Early Exposure to Anesthesia and Learning Disabilities in a Population-Based Birth Cohort
By R. Wilder, R. Flick, J. Sprung, S. Katusic, W. Barbaresi, C. Mickelson, S. Gleich, D. Schroeder, A. Weaver, D. O. Warner. Anesthesiology, 2009
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Background:Anesthetic drugs administered to immature animals may cause neurohistopathologic changes and alterations in behavior. The authors studied association between anesthetic exposure before age 4 yr and the development of reading, written language, and math learning disabilities (LD). Methods:This was a population-based, retrospective birth cohort study. The educational and medical records of all children born to mothers residing in five townships of Olmsted County, Minnesota, from 1976 to 1982 and who remained in the community at 5 yr of age were reviewed to identify children with LD. Cox proportional hazards regression was used to calculate hazard ratios for anesthetic exposure as a predictor of LD, adjusting for gestational age at birth, sex, and birth weight. Results:Of the 5,357 children in this cohort, 593 received general anesthesia before age 4 yr. Compared with those not receiving anesthesia (n = 4,764), a single exposure to anesthesia (n = 449) was not associated with an increased risk of LD (hazard ratio = 1.0; 95% confidence interval, 0.79–1.27). However, children receiving two anesthetics (n = 100) or three or more anesthetics (n = 44) were at increased risk for LD (hazard ratio = 1.59; 95% confidence interval, 1.06–2.37, and hazard ratio = 2.60; 95% confidence interval, 1.60–4.24, respectively). The risk for LD increased with longer cumulative duration of anesthesia exposure (expressed as a continuous variable) (P = 0.016). Conclusion:Exposure to anesthesia was a significant risk factor for the later development of LD in children receiving multiple, but not single anesthetics. These data cannot reveal whether anesthesia itself may contribute to LD or whether the need for anesthesia is a marker for other unidentified factors that contribute to LD.
Subfields: Critical Care and Intensive Care Medicine, Developmental Neuroscience, Pediatrics, Perinatology and Child Health
View Paper: https://www.semanticscholar.org/paper/7d3f625b9f492089ec41faef845d31f175093686
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Citations in the corpus
- Basic statistical tools in research and data analysis (2016, background): “5 mm Hg Inferential statistics If one plans to study the association of learning disabilities[5] after exposure to anaesthesia before the age of 4 years, it will be feasible to compare the learning disabilities between children who have received anaesthesia and those who have not received anaesthesi”
- Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood (2016, neutral): “7,8,30,31 Differences between the results of the present study and those of others may be due to confounding by indications for anesthesia/surgery.”