Neonatal and Early Childhood Outcomes Following Maternal Anesthesia for Cesarean Section: A Population-based Cohort Study

Abstract

(Reg Anesth Pain Med. 2021;46:482–489. Epub April 8, 2021) The US Food and Drug Administration has previously warned that exposure to anesthetic medications during the third trimester of pregnancy or in children <3 years could affect children’s neurological development. While the literature (studies with n=310 to n=997) supports a single brief exposure to general anesthesia (GA) does not impair learning or behavior, there is no consensus regarding the long-range effects of anesthesia exposure on the fetus. Further, with the ubiquity of cesarean delivery (CD), the question of optimal mode of anesthesia for the fetus remains unclear. General anesthesia for CD may be used in situations of maternal or fetal compromise or in low-income settings where there is a lack of training in regional methods. With a global increase of CD, it is critical that anesthesia decisions be informed by better understanding of the short and long-term childhood effects following fetal exposure to GA. The aim of the study was to determine associations of exposure to spinal, epidural or GA on neonatal and childhood development outcomes during the first 1000 days of life.