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Pediatr Res. 2015 Sep;78(3):323-9. doi: 10.1038/pr.2015.106. Epub 2015 May 28.

Impaired cognitive performance in premature newborns with two or more surgeries prior to term-equivalent age.

Author information

1
Department of Pediatrics, University of California-San Francisco, San Francisco, California.
2
Department of Medicine, Queens University, Kingston, Ontario, Canada.
3
1] Department of Pediatrics, University of California-San Francisco, San Francisco, California [2] Department of Neurology, University of California, San Francisco, San Francisco, California.
4
Department of Epidemiology & Biostatistics, University of California-San Francisco, San Francisco, California.
5
1] Department of Pediatrics, University of California-San Francisco, San Francisco, California [2] Department of Neurology, University of California, San Francisco, San Francisco, California [3] Department of Radiology, University of California-San Francisco, San Francisco, California.

Abstract

BACKGROUND:

Anesthesia in early childhood is associated with adverse neurodevelopmental outcome; however, it is not known if age at exposure affects the risk of adverse outcome. Our objective was to evaluate the association of the number and timing of anesthetic exposures for surgery with cognitive outcome in a cohort of premature newborns.

METHODS:

A cohort study of exposure to anesthesia for surgery in premature newborns (<33 wk gestation) prospectively evaluated with neonatal magnetic resonance imaging (MRI) and neurodevelopmental testing at 3-6 y was employed. Exposure to anesthesia for surgery was classified as before term-equivalent age (TEA, <42 wk postmenstrual age) or after (≥42 wk). Multivariate regression was performed to analyze the association of composite IQ scores with the number of surgeries before and after TEA.

RESULTS:

Among 137 newborns, 25 (18.2%) had one surgery before TEA and 18 (13.1%) had ≥2 surgeries. Two or more surgeries before TEA were associated with significantly reduced composite IQ scores at 4.6 ± 0.6 y after adjusting for gestational age and illness severity. Neither the number of surgeries after TEA nor sedation for MRI was associated with cognitive outcome.

CONCLUSIONS:

More than one surgery prior to TEA is independently associated with impaired cognitive performance in premature newborns.

PMID:
26020148
PMCID:
PMC4540651
DOI:
10.1038/pr.2015.106
[Indexed for MEDLINE]
Free PMC Article

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