O Creagh, H Torres, K Rivera, M Morales-Franqui, G Altieri-Acevedo, D Warner
{"title":"以前的麻醉暴露和自闭症谱系障碍(ASD):波多黎各基于人群的兄弟姐妹队列研究。","authors":"O Creagh, H Torres, K Rivera, M Morales-Franqui, G Altieri-Acevedo, D Warner","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Autism Spectrum Disorder (ASD) is characterized by impaired social interaction\nand communication, and by restricted and repetitive behavior, that begins\nusually before a child is three years\nold.(1) Researchers have shown that prevalence\nrates in the U.S. may be as high as 1 in 68.(52) A number of studies have\nexamined the effects of early exposure to anesthesia on brain development and\nsubsequent impairment in neurocognitive function; yet, little is known about\nthe possible effects of anesthetic agents on social-behavioral functioning. The\nassociation between exposure to anesthesia either in uterus, during the first\nyears of life, or later and development of Autistic Spectrum Disorder (ASD) or its\nseverity was determined in a retrospective population based cohort study.</p><p><strong>Objectives: </strong>Identify if children who had previous exposure\nto anesthesia either in uterus, first years of life during their developing brain\nyears, or later, are at risk of developing ASD and its severe form of the disease.</p><p><strong>Methods: </strong>Data was obtained from structured interviews administered to a sample of 515\nparents/guardians distributed in two groups: ASD = 262 children diagnosed\nwith this condition and Non-ASD: 253 children (siblings of ASD group) without\ndiagnosis (95% confidence interval) that freely decided to participate and agreed\nto a consent form. Variables studied include: demographics, diagnosis and\nseverity of ASD, exposure to anesthesia, method of childbirth, and age of exposure\nChildren less than 2 years of age were considered into have developing\nbrain period. Data was analyzed using Chi-square or Fisher exact test.</p><p><strong>Results: </strong>In contrast to non-ASD group, most of the children within ASD group were\nmale, 76% (p=0.0001). With regards to methods of childbirth, 64% of the ASD\npopulation were vaginal delivery (VD; Non-anesthesia exposure group) and\n36% cesarean delivery (CD) compared to non-autistic population with 71%\nVD and 29% CD, which demonstrates no statistical difference between both\ngroups (p=0.1113). Out of the 36% of ASD population that underwent CD,\n7% were performed using general anesthesia and 93% regional anesthesia,\nwhile the 29% of the CD of non-ASD, 5% were performed using general anesthesia\nand 95% regional anesthesia. This reveals no statistical significance\n(p=0.7569) with the development of ASD and the type of anesthesia used\nwhen comparing ASD with non-ASD patients. In view of severity of autism, in\nVD, 56% of ASD population had mild form of the disorder, 34% moderate, and\n10% severe; while CD had a 54% mild form of the disorder, 33% moderate, and\n13% severe. This shows no statistical association (p=0.8069) when comparing\nexposure to anesthesia in uterus to subsequent severe form of ASD.\nOf the 262 ASD patients, 99 had exposure to anesthetics before their diagnosis,\nwhile in Non-ASD population, 110 had exposure to anesthesia, demonstrating\nno statistically significant association between both groups (p=0.2091).\nOut of 99 ASD patients exposed to anesthesia prior to their diagnosis, 72 were\nexposed before age 2. When compared to the 110 Non-ASD patients exposed\nto anesthesia, 86 had exposure during this developing brain period, which indicates\nno statistically significant association (p=0.4207). In addition, most of\nthe ASD children exposed to anesthesia during developing brain were diagnosed\nwith mild degree of the disorder when compared to ASD children without\nany previous exposure to anesthesia (p=0.9700) during the same period.\nWhen the exposure occurred after age 2, ASD children developed mild form\nof the disorder as compared with ASD children without any previous exposure\nto anesthesia (p=0.1699) in that period.</p><p><strong>Conclusions: </strong>Children under early exposure to anesthesia in uterus, first 2 years of life, or later are not more likely to develop neither ASD nor severe form of the disorder.</p>","PeriodicalId":75610,"journal":{"name":"Boletin de la Asociacion Medica de Puerto Rico","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Previous Exposure to Anesthesia and Autism Spectrum Disorder (ASD): A Puerto Rican Population-Based Sibling Cohort Study.