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Anesthesia, extremely premature infants and full-scale intelligence quotient at 5 years of age

Joanna J Fifen1,2, Mujtaba Siddique3, Arijit Lodha4

  • 1Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Pediatric Research
|March 29, 2025
PubMed

Insights

Exposure to Food and Drug Administration (FDA) warned anesthetics in premature infants did not significantly impact their full-scale intelligence quotient (FSIQ) scores at age five. Further research is needed to clarify potential long-term effects.

Area of Science:

  • Neonatal Neuroscience
  • Developmental Pediatrics
  • Anesthesiology

Background:

  • Premature infants born before 27 weeks gestational age are at risk for neurodevelopmental deficits.
  • Anesthetic agents used in early life may influence brain development.
  • The FDA has flagged certain anesthetic drugs for potential risks.

Purpose of the Study:

  • To investigate the association between exposure to FDA-warned anesthetics and full-scale intelligence quotient (FSIQ) in premature infants.
  • To determine if early anesthetic exposure affects cognitive outcomes at 5 years of age.

Main Methods:

  • Retrospective cohort study of 387 premature infants (<27 weeks gestational age) born between 2006-2012.
  • Exposure to FDA-warned anesthetics (volatile anesthetics, propofol, benzodiazepines, ketamine, chloral hydrate, barbiturates/phenobarbital) was assessed.
  • Associations with FSIQ at age 5 were analyzed using univariable and multivariable regression, with missing data imputation.

Main Results:

  • FSIQ scores at 5 years were available for 238 (61.5%) infants.
  • 110 (46.2%) infants were exposed to FDA-warned anesthetics.
  • Neither unadjusted nor adjusted analyses revealed a significant association between FDA-warned anesthetic exposure and FSIQ scores.

Conclusions:

  • Early exposure to FDA-warned anesthetics in extremely premature infants is not significantly associated with reduced FSIQ at 5 years of age.
  • The study highlights the need for continued investigation into the neurodevelopmental effects of early-life anesthetic exposure.
  • No significant impact on FSIQ was observed for specific anesthetic types or dosages.
Abstract

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