title: No association of labor epidural analgesia with cerebral palsy in children.
abstract: Some pregnant women avoid labor epidural analgesia because of their concerns about risk of cerebral palsy in children. Although it is believed that labor epidural does not contribute to cerebral palsy, to our knowledge no study has been published to specifically address this concern. We carried out a retrospective case-control study to investigate whether labor epidural analgesia is associated with cerebral palsy in children.
  
  
  
  This study used data that were collected and entered into the Geisinger electronic health records between January 2004 and January 2013. During this period, 20,929 children were born at Geisinger hospitals. Among them, 50 children were diagnosed with cerebral palsy, and 20 of those were born vaginally. Each of these 20 cerebral palsy children was matched with up to 5 non-cerebral palsy children born at the same hospitals in the same timeframe using propensity scoring methods. Analgesia was classified as epidural (including epidural or combined spinal and epidural) or non-epidural. Conditional logistic regression was used to compare the percentages of deliveries with each analgesia type between the cerebral palsy and non-cerebral palsy groups.
  
  
  
  In the non-cerebral palsy group, the percentage of patients receiving labor epidural analgesia was 72 %, and in the cerebral palsy group the percentage was 45 %. There was no significant difference between non-cerebral palsy and cerebral palsy groups (odds ratio, 0.57; 95 % confidence interval, 0.14-2.24; p = 0.42).
  
  
  
  We found no association between the use of labor epidural analgesia and the occurrence of cerebral palsy in children.
authors: Division of Anesthesiology, Geisinger Health System, Danville, PA, USA. lzhang1@geisinger.edu.
authors: Li
authors: 0000-0001-9939-8060
authors: L
authors: Zhang
authors: Center for Health Research, Geisinger Health System, Danville, PA, USA. jhgraham1@geisinger.edu.
authors: Jove H
authors: JH
authors: Graham
authors: Center for Health Research, Geisinger Health System, Danville, PA, USA.
authors: Wen
authors: W
authors: Feng
authors: Center for Health Research, Geisinger Health System, Danville, PA, USA.
authors: Meredith W
authors: MW
authors: Lewis
authors: Division of Anesthesiology, Geisinger Health System, Danville, PA, USA.
authors: Xiaopeng
authors: X
authors: Zhang
authors: Biomedical and Translational Informatics, Geisinger Health System, Danville, PA, USA.
authors: H Lester
authors: HL
authors: Kirchner
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000209:etiology*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cerebral palsy; Epidural analgesia; Labor and delivery; Neurological disorder