Early Childhood Exposure to Anesthesia and Risk of Developmental and Behavioral Disorders in a Sibling Birth Cohort

• DOI: 10.1213/ane.0b013e3182147f42
• Publication Date: 2011-03-19T06:45:38Z
• Authors: Charles DiMaggio; Lena S. Sun; Guohua Li
• Keywords: Databases, Factual; Developmental Disabilities; 610; Child Behavior Disorders; Kaplan-Meier Estimate; Anesthesia, General; Risk Assessment; Centers for Medicare and Medicaid Services, U.S.; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; International Classification of Diseases; Confidence Intervals; Humans; Psychology; Anesthesia; Autistic Disorder; Child; Retrospective Studies; Siblings; Infant, Newborn; Infant; 3. Good health; FOS: Psychology; Attention Deficit Disorder with Hyperactivity; Child, Preschool; Surgery

In Brief BACKGROUND: vitro and in vivo studies of anesthetics have demonstrated serious neurotoxic effects on the developing brain. However, clinical relevance these findings to children undergoing anesthesia remains unclear. Using data from a sibling birth cohort, we assessed association between exposure setting surgery patients younger than 3 years risk developmental behavioral disorders. METHODS: We constructed retrospective cohort 10,450 siblings who were born 1999 2005 enrolled New York State Medicaid program. The exposed group was 304 without history or disorders underwent when they years. unexposed 10,146 did not receive any surgical procedures Exposed entered into analysis at date surgery. Unexposed age 10 months (the mean which surgery). Both followed until diagnosis with disorder, loss follow-up, end 2005. subsequent both proportional hazards modeling, pair-matched analysis. RESULTS: incidence 128.2 diagnoses per 1000 person-years for 56.3 cohort. With adjustment sex birth-related medical complications, clustering by status, estimated hazard ratio associated 1.6 (95% confidence interval [CI]: 1.4, 1.8). increased 1.1 CI: 0.8, 1.4) 1 operation 2.9 (94% 2.5, 3.1) 2 operations 4.0 3.5, 4.5) ≥3 operations. relative matched 138 pairs 0.9 0.6, 1.4). CONCLUSION: being subsequently diagnosed state program had 60% greater that similar undergo More tightly pairwise analyses indicate extent excess is causally attributable mediated unmeasured factors be determined. Published ahead print March 17, 2011