A large study conducted by British scientists established no significant link between the use of epidural anesthesia during labor and the development of neurological disorders in infants. Furthermore, the use of this type of pain relief does not affect the probability of sepsis or the mortality rate within 28 days.
Epidural anesthesia is recognized as the most effective way to relieve pain during childbirth. In addition to alleviating maternal suffering, it facilitates a smoother transition to general anesthesia required for a C-section. It is assumed that pain relief helps reduce stress in the mother, which prevents the release of cortisol and catecholamines, hyperventilation, and reduced oxygen supply to the fetus.
Despite the obvious advantages, there are concerns about the potential negative impact of anesthesia on children's health. Since analgesia can cause a drop in blood pressure, worsen maternal-placental perfusion, and affect the fetal heart rate, many mothers continue to question the possible harm to newborns, even if observational data indicates the method is safe.
A group of researchers led by Rachel Kerns from the Royal Glasgow Hospital conducted a population cohort study to examine the link between epidural anesthesia and adverse outcomes in newborns. The sample included 495,695 mothers who had a singleton pregnancy and delivered between 24 and 43 weeks, either vaginally or via emergency C-section. Of the total number of women, 114,897 received epidural anesthesia.
The statistical analysis did not reveal a correlation (the adjusted relative risk was 0.87) between the use of epidural analgesia and an increased risk of serious neurological complications. These complications included hypoxic-ischemic encephalopathy, meningitis, encephalitis, neonatal seizures, intraventricular hemorrhage, periventricular leukomalacia, jaundice, birth asphyxia, or any other cerebral disease manifesting before 28 days of life.
Moreover, epidural anesthesia was not associated with other severe newborn conditions such as birth trauma, birth acidosis, brachial plexus injury, hypoglycemia, hypothermia, respiratory distress syndrome, respiratory failure, or pneumothorax.
The scientists also found no link between pain relief and an increased risk of neonatal sepsis or receiving a low score on the Apgar scale at five minutes. The risk of child death within the first 28 days of life and the development of cerebral palsy were also independent of this method. However, when analyzing subgroups, it was found that in cases of preterm birth, epidural anesthesia helped reduce the probability of a low Apgar score at five minutes (adjusted relative risk 0.59). The mode of delivery overall did not significantly affect the results obtained.
The researchers believe that the findings should serve as a basis for convincing both parents and medical staff about the safety of using epidural anesthesia during childbirth for children. These results will allow for more informed decisions when choosing pain management methods.
Canadian scientists analyzed data covering over 250,000 children and established a link between the presence of congenital heart defects in the mother and an increased risk of various developmental deviations in offspring. It was found that such defects increase the probability of delays in physical, cognitive, emotional, and social aspects of development by 28 percent. The results of this study were published in the scientific journal PLoS Medicine.
Congenital heart defects are among the most common categories of developmental anomalies, affecting about one percent of all newborns. According to 2019 data, 13.3 million cases of these diseases were registered worldwide. Thanks to advances in pediatric cardiac surgery, over ninety percent of children with such defects reach adulthood.
However, the increasing number of pregnant women with this developmental defect raises concerns about pregnancy outcomes and subsequent child development. Women suffering from congenital heart defects have an increased risk of preterm birth and giving birth to a low birth weight infant. It is hypothesized that this relationship may be linked to placental function impairments, which negatively affects the nutrition, growth, and overall development of the fetus.
A group of researchers led by Muhammad Hossain from the University of British Columbia studied whether maternal heart defects correlate with an increased risk of neurocognitive problems in children upon school entry. For this, a dataset including 256,629 kindergarten students was analyzed, of whom 48.6 percent were girls, and the average age was 5.6 years. Neurocognitive development was assessed using a questionnaire completed by educators in the second half of the academic year.
This questionnaire is designed to measure children's competencies in five key areas necessary for successful schooling. It consists of 103 questions and covers physical condition and well-being, social competence, emotional maturity, language and cognitive development, as well as communication skills and general knowledge. The main criterion in the study was neurocognitive vulnerability, defined as a score below the 10th percentile in two or more domains.
The initial analysis revealed that children whose mothers had congenital heart defects were more likely to be born prematurely and had serious developmental anomalies. Approximately 2.2 percent of these children were also diagnosed with congenital heart defects. The proportion of children showing neurocognitive problems was 25.2 percent in the group of mothers with heart defects compared to 16.6 percent among children of healthy mothers. After conducting a corrected analysis, exposed children showed a 28 percent higher risk of developing neurocognitive vulnerability, with delays observed in all studied domains.
Specifically, declines were recorded in areas such as physical independence, gross and fine motor skills, hyperactive and inattentive behavior, general social competence, ability to responsibility and respect, interest and approach to learning, as well as basic literacy and basic arithmetic. Sensitivity analysis showed that the impact of preterm birth accounted for about eight percent, and the association was stronger in children whose mothers also suffered from gestational diabetes. Although excluding children with congenital developmental defects significantly weakened this association, severe form of the disease in the mother had a stronger impact on the risk of child developmental vulnerability than the mild form.
The study authors emphasize that the data obtained highlight the need to consider maternal congenital heart defects as a potential risk factor for child developmental disorders. They also point out that optimizing preconception preparation and improving perinatal care can help reduce the likelihood of adverse long-term health and developmental outcomes for children.
