Prenatal exposure to general anesthesia is associated with an increased risk for a subsequent diagnosis of disruptive or internalizing behavior among children, according to a study published online Feb. 28 in the British Journal of Anaesthesia.
Caleb Ing, M.P.H., from the Columbia University Vagelos College of Physicians and Surgeons in New York City, and colleagues examined the association between prenatal exposure to general anesthesia for maternal surgery during pregnancy and the subsequent risk for a disruptive or internalizing behavioral disorder diagnosis in a nationwide sample of pregnant women linked to their liveborn infants. Each child prenatally exposed to general anesthesia due to maternal appendectomy or cholecystectomy during pregnancy was matched with five unexposed children (34,271 and 171,355 children, respectively).
The researchers found that the likelihood of receiving a diagnosis of a disruptive or internalizing behavioral disorder was higher for prenatally exposed children versus unexposed children (hazard ratio, 1.31). Increased risks for disruptive and internalizing behavioral disorders were observed (hazard ratios, 1.32 and 1.36, respectively), as were increased risks for attention-deficit/hyperactivity disorder, behavioral disorders, developmental speech or language disorders, and autism (hazard ratios, 1.32, 1.28, 1.16, and 1.31, respectively).
“Caution is advised, as many procedures in pregnant women are necessary, and avoidance of necessary procedures can have detrimental effects on both mothers and their children,” the authors write. “However, these results should be considered when performing risk assessments for elective procedures in pregnant women, or when viable alternative treatments are available.”
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