHRQ HHS R01 HS026493
6 · The paper itself

Abstract

backgroundRecent studies report conflicting results regarding the relationship between labour epidural analgesia (LEA) in mothers and neurodevelopmental disorders in their offspring. We evaluated behavioural and neuropsychological test scores in children of mothers who used LEA.

methodsChildren enrolled in the Raine Study from Western Australia and delivered vaginally from a singleton pregnancy between 1989 and 1992 were evaluated. Children exposed to LEA were compared with unexposed children. The primary outcome was the parent-reported Child Behaviour Checklist (CBCL) reporting total, internalising, and externalising behavioural problem scores at age 10 yr. Score differences, an increased risk of clinical deficit, and a dose-response based on the duration of LEA exposure were assessed. Secondary outcomes included language, motor function, cognition, and autistic traits.

resultsOf 2180 children, 850 (39.0%) were exposed to LEA. After adjustment for covariates, exposed children had minimally increased CBCL total scores (+1.41 points; 95% confidence interval [CI] 0.09 to 2.73; P=0.037), but not internalising (+1.13 points; 95% CI -0.08 to 2.34; P=0.066) or externalising (+1.08 points; 95% CI -0.08 to 2.24; P=0.068) subscale subscores. Increased risk of clinical deficit was not observed for any CBCL score. For secondary outcomes, score differences were inconsistently observed in motor function and cognition. Increased exposure duration was not associated with worse scores in any outcomes.

conclusionsAlthough LEA exposure was associated with slightly higher total behavioural scores, there was no difference in subscores, increased risk of clinical deficits, or dose-response relationship. These results argue against LEA exposure being associated with consistent, clinically significant neurodevelopmental deficits in children.

Indexed as

Analgesia, EpiduralNeuropsychological TestsPrenatal Exposure Delayed EffectsAdultAnalgesia, ObstetricalChildChild BehaviorChild Behavior DisordersChild, PreschoolFemaleHumansMaleNeurodevelopmental DisordersPregnancyWestern Australiabehaviourlabour epidural analgesianeurodevelopmentneurotoxicityobstetric anaesthesia

Identifiers

PMID38702238
PMCPMC11590713

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.