Table 4.

Association Between Neuraxial Labor Analgesia and Development of Learning Disabilities^¥

Model	Hazard Ratio	95% Confidence Interval	P value
Unadjusted	1.19	1.03 – 1.37	0.02
Adjusted *	1.15	0.98 – 1.35	0.08
Adjusted †	1.05	0.85 – 1.31	0.63

^¥Data were analyzed using proportional hazards regression. Three models were fit: 1) unadjusted; 2) adjusted for covariates known to be associated with learning disabilities (LD); and 3) adjusted for covariates known to be associated with LD, as well as additional peripartum maternal and child variables. For each model, the hazard ratio and corresponding 95% confidence interval for the association of neuraxial analgesia with LD is presented.

^*Adjusted for gestational age (≤31 weeks, 32-36 weeks, ≥37 weeks), sex (male, female), birth weight (<2500 g, ≥2500 g), maternal education (some high school, high school graduate, any college), 5-min Apgar score, and number of anesthesia exposures before the age of 4 (0, 1, 2 or more).

^†Adjusted for covariates included in initial adjusted model plus use of forceps or vacuum extraction, fetal presentation, dystocia, prolonged labor, birth trauma, use of any inhaled anesthetics during delivery, use of supplemental regional blocks, use of opioids, labor induction, delivery resuscitation or neonatal intensive care unit admission after delivery, and maternal age.