\",\"authors\":\"O Creagh, H Torres, K Rivera, M Morales-Franqui, G Altieri-Acevedo, D Warner\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Autism Spectrum Disorder (ASD) is characterized by impaired social interaction\\nand communication, and by restricted and repetitive behavior, that begins\\nusually before a child is three years\\nold.(1) Researchers have shown that prevalence\\nrates in the U.S. may be as high as 1 in 68.(52) A number of studies have\\nexamined the effects of early exposure to anesthesia on brain development and\\nsubsequent impairment in neurocognitive function; yet, little is known about\\nthe possible effects of anesthetic agents on social-behavioral functioning. The\\nassociation between exposure to anesthesia either in uterus, during the first\\nyears of life, or later and development of Autistic Spectrum Disorder (ASD) or its\\nseverity was determined in a retrospective population based cohort study.</p><p><strong>Objectives: </strong>Identify if children who had previous exposure\\nto anesthesia either in uterus, first years of life during their developing brain\\nyears, or later, are at risk of developing ASD and its severe form of the disease.</p><p><strong>Methods: </strong>Data was obtained from structured interviews administered to a sample of 515\\nparents/guardians distributed in two groups: ASD = 262 children diagnosed\\nwith this condition and Non-ASD: 253 children (siblings of ASD group) without\\ndiagnosis (95% confidence interval) that freely decided to participate and agreed\\nto a consent form. Variables studied include: demographics, diagnosis and\\nseverity of ASD, exposure to anesthesia, method of childbirth, and age of exposure\\nChildren less than 2 years of age were considered into have developing\\nbrain period. Data was analyzed using Chi-square or Fisher exact test.</p><p><strong>Results: </strong>In contrast to non-ASD group, most of the children within ASD group were\\nmale, 76% (p=0.0001). With regards to methods of childbirth, 64% of the ASD\\npopulation were vaginal delivery (VD; Non-anesthesia exposure group) and\\n36% cesarean delivery (CD) compared to non-autistic population with 71%\\nVD and 29% CD, which demonstrates no statistical difference between both\\ngroups (p=0.1113). Out of the 36% of ASD population that underwent CD,\\n7% were performed using general anesthesia and 93% regional anesthesia,\\nwhile the 29% of the CD of non-ASD, 5% were performed using general anesthesia\\nand 95% regional anesthesia. This reveals no statistical significance\\n(p=0.7569) with the development of ASD and the type of anesthesia used\\nwhen comparing ASD with non-ASD patients. In view of severity of autism, in\\nVD, 56% of ASD population had mild form of the disorder, 34% moderate, and\\n10% severe; while CD had a 54% mild form of the disorder, 33% moderate, and\\n13% severe. This shows no statistical association (p=0.8069) when comparing\\nexposure to anesthesia in uterus to subsequent severe form of ASD.\\nOf the 262 ASD patients, 99 had exposure to anesthetics before their diagnosis,\\nwhile in Non-ASD population, 110 had exposure to anesthesia, demonstrating\\nno statistically significant association between both groups (p=0.2091).\\nOut of 99 ASD patients exposed to anesthesia prior to their diagnosis, 72 were\\nexposed before age 2. When compared to the 110 Non-ASD patients exposed\\nto anesthesia, 86 had exposure during this developing brain period, which indicates\\nno statistically significant association (p=0.4207). In addition, most of\\nthe ASD children exposed to anesthesia during developing brain were diagnosed\\nwith mild degree of the disorder when compared to ASD children without\\nany previous exposure to anesthesia (p=0.9700) during the same period.\\nWhen the exposure occurred after age 2, ASD children developed mild form\\nof the disorder as compared with ASD children without any previous exposure\\nto anesthesia (p=0.1699) in that period.</p><p><strong>Conclusions: </strong>Children under early exposure to anesthesia in uterus, first 2 years of life, or later are not more likely to develop neither ASD nor severe form of the disorder.</p>\",\"PeriodicalId\":75610,\"journal\":{\"name\":\"Boletin de la Asociacion Medica de Puerto Rico\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Boletin de la Asociacion Medica de Puerto Rico\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Boletin de la Asociacion Medica de Puerto Rico","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Previous Exposure to Anesthesia and Autism Spectrum Disorder (ASD): A Puerto Rican Population-Based Sibling Cohort Study.
