Anesthesia and Cognitive Performance in Children: No Evidence for a Causal Relationship
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Why the study?
Does anesthesia exposure before age 3 cause later learning-related problems in children?
Population
1,143 monozygotic twin pairs from the Netherlands Twin Registry, born between 1986 and 1995, with…
Comparison
Exposure to anesthesia before age 3. vs No exposure to anesthesia.
Design
Cohort
Follow-up
up to age 12
Authors
Discussion
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Member takes
Implication
Anesthesia before age 3 should not prompt avoidance for cognitive risk; leaves open causality testing in broader populations.
Structured PICO
Does anesthesia exposure before age 3 cause later learning-related problems in children?
P
Population
1,143 monozygotic twin pairs (56% female) from the Netherlands Twin Registry, born between 1986 and 1995, with gestational age ≥32 weeks and birth weight ≥2000 grams.
I
Intervention
Exposure to anesthesia before age 3 (and ever before age 12).
C
Comparator
No exposure to anesthesia (specifically comparing unexposed co-twins in discordant monozygotic pairs).
O
Outcome
Educational achievement (assessed with Dutch CITO-elementary test) and cognitive problems (assessed with Conners' Teacher Rating Scale - Revised: Short Form) near age 12.patient reported
Early anesthesia exposure is likely a marker of an individual's underlying vulnerability for later learning problems rather than a direct neurotoxic cause, as evidenced by the lack of difference in cognitive outcomes between discordant monozygotic twins.
Limitations
- Did not directly assess for learning disabilities but rather for learning-related outcomes.
- Did not assess for the specific types of anesthesia.
Cite This Study
Bartels et al. (2009) studied this question.
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