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. 2022 Sep 6:13:974596.
doi: 10.3389/fpsyt.2022.974596. eCollection 2022.

Effects of epidural analgesia exposure during parturition on autism spectrum disorder in newborns: A systematic review and meta-analysis based on cohort study

Xiaobo Wang  1 , Jie Li  1 , Dezhao Liu  1
Affiliations

Effects of epidural analgesia exposure during parturition on autism spectrum disorder in newborns: A systematic review and meta-analysis based on cohort study

Xiaobo Wang et al. Front Psychiatry. .

Abstract

Background: Labor epidural analgesia (LEA) is one of the most effective and widely used approaches for pain relief during parturition. we conducted this meta-analysis to evaluate the association between LEA exposure during parturition and ASD in newborns.

Methods: PubMed, Cochrane Library, EMBASE and Web of Science database were searched from inception to January 2, 2022 to identify related articles. Literature screening was carried out strictly according to the inclusion and exclusion criteria, and data were extracted and imported into STATA 15.0 software for meta-analysis.

Results: A total of 5 studies with 1763454 participants were included. A statistically significant correlation was observed between LEA and changed ASD (RR = 1.20, 95%CI (1.17, 1.24)), and the correlation between LEA and ASD were analyzed by univariate HR (ES = 1.34, 95%CI(1.27,1.40), P < 0.05) and Multivariate HR (ES = 1.13, 95%CI (1.05,1.21), P < 0.05).

Limitation: First, few studies were included, and most patients were from the United States. Second, the included studies were observational cohort designs, which cannot avoid selection and measurement bias. Third, the results of the included studies were heterogeneous, and a more detailed subgroup analysis was not possible.

Conclusion: There is a correlation between LEA during parturition and the risk of ASD in newborns. The Newborn whose mother received LEA during her birth-giving might be more likely to develop ASD.

Keywords: autism spectrum disorder; epidural analgesia; labor epidural analgesia; meta analysis; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of literature screening.
FIGURE 2
FIGURE 2
Forest plot for the association between LEA and ASD.
FIGURE 3
FIGURE 3
Forest plot for association between LEA and ASD after removing Qiu.
FIGURE 4
FIGURE 4
Forest plot for univariate HR of LEA and ASD.
FIGURE 5
FIGURE 5
Forest plot for multivariate HR of LEA and ASD.
FIGURE 6
FIGURE 6
Sensitivity analysis for the association between LEA and ASD.
See this image and copyright information in PMC

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