ArticleMayo Clinic proceedings2012
Attention-deficit/hyperactivity disorder after early exposure to procedures requiring general anesthesia.
Article in Mayo Clinic proceedings, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 181 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
181 citing papers in PubMed, 8 syntheses or guidelines pooled it, 409 citations in OpenAlex.
- A Systematic Review and Meta-analysis of Chemical Exposures and Attention-Deficit/Hyperactivity Disorder in Children.Prevention science : the official journal of the Society for Prevention Research · 2024Pooled it
- Exposure to halogenated ethers causes neurodegeneration and behavioural changes in young healthy experimental animals: a systematic review and meta analyses.Scientific reports · 2023Pooled it
- Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- General anesthesia in children and long-term neurodevelopmental deficits: A systematic review.Frontiers in molecular neuroscience · 2022Pooled it
- Does Exposure to General Anesthesia Increase Risk of ADHD for Children Before Age of Three?Frontiers in psychiatry · 2021Pooled it
- Assessment of the Clinical Benefit of Imaging in Children With Unilateral Sensorineural Hearing Loss: A Systematic Review and Meta-analysis.JAMA otolaryngology-- head & neck surgery · 2019Pooled it
- Association between childhood exposure to single general anesthesia and neurodevelopment: a systematic review and meta-analysis of cohort study.Journal of anesthesia · 2015Pooled it
- Comprehensive evaluation of the child with intellectual disability or global developmental delays.Pediatrics · 2014Pooled it
- Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial.Lancet (London, England) · 2019Trial
- Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.Lancet (London, England) · 2016Trial
- Pet ownership and parent-reported mental health in pediatric transplantation. A cross-sectional study from the European reference network Transplantchild. The pink study.One health (Amsterdam, Netherlands) · 2026Article
- Sevoflurane, but not alphaxalone, causes lasting autism spectrum disorder-like pathology in male mice after exposure occurs during synaptogenesis.Neuropharmacology · 2026Article
- Incidence and predictive factors for development of ADHD post congenital heart disease surgery-a single tertiary center experience from India.Frontiers in cardiovascular medicine · 2026Article
- Review
- Influence of Repeated Exposure to Neonatal Isoflurane on Sleep Architecture and Neuronal Delta and Theta Oscillations in Adolescent Rats.Anesthesia and analgesia · 2025Article
- Comprehensive characterization of chronic midazolam exposure on neonates and long-term neurodevelopment.Molecular psychiatry · 2025Article
- The consensus statement of the Section of Paediatric Anaesthesiology and Intensive Therapy of the Polish Society of Anaesthesiology and Intensive Therapy on anaesthesia in children under 3 years of age.Anaesthesiology intensive therapy · 2025Article
- Factors That Impact the Success of Natural-Sleep Auditory Brainstem Response in a Tertiary Care Multidisciplinary Clinic.Journal of the American Academy of Audiology · 2025Article
- The Relationship between Early Exposure to General Anesthesia and Neurobehavioral Deficits.Developmental neuroscience · 2025Review
- Anesthesia-induced developmental neurotoxicity in the setting of systemic inflammation: the role of microglia.Experimental biology and medicine (Maywood, N.J.) · 2025Article
121 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo study the association between exposure to procedures performed under general anesthesia before age 2 years and development of attention-deficit/hyperactivity disorder (ADHD). PATIENTS AND
methodsStudy patients included all children born between January 1, 1976, and December 31, 1982, in Rochester, MN, who remained in Rochester after age 5. Cases of ADHD diagnosed before age 19 years were identified by applying stringent research criteria. Cox proportional hazards regression assessed exposure to procedures requiring general anesthesia (none, 1, 2 or more) as a predictor of ADHD using a stratified analysis with strata based on a propensity score including comorbid health conditions.
resultsAmong the 5357 children analyzed, 341 ADHD cases were identified (estimated cumulative incidence, 7.6%; 95% confidence interval [CI], 6.8%-8.4%). For children with no postnatal exposure to procedures requiring anesthesia before the age of 2 years, the cumulative incidence of ADHD at age 19 years was 7.3% (95% CI, 6.5%-8.1%). For single and 2 or more exposures, the estimates were 10.7% ( 95% CI, 6.8%-14.4%) and 17.9% ( 95% CI, 7.2%-27.4%), respectively. After adjusting for gestational age, sex, birth weight, and comorbid health conditions, exposure to multiple (hazard ratio, 1.95; 95% CI, 1.03-3.71), but not single (hazard ratio,1.18; 95% CI, 0.79-1.77), procedures requiring general anesthesia was associated with an increased risk for ADHD.
conclusionChildren repeatedly exposed to procedures requiring general anesthesia before age 2 years are at increased risk for the later development of ADHD even after adjusting for comorbidities.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.