ArticleBritish journal of anaesthesia2025
Association of labour epidural analgesia exposure with infant neurodevelopment: secondary analysis of a prospective cohort study.
Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvidence regarding the safety of labour epidural analgesia for infant neurodevelopment remains scarce. We conducted a secondary analysis of the Jiangsu Birth Cohort (JBC) to assess the association between labour epidural analgesia exposure and infant neurodevelopment across five domains: cognition, receptive communication, expressive communication, fine motor, and gross motor.
methodsThis secondary analysis included singleton vaginal births from data prospectively collected between 1 November 2017 and 1 October 2022. At 1 yr of age, trained paediatricians assessed infant neurodevelopment using the Bayley Scales of Infant and Toddler Development Screening Test, Third Edition (Bayley-III Screening Test). Infants with raw scores below domain-specific thresholds were classified as 'emerging or at risk'. Associations between maternally self-selected labour epidural analgesia exposure and infant neurodevelopment were analysed using generalised linear models adjusted for confounders.
resultsAmong 1811 mother-infant dyads, 1224 (67.6%) received labour epidural analgesia. Labour epidural analgesia exposure was not associated with classification as emerging or at risk in any domain (cognition: adjusted risk ratio [aRR] 1.24; 95% confidence interval [CI] 0.89-1.74, P=0.205; receptive communication: aRR 0.78; 95% CI 0.58-1.04, P=0.095; expressive communication: aRR 1.03; 95% CI 0.59-1.81, P=0.904; fine motor: aRR 0.75; 95% CI 0.38-1.50, P=0.417; gross motor: aRR 0.89; 95% CI 0.57-1.38, P=0.594). The duration of labour epidural analgesia was also not associated with neurodevelopmental outcomes.
conclusionsOur findings do not support an association between labour epidural analgesia exposure and increased neurodevelopmental risk at 1 yr of age. These results provide valuable insights, although the CIs and risk ratios underscore the need for larger studies with careful interpretation of clinical significance.
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