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General anesthesia in early childhood and possible association with autism : a population-based matched cohort study

Pikwer, Andreas LU ; Yang, Bei ; Granström, Malin ; Mattsson, Niklas LU orcid and Sadr-Azodi, Omid (2023) In Minerva Anestesiologica 89(1-2). p.22-31
Abstract

BACKGROUND: In experimental animal studies, exposure to general anesthesia in early childhood may results in changes in infant brain morphology and behavior, potentially leading to the development of autistic behaviors in the long-term. However, in clinical studies the role of exposure to general anesthesia in early childhood and the risk of autism is unknown. METHODS: This is a population-based cohort study including all children aged 0-5 years of age exposed to general anesthesia between 2001 and 2014 and a corresponding matched population without such an exposure. Propensity score calculation was based on 49 variables (including age of parents, malformations, APGAR Score, and family income, among others). Quasi-Poisson regression was... (More)

BACKGROUND: In experimental animal studies, exposure to general anesthesia in early childhood may results in changes in infant brain morphology and behavior, potentially leading to the development of autistic behaviors in the long-term. However, in clinical studies the role of exposure to general anesthesia in early childhood and the risk of autism is unknown. METHODS: This is a population-based cohort study including all children aged 0-5 years of age exposed to general anesthesia between 2001 and 2014 and a corresponding matched population without such an exposure. Propensity score calculation was based on 49 variables (including age of parents, malformations, APGAR Score, and family income, among others). Quasi-Poisson regression was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs) for the association between exposure to general anesthesia and autism or autism spectrum disorder. RESULTS: In total, 401,750 children exposed to general anesthesia were compared with 1,187,796 unexposed individuals. Autism or autism spectrum disorder were more common in the children exposed to general anesthesia as compared to unexposed children (1.65% and 0.98%, respectively, P<0.01). There was a statistically significant higher risk of autism or autism spectrum disorder in children exposed to general anesthesia as compared to unexposed children also after propensity score adjustment (RR 1.62, 95% CI: 1.57-1.67). CONCLUSIONS: Exposure to general anesthesia in early childhood was associated with an increased risk of autism or autism spectrum disorder. Future studies are needed to asses if general anesthesia may cause autism or if the association is due to other factors.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Minerva Anestesiologica
volume
89
issue
1-2
pages
10 pages
publisher
Edizioni Minerva Medica S.p.A.
external identifiers
  • scopus:85147536827
  • pmid:36282219
ISSN
1827-1596
DOI
10.23736/S0375-9393.22.16543-0
language
English
LU publication?
yes
id
2b791863-702e-4e51-a9b1-9f2186b9fbee
date added to LUP
2023-02-24 11:37:34
date last changed
2024-04-18 19:06:04
@article{2b791863-702e-4e51-a9b1-9f2186b9fbee,
  abstract     = {{<p>BACKGROUND: In experimental animal studies, exposure to general anesthesia in early childhood may results in changes in infant brain morphology and behavior, potentially leading to the development of autistic behaviors in the long-term. However, in clinical studies the role of exposure to general anesthesia in early childhood and the risk of autism is unknown. METHODS: This is a population-based cohort study including all children aged 0-5 years of age exposed to general anesthesia between 2001 and 2014 and a corresponding matched population without such an exposure. Propensity score calculation was based on 49 variables (including age of parents, malformations, APGAR Score, and family income, among others). Quasi-Poisson regression was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs) for the association between exposure to general anesthesia and autism or autism spectrum disorder. RESULTS: In total, 401,750 children exposed to general anesthesia were compared with 1,187,796 unexposed individuals. Autism or autism spectrum disorder were more common in the children exposed to general anesthesia as compared to unexposed children (1.65% and 0.98%, respectively, P&lt;0.01). There was a statistically significant higher risk of autism or autism spectrum disorder in children exposed to general anesthesia as compared to unexposed children also after propensity score adjustment (RR 1.62, 95% CI: 1.57-1.67). CONCLUSIONS: Exposure to general anesthesia in early childhood was associated with an increased risk of autism or autism spectrum disorder. Future studies are needed to asses if general anesthesia may cause autism or if the association is due to other factors.</p>}},
  author       = {{Pikwer, Andreas and Yang, Bei and Granström, Malin and Mattsson, Niklas and Sadr-Azodi, Omid}},
  issn         = {{1827-1596}},
  language     = {{eng}},
  number       = {{1-2}},
  pages        = {{22--31}},
  publisher    = {{Edizioni Minerva Medica S.p.A.}},
  series       = {{Minerva Anestesiologica}},
  title        = {{General anesthesia in early childhood and possible association with autism : a population-based matched cohort study}},
  url          = {{http://dx.doi.org/10.23736/S0375-9393.22.16543-0}},
  doi          = {{10.23736/S0375-9393.22.16543-0}},
  volume       = {{89}},
  year         = {{2023}},
}