There appears to be no association between cerebral palsy (CP) in children and the use of epidural analgesia during labor, a new study says.
The study, “No Association Of Labor Epidural Analgesia With Cerebral Palsy In Children,” published in The Journal of Anesthesia, was conducted by Li Zhang and colleagues from the Geisinger Health System headquarted in Danville, Pennsylvania.
Pregnant women frequently worry whether they should avoid an epidural during labor because they think it may increase the risk of cerebral palsy in their children. Although researchers believe there is no connection between epidural and CP, no study had specifically investigated the question.
Researchers retrospectively analyzed the health records of 20,929 children born between January 2004 and January 2013 at Geisinger hospitals. According to these records, 50 children were diagnosed with cerebral palsy, 20 of whom were born vaginally. Each of these children was matched with up to five non-CP children who had been born at the same hospital and in the same time period.
In the analysis, analgesia was classified as epidural (either epidural alone or combined spinal and epidural) or non-epidural. Researchers then compared the percentage of deliveries with each type of analgesia between the groups of children with and without cerebral palsy.
Results indicated that in the children without cerebral palsy, the percentage of patients who had received epidural during labor was 72 percent, whereas in the group of children with CP, the percentage was 45 percent. Therefore, the authors found no significant difference between these groups, nor a strong indication that cerebral palsy develops in children whose mothers had received epidural during labor and delivery.
Although the study identified a small group of children born vaginally (20 children), which leaves open the possibility that there could be a modest difference in the true percentages of cerebral palsy and non-CP births utilizing epidural analgesia, the authors believe the tight inclusion criteria and rigorous matching between children support the reliability of their findings.
“Our study found no association of labor epidural analgesia with cerebral palsy in children,” the authors concluded in their report. “Larger-scale, multiple-center, prospective studies are needed to further confirm our findings. Nevertheless, as suggested from our study, pregnant women should not avoid labor epidural analgesia based on the concern of CP in their children.”