AUTHOR=Deng Chun-Mei , Ding Ting , Liu Zhi-Hua , He Shu-Ting , Ma Jia-Hui , Xu Ming-Jun , Wang Lei , Li Ming , Liang Wei-Lan , Li Xue-Ying , Ma Daqing , Wang Dong-Xin 

TITLE=Impact of maternal neuraxial labor analgesia exposure on offspring's neurodevelopment: A longitudinal prospective cohort study with propensity score matching

JOURNAL=Frontiers in Public Health

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.831538

DOI=10.3389/fpubh.2022.831538

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>Neuraxial analgesia is widely used to relieve labor pain; its effects on long-term neurodevelopment of offspring remain unclear. This study was designed to investigate the influence of maternal neuraxial labor analgesia on offspring mental development.</p></sec><sec><title>Methods</title><p>This was a predefined secondary analysis of a 2-year prospective longitudinal study. Nulliparous women with single-term cephalic pregnancy preparing for vaginal delivery self-selected neuraxial analgesia or not during labor. Mothers and their offspring were followed up 2 years later. children's mental development was assessed with the bayley scales of infant development. A multivariable logistic model was used to identify factors associated with below-average mental development (Mental Development Index &lt;90).</p></sec><sec><title>Results</title><p>A Total of 508 pairs of mothers and children completed a 2-year follow-up. after propensity score matching, 387 pairs were included in the analysis. In both cohorts, the proportions with below-average mental development were slightly lower in children whose mothers received neuraxial labor analgesia, although not statistically significant [in the full cohort: 9.8 % (36/368) vs. 15.7% (22/140), <italic>P</italic> = 0.060; In the matched cohort: 8.3% (21/254) vs. 14.3% (19/133), <italic>P</italic> = 0.065]. A higher 2-year depression score (in the full cohort: Odds Ratio 1.15, 95% CI 1.08–1.22, <italic>P</italic> &lt; 0.001; In the matched cohort: Odds Ratio 1.09, 95% CI 1.01–1.18, <italic>P</italic> = 0.037), but not neuraxial analgesia exposure, was associated with an increased risk of below-average mental development.</p></sec><sec><title>Conclusions</title><p>Maternal depression at 2 years was associated with the risk of below-average mental development, whereas maternal exposure to neuraxial labor analgesia was not.</p></sec><sec><title>Clinical Trial Registration</title><p>The study was registered with <ext-link ext-link-type="uri" xlink:href="http://www.chictr.org.cn/" xmlns:xlink="http://www.w3.org/1999/xlink">www.chictr.org.cn</ext-link> (ChiCTR-OCH-14004888) and ClinicalTrials.gov (NCT02823418).</p></sec>