Key result
Multiple exposures to general anesthesia in children before the age of 3 increased the risk of ADHD (HR 1.83), whereas a single exposure did not significantly increase the risk.
Why the study?
To evaluate the relationship between frequency of exposure to general anesthesia before age 3 and the subsequent risk of ADHD diagnosis.
Does exposure to general anesthesia increase the risk of ADHD in children before age 3?
Meta-Analysis (n=26,510)
Does exposure to general anesthesia increase the risk of ADHD in children before age 3?
Hazard Ratio: 1.83 (95% CI 1–3.32)
p-value: p=0.05
Multiple, but not single, exposures to general anesthesia in children before age 3 are associated with an increased risk of subsequent ADHD diagnosis.
Multiple exposures warrant caution but should not yet change practice; leaves open causality and need for prospective trials.
Objective: The objective of the study was to evaluate the relationship between frequency of exposure to general anesthesia before the age of 3 and subsequent risk of diagnosis for attention-deficit hyperactivity disorder (ADHD). Method: We searched PubMed, Embase, Web of Science, and Cochrane Library database for eligible inclusion in the meta-analysis. The indicated outcomes were extracted from the included studies, and the combined effects were calculated using the RevMan software 5.3. Results: Compared with no exposure to general anesthesia, single exposure to general anesthesia did not increase the risk of ADHD for children before the age of 3 [hazard ratio (HR): 1.14, 95%; confidence intervals (CI): 0.97–1.35; p = 0.11; I 2 = 0%], while multiple exposures to general anesthesia did increase the risk of ADHD (HR: 1.83; 95% CIs: 1.00–3.32; p = 0.05; I 2 = 81%). Conclusion: Multiple, but not single, exposures to general anesthesia in children before age of 3 increased the risk of ADHD.
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Song et al. (2021) conducted a meta-analysis in Attention-deficit hyperactivity disorder (ADHD) (n=26,510). Multiple exposures to general anesthesia vs. No exposure to general anesthesia was evaluated on Diagnosis of ADHD (HR 1.83, 95% CI 1.00-3.32, p=0.05). Multiple exposures to general anesthesia in children before the age of 3 increased the risk of ADHD (HR 1.83), whereas a single exposure did not significantly increase the risk.
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