Epidural analgesia in labour and neonatal and childhood outcomes: national population based cohort study
An erratum to this article was published (BMJ, 11 Aug 2026 ↗)
Main findingResult — go to the resultAdjusted relative risk 0.87 95% CI 0.68–1.12Authors' conclusion
Epidural analgesia during labour was not associated with clinically significant risks of harm to newborn babies or children, including risks of neonatal morbidity, death, or cerebral palsy.
Study context
- Population
- Women in labour with a singleton pregnancy at 24+0 to 42+6 weeks' gestation delivering vaginally or via unplanned caesarean birth, all NHS hospitals in Scotland, 2007–2019
- Participants
- 495,695 women
- Exposure
- Epidural analgesia in labour vs no epidural analgesia
- Epiduraln = 114,897
- Outcome
- Neonatal neurological morbidity (ICD-10: hypoxic ischaemic encephalopathy, neonatal seizures, intraventricular haemorrhage or infarction, periventricular leukomalacia, meningitis, encephalitis, kernicterus, hypotonia, birth asphyxia, or other cerebral diagnosis)
- Follow-up
- Within 28 days of birth
Methodological detailsnational linked administrative data
- National linked administrative data
Main finding
As reported in the abstract
Adjusted relative risk
0.87
95% CI 0.68–1.12
Epidural vs No epidural
adjusted RR 0.87 (95% CI 0.68–1.12)
- Neonatal neurological morbidity, all births (434 babies), per 1000 births
- 0.9 (95% CI 0.8 to 1.0)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted RR (95% CI) | |
|---|---|---|
| Other severe neonatal morbidity | 1.17 (0.90–1.51) | |
| Neonatal sepsis | 1.11 (0.90–1.37) | |
| Apgar score <4 at five minutes | 0.97 (0.87–1.09) | |
| Neonatal mortality · 28 days | 0.81 (0.62–1.06) | |
| Cerebral palsy in childhood | 0.80 (0.60–1.06) | |
| 0.512Adjusted relative risk (log scale) |
Subgroups (high risk pregnancies, preterm births, modes of birth)
- Findings consistent across subgroups
Original publication
Epidural analgesia in labour and neonatal and childhood outcomes: national population based cohort study. BMJ. Published 15 July 2026. doi:10.
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