Anesthesia Administered During the Birth Process Does Not Harm Newborns

A study has found that children exposed to anesthesia during Cesarean delivery (CD) are not at a higher risk for learning disabilities (LDs) later in life than children delivered by natural birth.

Researchers at the Mayo Clinic (Rochester, MN, USA) analyzed data from the Rochester epidemiology project and reviewed the medical and educational records of 5,320 children born between 1976 and 1982 to mothers living in Olmsted County (MN, USA). Those that remained in the community at age 5 were reviewed to identify the children with LDs; of the children in the cohort, 497 were delivered via CD. Cox proportional hazards regression was used to compare rates of LD between children delivered vaginally and via CD (with either general or epidural anesthesia).

The researchers find that the use of anesthesia during delivery was not harmful to the babies, and that in fact those delivered by Cesarean section using an epidural anesthetic had a substantially reduced risk for learning disabilities later in life. The incidence of LDs depended on mode of delivery, adjusted for sex, birth weight, gestational age, exposure to anesthesia before four years of age, and maternal education. The results suggest that brief perinatal exposure to anesthetic drugs does not adversely affect long-term neurodevelopmental outcomes. The researchers are now investigating whether use of an epidural during natural labor has similar effects on the incidence of LDs in children as a Caesarean section with an epidural. The study was published in the August 2009 issue of the journal Anesthesiology.

"The risk was reduced by about 40% compared to children delivered vaginally and those delivered via Cesarean section but with general anesthesia,” said lead author anesthesiologist Juraj Sprung, M.D., Ph.D. "We found that the incidence of learning disabilities was equal between children who were delivered vaginally and those who were delivered via C-section but with general anesthesia. It's reassuring that the anesthetics required for Cesarean delivery do not appear to cause long-term brain problems.”

The study builds on a previous study, which found that children exposed to a single dose of anesthesia during the first three years of life had no increased risk for learning disabilities, but those exposed multiple times had an almost doubled risk for later identification of LDs. Prolonged exposure to anesthetics has been shown to cause brain abnormalities in young animals, which was the impetus behind the two studies.

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