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Associations between maternal exposure to surgery or pregnancy exposure to fluorinated anesthetics and children’s cognitive development and educational outcomes

Published online by Cambridge University Press:  15 August 2022

Melissa E. Kravets ,
Mark A. Klebanoff  and
Sarah A. Keim Open the ORCID record for Sarah A. Keim [Opens in a new window]
Melissa E. Kravets
Affiliation:
Center for Biobehavioral Health, The Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA
Mark A. Klebanoff
Affiliation:
Center for Biobehavioral Health, The Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
Sarah A. Keim*
Affiliation:
Center for Biobehavioral Health, The Research Institute, Nationwide Children’s Hospital, Columbus, OH 43205, USA Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
*
Address for correspondence: Sarah A. Keim, Center for Biobehavioral Health, The Research Institute, Nationwide Children’s Hospital, 700 Children’s Dr., Columbus, OH 43205, USA. Email: Sarah.Keim@nationwidechildrens.org.
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Abstract

A transgenerational, epigenetic effect of anesthesia, particularly fluorinated agents, has been examined in rat models, but translation to humans is unclear. This study examined associations of maternal lifetime exposure to anesthesia and pregnancy exposure to fluorinated anesthetics with child cognitive and educational outcomes. Women in the US Collaborative Perinatal Project (1959–1963) reported lifetime history of surgeries, and the obstetric record captured pregnancy exposure to anesthetics. Children were followed to age 7 for global cognitive ability and educational outcomes (n=47,977). Logistic and linear regressions were adjusted for maternal and child birth years, race and ethnicity, smoking, education, parity, study site. Many outcomes were not associated with exposure to maternal surgery that occurred at various life stages. However, maternal surgery in early childhood was associated both with being in a special school or not in school (adj OR=1.42; 95% CI 1.02, 1.98) and with slightly better cognitive ability across childhood (e.g., WISC IQ (adj β=0.59; CI 0.13, 1.04) (especially among boys)). Maternal surgery in puberty was associated with slightly lower IQ (adj β = –0.42; CI –0.79, –0.05) and poorer spelling at age 7. Children’s prenatal exposure to fluorinated anesthetics was associated with slightly better spelling ability (adj β = 1.20; CI 0.02, 2.38) but lower performance IQ at age 7 (only among boys, adj β = –1.97; CI –3.88, –0.06). This study shows inconsistent evidence of effects of maternal exposure to surgery or prenatal exposure to fluorinated agents on child developmental and educational outcomes Residual confounding by indication and socioeconomic status may explain observed associations.

Keywords

Anesthesiasurgeryneurodevelopmentpediatriccognition
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 14 , Issue 2 , April 2023 , pp. 199 - 208
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Copyright
© The Author(s), 2022. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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