Neurodevelopmental impact of prenatal regional or general anaesthesia: An ambidirectional pilot cohort study

Up to 2% of pregnant women undergo non-obstetric surgery, yet literature on the long-term effects of prenatal anaesthesia exposure is scarce and conflicting. This study aimed to assess executive functions in children born to mothers exposed to general anaesthesia (GA) or regional anaesthesia (RA) for non-obstetric surgery during pregnancy, compared with children born to women who did not undergo surgery. The second aim was to assess executive functions, considering potential confounding factors affecting brain development.

This single-centre ambidirectional pilot cohort study included children born between 2011 and 2018 at Caen Normandy University Hospital, with retrospective identification of children born to mothers exposed, or not, to GA or RA during pregnancy. Children with a diagnosed neurodevelopmental disorder were excluded. Neurodevelopmental outcomes were assessed using the Behaviour Rating Inventory of Executive Function (BRIEF) parental questionnaire. Analyses included potential confounding factors. We conducted an analysis of variance (ANOVA) between the three groups for the primary outcome and univariate ANOVAs to study the influence of confounders on BRIEF scoring.

Ninety-four children (6.3-10.3 years old) were studied: children born to mothers exposed to GA (n = 40), RA (n = 13), and the control group (n = 41). No difference in BRIEF scores was observed among the groups. No confounding factors influenced this result.

This study is the first to compare neurodevelopmental outcomes in children born to mothers exposed, or not, to RA or GA during pregnancy. No difference in BRIEF scores was observed. Larger studies with detailed executive function analyses and daily life habits are needed.