Association between surgical procedures under general anesthesia in infancy and developmental outcomes at 1 year: the Japan Environment and Children's Study.
Ages and Stages Questionnaires (ASQ)
Development
General anesthesia
Infant
Japan Environment and Children’s Study (JECS)
Neurotoxicity
Surgery
Journal
Environmental health and preventive medicine
ISSN: 1347-4715
Titre abrégé: Environ Health Prev Med
Pays: Japan
ID NLM: 9609642
Informations de publication
Date de publication:
25 Jul 2020
25 Jul 2020
Historique:
received:
26
05
2020
accepted:
14
07
2020
entrez:
27
7
2020
pubmed:
28
7
2020
medline:
20
9
2020
Statut:
epublish
Résumé
The neurotoxicity of general anesthesia to the developing human brains is controversial. We assessed the associations between surgery under general anesthesia in infancy and development at age 1 year using the Japan Environment and Children's Study (JECS), a large-scale birth cohort study. In the JECS, 103,062 pregnancies and 104,065 fetuses were enrolled between January 2011 and March 2014. Of the 100,144 registered live births, we excluded preterm or post-term infants, multiple births, and infants with chromosomal anomalies and/or anomalies of the head or brain. Data on surgical procedures under general anesthesia in infancy were collected from self-administered questionnaires by parents at the 1-year follow-up. Developmental delay at age 1 year was assessed using the Japanese translation of the Ages and Stages Questionnaires, Third Edition (J-ASQ-3), comprising five developmental domains. Among the 64,141 infants included, 746 infants had surgery under general anesthesia once, 90 twice, and 71 three or more times. The percentage of developmental delay in the five domains of the J-ASQ-3 significantly increased with the number of surgical procedures. After adjusting for potential confounding factors, the risk of developmental delays in all five domains was significantly increased in infants who had surgery under general anesthesia three times or more (adjusted odds ratios: for communication domain 3.32; gross motor domain 4.69; fine motor domain 2.99; problem solving domain 2.47; personal-social domain 2.55). Surgery under general anesthesia in infancy was associated with an increased likelihood of developmental delay in all five domains of the J-ASQ-3, especially the gross motor domain at age 1 year. The neurodevelopment with the growth should be further evaluated among the children who had surgery under general anesthesia. UMIN Clinical Trials Registry (number: UMIN000030786 ).
Sections du résumé
BACKGROUND
BACKGROUND
The neurotoxicity of general anesthesia to the developing human brains is controversial. We assessed the associations between surgery under general anesthesia in infancy and development at age 1 year using the Japan Environment and Children's Study (JECS), a large-scale birth cohort study.
METHODS
METHODS
In the JECS, 103,062 pregnancies and 104,065 fetuses were enrolled between January 2011 and March 2014. Of the 100,144 registered live births, we excluded preterm or post-term infants, multiple births, and infants with chromosomal anomalies and/or anomalies of the head or brain. Data on surgical procedures under general anesthesia in infancy were collected from self-administered questionnaires by parents at the 1-year follow-up. Developmental delay at age 1 year was assessed using the Japanese translation of the Ages and Stages Questionnaires, Third Edition (J-ASQ-3), comprising five developmental domains.
RESULTS
RESULTS
Among the 64,141 infants included, 746 infants had surgery under general anesthesia once, 90 twice, and 71 three or more times. The percentage of developmental delay in the five domains of the J-ASQ-3 significantly increased with the number of surgical procedures. After adjusting for potential confounding factors, the risk of developmental delays in all five domains was significantly increased in infants who had surgery under general anesthesia three times or more (adjusted odds ratios: for communication domain 3.32; gross motor domain 4.69; fine motor domain 2.99; problem solving domain 2.47; personal-social domain 2.55).
CONCLUSIONS
CONCLUSIONS
Surgery under general anesthesia in infancy was associated with an increased likelihood of developmental delay in all five domains of the J-ASQ-3, especially the gross motor domain at age 1 year. The neurodevelopment with the growth should be further evaluated among the children who had surgery under general anesthesia.
TRIAL REGISTRATION
BACKGROUND
UMIN Clinical Trials Registry (number: UMIN000030786 ).
Identifiants
pubmed: 32711462
doi: 10.1186/s12199-020-00873-6
pii: 10.1186/s12199-020-00873-6
pmc: PMC7382792
doi:
Substances chimiques
Anesthetics, General
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
32Investigateurs
Michihiro Kamijima
(M)
Shin Yamazaki
(S)
Yukihiro Ohya
(Y)
Reiko Kishi
(R)
Nobuo Yaegashi
(N)
Koichi Hashimoto
(K)
Chisato Mori
(C)
Shuichi Ito
(S)
Zentaro Yamagata
(Z)
Hidekuni Inadera
(H)
Takeo Nakayama
(T)
Hiroyasu Iso
(H)
Youichi Kurozawa
(Y)
Narufumi Suganuma
(N)
Koichi Kusuhara
(K)
Takahiko Katoh
(T)
Commentaires et corrections
Type : CommentIn
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