Does having an epidural during birth cause neurodevelopmental disorders in the baby?
Many parents worry about whether epidural pain relief during labor could affect their baby's brain development. The short answer is that high-quality research, including studies that compare siblings to control for genetic and family factors, has not found a convincing link between epidurals and neurodevelopmental disorders such as autism or ADHD. While some population studies show a small increase in risk, this appears to be due to other factors that are more common in mothers who choose epidurals, not the epidural itself.
What the research says
A 2026 systematic review and meta-analysis examined 19 studies on neuraxial labor analgesia (which includes epidurals) and neurodevelopmental outcomes in children 39. The strongest evidence came from sibling-matched studies, which control for shared genetics and family environment. In these studies, epidural use was not associated with autism spectrum disorder (adjusted hazard ratio 1.06; 95% CI 0.98-1.14) or attention-deficit/hyperactivity disorder (ADHD) 39. This means the risk was essentially the same between siblings who were and were not exposed to epidurals.
Population-based studies that did not control for family factors showed a small increase in autism risk (adjusted hazard ratio 1.10; 95% CI 1.08-1.13) 39. However, this effect disappeared when researchers accounted for shared familial factors, suggesting that the apparent link is due to confounding—meaning mothers who choose epidurals may have other characteristics that independently influence neurodevelopment 39. The review concluded there is no convincing evidence that epidural analgesia causes neurodevelopmental disorders.
Other research on ADHD risk factors has looked at environmental exposures like air pollution and noise, but not epidurals 2. Studies on gut mycobiota and ADHD have focused on fungal imbalances in the gut, not birth interventions 1. These areas are separate from the question of epidural safety.
What to ask your doctor
- What does the current evidence say about epidurals and my baby's brain development?
- Are there any specific risks of epidural for my particular pregnancy or medical history?
- What pain relief options are available during labor, and how do their risks compare?
- If I have concerns about neurodevelopmental disorders, what factors should I focus on instead?
- Can you explain how family history and genetics might influence my child's risk more than birth interventions?
This question is drawn from common patient questions about OB/GYN & Women's Health and answered using cited medical research. We do not provide individualized advice.