Exposure to general anesthesia in early life and the risk of attention deficit/hyperactivity disorder development: A nationwide, retrospective matched-cohort study

Wen Ru Ko, Yung Po Liaw, Jing Yang Huang, De Hui Zhao, Hui Chin Chang, Pei Chieh Ko, Shiou Rung Jan, Oswald Ndi Nfor, Yi Chen Chiang, Long Yau Lin

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)

Abstract

Background Postnatal exposure to anesthetics can cause neural apoptosis and degeneration in animals, but results from studies conducted on humans were discordant. Previous studies contained no information on the relationship between neurobehavioural disorders and anesthesia exposure in Asian children. We conducted a retrospective matched-cohort study in Taiwan to investigate the association of early life anesthesia exposure with risk of attention deficit/hyperactivity disorder (ADHD). Methods Data were obtained from the National Health Insurance Research Database of Taiwan. Children born between January 1, 2001 and December 31, 2005 were included. Each child with anesthesia exposure before 3 years of age was matched to four unexposed children. Observation was concluded on December 31, 2010. Proportional hazards regression was used to assess the association of anesthesia exposure with ADHD. Analyses were also made based on exposure number and age at the time of first exposure. Results This matched-cohort comprised of 16 465 children, among which 3293 were exposed to general anesthesia before age 3 years. The adjusted hazard ratio of developing ADHD was 1.06 (95% CI: 0.86,1.31) for general anesthesia exposure. The adjusted hazard ratio of developing ADHD for single and multiple exposures were 1.11 (95% CI: 0.88, 1.41) and 0.96 (95% CI: 0.71,1.31), respectively. No trend of increasing risk was noted based on age at the time of first exposure. Conclusions Exposure to general anesthesia before 3 years of age was not associated with ADHD.

Original languageEnglish
Pages (from-to)741-748
Number of pages8
JournalPaediatric Anaesthesia
Volume24
Issue number7
DOIs
Publication statusPublished - 2014 Jul

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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