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Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.

ABSTRACT: Background:The anaesthetic dose causing neurotoxicity in animals has been evaluated, but the relationship between duration of volatile anaesthetic (VA) exposure and neurodevelopment in children remains unclear. Methods:Data were obtained from the Western Australian Pregnancy Cohort (Raine) Study, with language (Clinical Evaluation of Language Fundamentals: Receptive [CELF-R] and Expressive [CELF-E] and Total [CELF-T]) and cognition (Coloured Progressive Matrices [CPM]) assessed at age 10?yr. Medical records were reviewed, and children divided into quartiles based on total VA exposure duration before age three yr. The association between test score and exposure duration quartile was evaluated using linear regression, adjusting for patient characteristics and comorbidity. Results:Of 1622 children with available test scores, 148 had documented VA exposure and were split into the following quartiles:??25,?>25 to??35,?>35 to??60 and?>60?min. Compared with unexposed children, CELF-T scores for children in the first and second quartiles did not differ, but those in the third and fourth quartiles had significantly lower scores ([3 rd quartile - Unexposed] -5.3; 95% confidence interval [CI], (-10.2 - -0.4), [4 th quartile - Unexposed] -6.2; 95% CI, (-11.6 - -0.9). CELF-E showed similar findings, but significant differences were not found in CELF-R or CPM for any quartile. Conclusions:Children with VA exposures??35?min did not differ from unexposed children, but those with exposures?>35?min had lower total and expressive language scores. It remains unclear if this is a dose-response relationship, or if children requiring longer exposures for longer surgeries have other clinical reasons for lower scores.

SUBMITTER: Ing C

PROVIDER: S-EPMC5901742 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.

Ing C C Hegarty M K MK Perkins J W JW Whitehouse A J O AJO DiMaggio C J CJ Sun M M Andrews H H Li G G Sun L S LS von Ungern-Sternberg B S BS

British journal of anaesthesia 20170901 3

<h4>Background</h4>The anaesthetic dose causing neurotoxicity in animals has been evaluated, but the relationship between duration of volatile anaesthetic (VA) exposure and neurodevelopment in children remains unclear.<h4>Methods</h4>Data were obtained from the Western Australian Pregnancy Cohort (Raine) Study, with language (Clinical Evaluation of Language Fundamentals: Receptive [CELF-R] and Expressive [CELF-E] and Total [CELF-T]) and cognition (Coloured Progressive Matrices [CPM]) assessed at ...[more]

PMID: 28969309

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Project description:BackgroundChildhood cognitive ability has been identified as a novel risk factor for adulthood overweight and obesity as assessed by adult body mass index (BMI). BMI does not, however, distinguish fat-free and metabolically harmful fat tissue. Hence, we examined the associations between childhood cognitive abilities and body fat percentage (BF%) in young adulthood.MethodsParticipants of the Arvo Ylppö Longitudinal Study (n=816) underwent tests of general reasoning, visuomotor integration, verbal competence and language comprehension (M=100; s.d.=15) at the age of 56 months. At the age of 25 years, they underwent a clinical examination, including measurements of BF% by the InBody 3.0 eight-polar tactile electrode system, weight and height from which BMI (kg?m(-2)) was calculated and waist circumference (cm).ResultsAfter adjustments for sex, age and BMI-for-age s.d. score at 56 months, lower general reasoning and visuomotor integration in childhood predicted higher BMI (kg?m(-2)) increase per s.d. unit decrease in cognitive ability (-0.32, 95% confidence interval -0.60,-0.05; -0.45, -0.75,-0.14, respectively) and waist circumference (cm) increase per s.d. unit decrease in cognitive ability (-0.84, -1.56,-0.11; -1.07,-1.88,-0.26, respectively) in adulthood. In addition, lower visuomotor integration predicted higher BF% per s.d. unit decrease in cognitive ability (-0.62,-1.14,-0.09). Associations between general reasoning and BMI/waist were attenuated when adjusted for smoking, alcohol consumption, intake of fruits and vegetables and physical activity in adulthood, and all associations, except for visuomotor integration and BMI, were attenuated when adjusted for parental and/or own attained education and/or birth weight.ConclusionsOf the measured childhood cognitive abilities, only lower visuomotor integration was associated with BF% in adulthood. This challenges the view that cognitive ability, at least when measured in early childhood, poses a risk for adiposity in adulthood, as characterized by higher BF%.

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Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.

Publications

Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.

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