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在产前暴露于母亲手术麻醉后的行为障碍

Caleb Ing¹, Jeffrey H Silber², Deven Lackraj³

¹Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.

British journal of anaesthesia

|February 29, 2024

概括

在怀孕期间,产前暴露于全身麻醉会增加儿童患行为障碍的风险. 对于需要手术的孕妇,建议谨慎,平衡母亲和孩子的风险和益处.

科学领域:

产科和妇科产科和妇科
儿科神经学儿科神经学
麻醉学麻醉学

背景情况:

产前暴露于母体手术全身麻醉和儿童行为障碍之间的联系尚未得到充分证实.
了解这种关联对于在怀孕期间管理手术护理至关重要.

研究的目的:

调查产前暴露于全身麻醉和儿童行为障碍诊断风险之间的关联.
为了确定特定类型的行为和神经精神疾病可能与这种暴露相关.

主要方法:

利用全国范围的医疗补助分析提取 (MAX) 数据库 (1999-2013) 连接孕妇和活产婴儿.
采用多变量匹配来比较暴露于全身麻醉的儿童进行母体尾切除或胆囊切除与未暴露的对照.
主要结局:破坏性或内化行为障碍的诊断;次要结局:其他神经精神病学诊断.

主要成果:

匹配了34,271名暴露儿童和171,355名未暴露儿童.
产前暴露的儿童出现破坏性或内化行为障碍诊断的可能性更高 (HR, 1.31; 95% CI, 1.23-1.40).
在暴露儿童中观察到ADHD,行为障碍,言语/语言障碍和自闭症的风险增加.

结论:

产前暴露于全身麻醉与儿童中破坏性或内化行为障碍的风险增加31%有关.
关于怀孕期间必要的母体手术的临床决定需要仔细考虑潜在的风险和益处.
避免必要的手术可能会对母亲和儿童的健康结果产生负面影响.

关键词:

麻醉神经毒性麻醉神经毒性行为赤字是指行为赤字.孕产妇的外科手术神经发育的神经发育儿科麻醉儿科麻醉在产前暴露,产前暴露.

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