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Environmental Health and Preventive Medicine
Published in: Environmental Health and Preventive Medicine 1/2020

Open Access 01-12-2020 | General Anesthesia | Research article

Association between surgical procedures under general anesthesia in infancy and developmental outcomes at 1 year: the Japan Environment and Children’s Study

Authors: Yoshiko Kobayashi, Narumi Tokuda, Sho Adachi, Yasuhiro Takeshima, Munetaka Hirose, Masayuki Shima, Japan Environment and Children’s Study (JECS) Group

Published in: Environmental Health and Preventive Medicine | Issue 1/2020

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Abstract

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

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

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

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

UMIN Clinical Trials Registry (number: UMIN000030786)
Appendix
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Metadata
Title
Association between surgical procedures under general anesthesia in infancy and developmental outcomes at 1 year: the Japan Environment and Children’s Study
Authors
Yoshiko Kobayashi
Narumi Tokuda
Sho Adachi
Yasuhiro Takeshima
Munetaka Hirose
Masayuki Shima
Japan Environment and Children’s Study (JECS) Group
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Environmental Health and Preventive Medicine / Issue 1/2020
Print ISSN: 1342-078X
Electronic ISSN: 1347-4715
DOI
https://doi.org/10.1186/s12199-020-00873-6

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