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

Andreas Pikwer1,2, Bei Yang3, Malin Granström3,4

  • 1Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden - andreas.pikwer@med.lu.se.

Minerva Anestesiologica
|October 25, 2022
PubMed

Insights

Exposure to general anesthesia in early childhood is linked to a higher risk of autism spectrum disorder. Further research is needed to determine if anesthesia causes autism or if other factors are involved.

Area of Science:

  • Pediatric Anesthesiology
  • Neurodevelopmental Disorders
  • Epidemiology

Background:

  • Animal studies suggest early anesthesia exposure may alter infant brain development and behavior.
  • Potential long-term risks include the development of autistic behaviors.
  • Clinical evidence linking childhood anesthesia exposure to autism risk remains unclear.

Purpose of the Study:

  • To investigate the association between early childhood exposure to general anesthesia and the risk of autism spectrum disorder.
  • To compare autism rates in children exposed to general anesthesia versus an unexposed cohort.

Main Methods:

  • Population-based cohort study of children aged 0-5 years (2001-2014).
  • Matched comparison group without anesthesia exposure.
  • Propensity score matching used 49 variables for adjustment.
  • Quasi-Poisson regression analyzed the association and estimated risk ratios (RRs).

Main Results:

  • Over 400,000 children exposed to general anesthesia were compared with nearly 1.2 million unexposed children.
  • Autism spectrum disorder was more prevalent in the anesthesia-exposed group (1.65% vs. 0.98%).
  • A statistically significant increased risk of autism spectrum disorder was observed post-propensity score adjustment (RR 1.62).

Conclusions:

  • Early childhood exposure to general anesthesia is associated with an elevated risk of autism spectrum disorder.
  • Further investigation is required to ascertain causality or identify confounding factors.
  • The study highlights a potential link warranting continued research into anesthesia's neurodevelopmental effects.
Abstract

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