Association Between Behavioral and Learning Outcomes and Single Exposures to Procedures Requiring General Anesthesia Before Age 3: Secondary Analysis of Data From Olmsted County, MN.

Tytuł:: Association Between Behavioral and Learning Outcomes and Single Exposures to Procedures Requiring General Anesthesia Before Age 3: Secondary Analysis of Data From Olmsted County, MN.
Autorzy:: Warner DO; From the Departments of Anesthesiology and Perioperative Medicine.
Hu D; From the Departments of Anesthesiology and Perioperative Medicine.
Zaccariello MJ; Psychiatry Psychology.
Schroeder DR; Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Hanson AC; Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Wilder RT; From the Departments of Anesthesiology and Perioperative Medicine.
Sprung J; From the Departments of Anesthesiology and Perioperative Medicine.
Flick RP; From the Departments of Anesthesiology and Perioperative Medicine.
Źródło:: Anesthesia and analgesia [Anesth Analg] 2021 Jul 01; Vol. 133 (1), pp. 160-167.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins
Original Publication: Cleveland, International Anesthesia Research Society.
MeSH Terms:: Data Interpretation, Statistical*
Anesthesia, General/*trends
Attention Deficit Disorder with Hyperactivity/*epidemiology
Child Behavior Disorders/*epidemiology
Learning Disabilities/*epidemiology
Anesthesia, General/adverse effects ; Attention Deficit Disorder with Hyperactivity/chemically induced ; Attention Deficit Disorder with Hyperactivity/diagnosis ; Child Behavior/drug effects ; Child Behavior/physiology ; Child Behavior Disorders/chemically induced ; Child Behavior Disorders/diagnosis ; Child, Preschool ; Cohort Studies ; Female ; Humans ; Infant ; Learning Disabilities/chemically induced ; Learning Disabilities/diagnosis ; Male ; Minnesota/epidemiology ; Retrospective Studies
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Grant Information:: R01 AG034676 United States AG NIA NIH HHS; R01 HD071907 United States HD NICHD NIH HHS; R01 HD099147 United States HD NICHD NIH HHS
Entry Date(s):: Date Created: 20200915 Date Completed: 20210727 Latest Revision: 20230721
Update Code:: 20240104
PubMed Central ID:: PMC7936987
DOI:: 10.1213/ANE.0000000000005180
PMID:: 32932391
: Czasopismo naukowe

Background: Two prior population-based (children born in Olmsted County, MN), retrospective cohort studies both found that multiple exposures to anesthesia before age 3 were associated with a significant increase in the frequency of attention-deficit hyperactivity disorder (ADHD) and learning disabilities (LD) later in life. The primary purpose of this secondary analysis of these data was to test the hypothesis that a single exposure to anesthesia before age 3 was associated with an increased risk of ADHD. We also examined the association of single exposures with LD and the need for individualized educational plans as secondary outcomes.
Methods: This analysis includes 5339 children who were unexposed to general anesthesia before age 3 (4876 born from 1976 to 1982 and 463 born from 1996 to 2000), and 1054 children who had a single exposure to anesthesia before age 3 (481 born from 1976 to 1982 and 573 born from 1996 to 2000). The primary outcome of interest was ADHD. Secondary outcomes included LD (reading, mathematics, and written language) and the need for individualized educational programs (speech/language and emotion/behavior). To compare the incidence of each outcome between those who were unexposed and singly exposed to anesthesia before the age of 3 years, an inverse probability of treatment weighted proportional hazards model was used.
Results: For children not exposed to anesthesia, the estimated cumulative frequency (95% confidence interval [CI]) of ADHD at age 18 was 7.3% (95% CI, 6.5-8.1) and 13.0% (95% CI, 10.1-16.8) for the 1976-1982 and 1996-2000 cohorts, respectively. For children exposed to a single anesthetic before age 3, the cumulative frequency of ADHD was 8.1% (95% CI, 5.3-12.4) and 17.6% (95% CI, 14.0-21.9) for the 1976-1982 and 1996-2000 cohorts, respectively. In weighted analyses, single exposures were not significantly associated with an increased frequency of ADHD (hazard ratio [HR], 1.21; 95% CI, 0.91-1.60; P = .184). Single exposures were also not associated with an increased frequency of any LD (HR, 0.98; 95% CI, 0.78-1.23), or the need for individualized education plans.
Conclusions: This analysis did not find evidence that single exposures to procedures requiring general anesthesia, before age 3, are associated with an increased risk of developing ADHD, LD, or the need for individualized educational plans in later life.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2020 International Anesthesia Research Society.)

Comment in: J Neurosurg Anesthesiol. 2023 Jan 1;35(1):97-103. (PMID: 36745170)

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