Background: Autism Spectrum Disorder (ASD) is characterized by impaired social interaction
and communication, and by restricted and repetitive behavior, that begins
usually before a child is three years
old.(1) Researchers have shown that prevalence
rates in the U.S. may be as high as 1 in 68.(52) A number of studies have
examined the effects of early exposure to anesthesia on brain development and
subsequent impairment in neurocognitive function; yet, little is known about
the possible effects of anesthetic agents on social-behavioral functioning. The
association between exposure to anesthesia either in uterus, during the first
years of life, or later and development of Autistic Spectrum Disorder (ASD) or its
severity was determined in a retrospective population based cohort study.
Objectives: Identify if children who had previous exposure
to anesthesia either in uterus, first years of life during their developing brain
years, or later, are at risk of developing ASD and its severe form of the disease.
Methods: Data was obtained from structured interviews administered to a sample of 515
parents/guardians distributed in two groups: ASD = 262 children diagnosed
with this condition and Non-ASD: 253 children (siblings of ASD group) without
diagnosis (95% confidence interval) that freely decided to participate and agreed
to a consent form. Variables studied include: demographics, diagnosis and
severity of ASD, exposure to anesthesia, method of childbirth, and age of exposure
Children less than 2 years of age were considered into have developing
brain period. Data was analyzed using Chi-square or Fisher exact test.
Results: In contrast to non-ASD group, most of the children within ASD group were
male, 76% (p=0.0001). With regards to methods of childbirth, 64% of the ASD
population were vaginal delivery (VD; Non-anesthesia exposure group) and
36% cesarean delivery (CD) compared to non-autistic population with 71%
VD and 29% CD, which demonstrates no statistical difference between both
groups (p=0.1113). Out of the 36% of ASD population that underwent CD,
7% were performed using general anesthesia and 93% regional anesthesia,
while the 29% of the CD of non-ASD, 5% were performed using general anesthesia
and 95% regional anesthesia. This reveals no statistical significance
(p=0.7569) with the development of ASD and the type of anesthesia used
when comparing ASD with non-ASD patients. In view of severity of autism, in
VD, 56% of ASD population had mild form of the disorder, 34% moderate, and
10% severe; while CD had a 54% mild form of the disorder, 33% moderate, and
13% severe. This shows no statistical association (p=0.8069) when comparing
exposure to anesthesia in uterus to subsequent severe form of ASD.
Of the 262 ASD patients, 99 had exposure to anesthetics before their diagnosis,
while in Non-ASD population, 110 had exposure to anesthesia, demonstrating
no statistically significant association between both groups (p=0.2091).
Out of 99 ASD patients exposed to anesthesia prior to their diagnosis, 72 were
exposed before age 2. When compared to the 110 Non-ASD patients exposed
to anesthesia, 86 had exposure during this developing brain period, which indicates
no statistically significant association (p=0.4207). In addition, most of
the ASD children exposed to anesthesia during developing brain were diagnosed
with mild degree of the disorder when compared to ASD children without
any previous exposure to anesthesia (p=0.9700) during the same period.
When the exposure occurred after age 2, ASD children developed mild form
of the disorder as compared with ASD children without any previous exposure
to anesthesia (p=0.1699) in that period.
Conclusions: Children under early exposure to anesthesia in uterus, first 2 years of life, or later are not more likely to develop neither ASD nor severe form of the disorder.