AUTHOR=Fang Ling-ling , Zhou Yuan-yue , Jiang Hai-yin , Shi Yu-dan 

TITLE=Labor epidural analgesia and risk of autism Spectrum disorders in offspring: A systematic review and meta-analysis

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.965205

DOI=10.3389/fped.2022.965205

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>The effect of labor epidural anesthesia (LEA) on the risk of autism spectrum disorder (ASD) in offspring has been investigated recently, and available results are inconsistent.</p></sec><sec><title>Methods</title><p>We searched the PubMed and EMBASE databases for relevant studies and performed a systematic review and meta-analysis of the literature. Subgroup analyses were conducted to assess the sources of heterogeneity. Both fixed and random effects models were used was used to estimate overall relative risk.</p></sec><sec><title>Results</title><p>Our results showed that LEA was associated with an increased risk of ASD in offspring [HR = 1.3, 95% confidence interval (CI): 1.25–1.35; <italic>P</italic> &lt; 0.001] after combining crude estimates from the included studies. This association was gradually reduced, but still statistically significant, when potential confounding factors were considered (HR 1.13, 95% CI 1.03–1.25, <italic>P</italic> = 0.014). However, there was no significant association when we combined data of siblings from other pregnancies (HR = 1.07, 95% CI: 0.99–1.16, <italic>P</italic> = 0.076), implying that the association was due to confounding factors.</p></sec><sec><title>Conclusion</title><p>The statistically significant association between LEA and ASD in the offspring can be partially explained by unmeasured confounding.</p></sec><sec><title>Systematic Review Registration</title><p>Identifier CRD42022302892.</p></sec>