[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.170.64.36. Please contact the publisher to request reinstatement.
Editorial
April 19, 2021

Epidural Analgesia and Autism Spectrum Disorder Risk—The Challenges Inherent in Complex Observational Research

Author Affiliations
  • 1Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
  • 2Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
  • 3School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
JAMA Pediatr. Published online April 19, 2021. doi:10.1001/jamapediatrics.2021.0382

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a cluster of social and communication impairments and repetitive and restrictive behaviors across a spectrum of severity that appears to arise from disordered brain development early in gestation.1 With an increase in prevalence in ASD from 1 in 150 in 2000 to 1 in 54 children in 2016, considerable2 attention has focused on a search for modifiable exposure-related risk factors. A recent population-based study by Qiu et al3 reported a 37% increased risk for a diagnosis of ASD in children of mothers receiving epidural labor analgesia (ELA) for labor and delivery. Given that ELA is widely accepted as a standard for labor analgesia, these findings led to widespread public4 and scientific5concern. It thus comes with some relief that Wall-Wieler et al6 found no association when controlling for key maternal sociodemographic and perinatal factors. But does the finding of the absence of evidence put this issue to rest?

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×