Neurodevelopment at 10 months and 2–3 years old after early and prolonged anaesthesia in infancy: General Anaesthesia & Brain Activity study (GABA) secondary analysis

Abstract

Background

Effects of early and prolonged exposure to general anaesthesia on the developing brain are unclear. The study objective was to examine developmental outcomes at 10 months and 2–3 yr of age after general anaesthesia planned for >2 h in the first 2 months of life.

Methods

This is a secondary analysis of the General Anaesthesia & Brain Activity (GABA) study—a prospective, single-centre, longitudinal observational study. The final dataset included 59 children who were unexposed and 31 children who were exposed to early prolonged general anaesthesia who completed the primary outcome measure, Bayley Scales of Infant and Toddler Development-III (BSID) assessments at 10 months, at 2–3 yr old, or both. Analyses used adjusted Welch's t-tests, linear regression, and linear mixed effects models.

Results

BSID composite scores for cognition were similar between general anaesthesia and unexposed cohorts at 10 months (P_adj=0.566, standardised mean difference [SMD]=0.27) and at 2–3 yr (P_adj=0.651, SMD=0.25). Motor and language scores were similar between cohorts at 10 months (motor: P_adj=1, SMD=0.13; language: P_adj=0.806, SMD=0.19) and fell within typical reference ranges. Linear regression analysis found no association between BSID cognition scores and cumulative hours of general anaesthesia at 10 months (R=0.06, P=0.635) or at 2–3 yr (R=−0.13, P=0.293).

Conclusions

Children with early prolonged general anaesthesia showed BSID scores comparable to age-matched controls. This analysis provides additional preliminary support for the safety of general anaesthesia on the developing brain even when general anaesthesia is prolonged, repeated, or administered very early in life.