Key result
Prenatal exposure to anesthesia for maternal surgery showed no significant difference in the global executive composite score compared to unexposed children (MD 1.9; 95% CI -0.4-4.2; p=0.10).
Why the study?
Up to 1% of pregnant women undergo anaesthesia for non-obstetric surgery, but neurodevelopmental outcomes after prenatal anaesthesia for maternal surgery required investigation.
Does prenatal exposure to anaesthesia for maternal surgery impair neurodevelopmental outcomes in children?
Cohort (n=582)
Does prenatal exposure to anaesthesia for maternal surgery impair neurodevelopmental outcomes in children?
Mean Difference: 1.9 (95% CI -0.4–4.2)
p-value: p=0.10
Prenatal exposure to anesthesia for maternal non-obstetric surgery does not appear to be associated with impaired neurodevelopmental outcomes in the general population.
This is the authors' abstract. We don't add key points for this paper.
Up to 1% of pregnant women undergo anaesthesia for non-obstetric surgery. This study investigated neurodevelopmental outcomes after prenatal anaesthesia for maternal surgery. A bidirectional cohort study of children born between 2001 and 2018 was performed: neurodevelopmental outcomes of children who had received prenatal anaesthesia for maternal surgery were prospectively compared with unexposed children, with exposure status being assessed retrospectively. Children exposed to anaesthesia for obstetric and fetal surgery were excluded. The primary outcome was the global executive composite of the behaviour rating inventory of executive function score. Our secondary outcomes were: total problems; internalising problems and externalising problems derived from the child behaviour checklist; psychiatric diagnoses; and learning disorders. In 90% of exposed children, there was a single mean (SD) antenatal anaesthesia exposure lasting 91(94) min. There was a broad spectrum of indications, with abdominal surgery being most frequent. Parents of 129 exposed (response rate 68%) and 453 unexposed (response rate 63%) children participated. There were no arguments for non-response bias. After propensity weighting, there were no statistically significant differences in primary outcome, with a weighted mean difference (95%CI) of exposed minus unexposed children of 1.9 (-0.4-4.2), p = 0.10; or any of the secondary outcomes. Sensitivity analyses confirmed the robustness. Exploratory analyses, however, showed significant differences in certain subgroups for the primary outcome, (e.g. for intra-abdominal surgery, exposure duration > 1 h) and some cognitive subdomains (e.g. working memory and attention). 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.
Supports indicated maternal surgery without neurodevelopmental concern; leaves open effects of specific agents or timing.
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Bleeser et al. (2022) conducted a cohort in Prenatal exposure to anesthesia (n=582). Prenatal exposure to anaesthesia for maternal surgery vs. Unexposed children was evaluated on Global executive composite of the behaviour rating inventory of executive function score (MD 1.9, 95% CI -0.4-4.2, p=0.10). Prenatal exposure to anesthesia for maternal surgery showed no significant difference in the global executive composite score compared to unexposed children (MD 1.9; 95% CI -0.4-4.2; p=0.10).
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