Association Between Exposure of Children to General Anesthesia and Autism Spectrum Disorder.
Mariana L Laporta, Juraj Sprung, Caroline A Fejedelem and 9 others
PMID 34618293WHAT IT FOUND
General anesthesia before age 3 was not associated with increased autism risk once health status and birth weight were considered.
Early apparent links disappeared after adjustment, suggesting confounding by underlying health issues rather than anesthetic toxicity.
Key findings
01After adjusting for birth weight and health status, no significant association was detected between anesthesia exposure and ASD.
02Factors related to differences in health status between children who did and did not receive anesthesia accounted for the significant association observed in univariate analysis.
03The main finding is that receiving procedures requiring general anesthesia before age 3 is not associated with increased incidence of later ASD.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study population is from Olmsted County, which may not represent the broader US population. Some potentially relevant covariates like parental education and socioeconomic status were not available for all participants. The number of cases might be insufficient to detect a very small odds ratio, though the lack of dose-response makes a strong association unlikely. ASD cases were defined by research criteria rather than clinical diagnosis, which may differ from how other studies define the population.
Declared interests
The authors have no conflict of interest to declare.
The easy way to misread this
Do not conclude that general anesthesia is proven safe for neurodevelopment based on this single study. It shows no association with ASD after adjustment, but it does not rule out other neurocognitive outcomes, and the null result relies heavily on the accuracy of health status adjustments.