What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Attention-deficit hyperactivity disorder (ADHD) (n=26510). Intervention: Multiple exposures to general anesthesia vs. No exposure to general anesthesia. Primary outcome: Diagnosis of ADHD (HR 1.83, 95% CI 1.00-3.32, p=0.05).

November 24, 2021Open Access

Does Exposure to General Anesthesia Increase Risk of ADHD for Children Before Age of Three?

JSJunjie SongHarbin Medical University HLHuifang LiXinjiang Medical University YWYing WangHebei Medical University

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.

Study Design

Type

Meta-Analysis (n=26,510)

Structured PICO

Does exposure to general anesthesia increase the risk of ADHD in children before age 3?

Population

26,510 children from 4 observational studies who were exposed to general anesthesia before the age of 3, evaluated for subsequent risk of ADHD.

Exposure

Single or multiple exposures to general anesthesia before the age of 3.

Comparator

No exposure to general anesthesia.

Outcome

Subsequent risk of diagnosis for attention-deficit hyperactivity disorder (ADHD).safety

Multiple, but not single, exposures to general anesthesia in children before age 3 are associated with an increased risk of subsequent ADHD diagnosis.

Main Result

Hazard Ratio: 1.83 (95% CI 1–3.32)

p-value: p=0.05

Limitations

All included studies were observational retrospective studies, which are inherently biased by selection and confounding.
Children requiring anesthesia might differ in baseline health status from those who do not.
Unable to distinguish the effect of anesthesia itself from the potential effect of the underlying surgery or procedure.

Abstract

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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Cite This Study

Song et al. (Wed,) 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.

synapsesocial.com/papers/6a2237261b095894fc4edd84 https://doi.org/https://doi.org/10.3389/fpsyt.2021.717093

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