• Caleb Ing, Melanie M Wall, Charles J DiMaggio, WhitehouseAndrew J OAJO, Mary K Hegarty, Ming Sun, Britta S von Ungern-Sternberg, Guohua Li, and Lena S Sun.
• Departments of *Anesthesiology ††Anesthesiology and Pediatrics, Columbia University College of Physicians and Surgeons Departments of †Psychiatry and Biostatistics ‡Anesthesiology and Epidemiology ¶Anesthesiology and Biostatistics **Anesthesiology and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, New York, NY §Telethon Kids Institute #School of Medicine and Pharmacology, The University of Western Australia ∥Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, WA, Australia.
• J Neurosurg Anesthesiol. 2017 Jul 1; 29 (3): 264273264-273.

IntroductionAlthough some studies have reported an association between early exposure to anesthesia and surgery and long-term neurodevelopmental deficit, the clinical phenotype of children exposed to anesthesia is still unknown.MethodsData were obtained from the Western Australian Pregnancy Cohort Study (Raine) with neuropsychological tests at age 10 years measuring language, cognition, motor function, and behavior. Latent class analysis of the tests was used to divide the cohort into mutually exclusive subclasses of neurodevelopmental deficit. Multivariable polytomous logistic regression was used to evaluate the association between exposure to surgery and anesthesia and each latent class, adjusting for demographic and medical covariates.ResultsIn our cohort of 1444 children, latent class analysis identified 4 subclasses: (1) Normal: few deficits (n=1135, 78.6%); (2) Language and Cognitive deficits: primarily language, cognitive, and motor deficits (n=96, 6.6%); (3) Behavioral deficits: primarily behavioral deficits, (n=151, 10.5%); and (4) Severe deficits: deficits in all neuropsychological domains (n=62, 4.3%). Language and cognitive deficit group children were more likely to have exposure before age 3 (adjusted odds ratio [aOR], 2.11; 95% confidence interval [CI], 1.17-3.81), whereas a difference in exposure was not found between Behavioral or Severe deficit children (aOR, 1.00; 95% CI, 0.58-1.73, and aOR, 0.85; 95% CI, 0.34-2.15, respectively) and Normal children.ConclusionsOur results suggest that in evaluating children exposed to surgery and anesthesia at an early age, the phenotype of interest may be children with deficits primarily in language and cognition, and not children with broad neurodevelopmental delay or primarily behavioral deficits.

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