Pediatric anesthesia & critical care
Neurodevelopmental outcomes after prenatal exposure to anaesthesia for maternal surgery: a propensity‐score weighted bidirectional cohort study
Main finding · Exposed minus unexposedResult — go to the resultWeighted mean difference 1.9 95% CI −0.4-4.2Authors' conclusion
This bidirectional cohort study, the largest investigation on the subject to date, has found no evidence in the general population for an association between prenatal exposure to anaesthesia and impaired neurodevelopmental outcomes.
Study context
- Population
- Children born between 2001 and 2018response rates 68% and 63%
- Participants
- 129 vs 453
- Exposure
- Prenatal anaesthesia for maternal non-obstetric surgery vs no exposure
- Exposedn = 129
- Unexposedn = 453reference
- Outcome
- Global executive composite of the behaviour rating inventory of executive function score
Methodological detailspropensity-score weighted, 90% of exposed children had a single antenatal anaesthesia exposure, mean (SD) 91(94) min; abdominal surgery most frequent, Sensitivity analyses confirmed robustness; no arguments for non-response bias
- Propensity-score weighted
- 90% of exposed children had a single antenatal anaesthesia exposure, mean (SD) 91(94) min; abdominal surgery most frequent
- Sensitivity analyses confirmed robustness; no arguments for non-response bias
Main finding
Exposed minus unexposed
Weighted mean difference
1.9
95% CI −0.4-4.2
P = 0.10
Exposed vs Unexposed
weighted mean difference 1.9 (95% CI −0.4-4.2); P = 0.10
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Total, internalising and externalising problems (child behaviour checklist); psychiatric diagnoses; learning disorders
- No statistically significant differences in any secondary outcome
Primary outcome in subgroups and cognitive subdomains (exploratory)
- Significant differences in certain subgroups (e.g. intra-abdominal surgery, exposure duration > 1 h) and some cognitive subdomains (e.g. working memory and attention)
- Exploratory analyses
Original publication
Neurodevelopmental outcomes after prenatal exposure to anaesthesia for maternal surgery: a propensity‐score weighted bidirectional cohort study. Anaesthesia. Published 25 October 2022. doi:10.
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