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Association of epidural analgesia in labor with neurodevelopmental outcomes in premature infants born at <29 weeks of gestational age

Journal of Perinatology volume 44, pages 548–553 (2024)Cite this article

Subjects

Abstract

Objective

To explore associations between epidural administration to mothers in labor with neurodevelopmental outcomes at 3 years corrected age in preterm infants born <29 weeks gestational age.

Study design

Infants born <29 weeks gestational age between 2006 and 2012 were included. Our primary outcome was a composite of death or neurodevelopmental impairment at 3 years corrected age. Infants were divided into those whose mothers did or did not receive epidural analgesia in labor. Univariable and multivariable regression was used for analysis.

Results

There were 548 infants in the no epidural analgesia group and 121 in the epidural analgesia group. The adjusted odds ratio (95%CI) of neurodevelopmental impairment or death in the epidural group was 1.25 (0.82–1.93). Propensity score-matched results were 1.32 (0.79–2.22).

Conclusion

Preterm infants born <29 weeks gestational age to mothers who received epidural analgesia during labor were not associated with poor neurodevelopmental outcomes at 3 years corrected age.

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Data availability

In accordance with the Alberta Health Services Data Disclosure Agreement, we are not able to provide or make the data available for any purpose to a third party without the prior written consent of Alberta Health Services, Calgary, Alberta. Custom generated R Studio code used for data analysis is available upon reasonable request to the authors.

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Funding

Findings were presented in part at the 46th American Academy of Pediatrics, Section of Neonatal-Perinatal Medicine, District 8 Conference, San Diego, California, June 1–4, 2023.

Author information

Authors and Affiliations

  1. Medical Student, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada

    Arijit Lodha

  2. Clinical Assistant Professor, Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    J. J. Moser

  3. Senior Consultant, Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    A. Walker

  4. Professor, Department of Pediatrics & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    A. Lodha

  5. Analyst, Department of Obstetrics & Gynecology and Alberta Children’s Hospital Neonatal Follow-up Clinic, Alberta Health Services, Calgary, Alberta, Canada

    S. Tang

  6. Clinical Associate Professor, Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    D. McAllister

Authors
  1. Arijit Lodha
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  2. J. J. Moser
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  3. A. Walker
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  4. A. Lodha
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Contributions

Mr. Arijit Lodha drafted the initial version of the manuscript and was involved in the critical review and revision of the manuscript. Dr. J J Moser, Dr. A Lodha and Dr. D McAllister conceptualized and designed the study and were involved in the acquisition and interpretation of the data and the critical review and revision of the manuscript. Dr. Walker was involved in data acquisition, statistical analysis and interpretation of the data and the critical review and revision of the manuscript.Ms. Selphee Tang was involved in the acquisition and interpretation of the data and critical review and revision of the manuscript.

Corresponding author

Correspondence to D. McAllister.

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Lodha, A., Moser, J.J., Walker, A. et al. Association of epidural analgesia in labor with neurodevelopmental outcomes in premature infants born at <29 weeks of gestational age. J Perinatol 44, 548–553 (2024). https://doi.org/10.1038/s41372-024-01893-8

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