Observational studyPediatric research2021
Surgery requiring general anesthesia in preterm infants is associated with altered brain volumes at term equivalent age and neurodevelopmental impairment.
Observational study in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- 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
- Dexamethasone Eye Drops to Prevent Treatment-Requiring Retinopathy of Prematurity: The DROPROP Randomized Clinical Trial.JAMA pediatrics · 2026Article
- Rutin ameliorates sevoflurane-induced neurotoxicity by inhibiting microglial synaptic phagocytosis through the complement pathway.Scientific reports · 2025Article
- A Hidden Twist: Unilateral Blue Scrotum in a Very Preterm Infant in the Delivery Room.NeoReviews · 2025Article
- Article
- Effects of Anesthesia and Surgery on the Morphologic and Functional Development of the Premature Neonatal Brain: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Risk of neurodevelopmental impairment in Swedish preterm children treated for necrotizing enterocolitis: retrospective cohort study.BJS open · 2024Article
- Morbidity and neurodevelopmental outcomes at 2 years in preterm infants undergoing percutaneous transcatheter closure vs. surgical ligation of the PDA.Journal of perinatology : official journal of the California Perinatal Association · 2024Observational
- Lacosamide and Levetiracetam Are Not Toxic to the Developing Mouse Brain.Annals of neurology · 2024Article
- Neurobehavioral Abnormalities in Offspring of Young Adult Male Rats With a History of Traumatic Brain Injury.Journal of neurotrauma · 2024Article
- Complement C1q-mediated microglial synaptic elimination by enhancing desialylation underlies sevoflurane-induced developmental neurotoxicity.Cell & bioscience · 2024Article
- Major Surgery, Brain Injury, and Neurodevelopmental Outcomes in Very Preterm Infants.Neurology · 2023Article
- Behavioral and Cognitive Outcomes of Rhesus Macaques Following Neonatal Exposure to Antiseizure Medications.Annals of neurology · 2023Article
- Early surgery in very preterm infants is associated with brain abnormalities on term MRI: a propensity score analysis.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- Gut Microbiome-Brain Axis as an Explanation for the Risk of Poor Neurodevelopment Outcome in Preterm Infants with Necrotizing Enterocolitis.Microorganisms · 2023Review
- Intergenerational Perioperative Neurocognitive Disorder.Biology · 2023Review
- Mild hypothermia fails to protect infant macaques from brain injury caused by prolonged exposure to Antiseizure drugs.Neurobiology of disease · 2022Article
- Impact of Comorbid Prematurity and Congenital Anomalies: A Review.Frontiers in physiology · 2022Review
- Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe aim of the study was to describe and contrast the brain development and outcome among very preterm infants that were and were not exposed to surgery requiring general anesthesia prior to term equivalent age (TEA).
methodsPreterm infants born ≤30 weeks' gestation who did (n = 25) and did not (n = 59) have surgery requiring general anesthesia during the preterm period were studied. At TEA, infants had MRI scans performed with measures of brain tissue volumes, cortical surface area, Gyrification Index, and white matter microstructure. Neurodevelopmental follow-up with the Bayley Scales of Infant and Toddler Development, Third Edition was undertaken at 2 years of corrected age. Multivariate models, adjusted for clinical and social risk factors, were used to compare the groups.
resultsAfter controlling for clinical and social variables, preterm infants exposed to surgical anesthesia demonstrated decreased relative white matter volumes at TEA and lower cognitive and motor composite scores at 2-year follow-up. Those with longer surgical exposure demonstrated the greatest decrease in white matter volumes and lower cognitive and motor outcomes at age 2 years.
conclusionsVery preterm infants who required surgery during the preterm period had lower white mater volumes at TEA and worse neurodevelopmental outcome at age 2 years. IMPACT: In very preterm infants, there is an association between surgery requiring general anesthesia during the preterm period and reduced white mater volume on MRI at TEA and lower cognitive and motor composite scores at age 2 years. It is known that the very preterm infant's brain undergoes rapid growth during the period corresponding to the third trimester. The current study suggests an association between surgery requiring general anesthesia during this period and worse outcomes.
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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.