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General anaesthesia under the age of 4 years has minimal impact on future academic performance
  1. Amanda Jane Friend1,2,
  2. Thomas Engelhardt3,
  3. Tom Hansen4,5
  1. 1 Department of Paediatrics, Leeds General Infirmary, Leeds, UK
  2. 2 University of Leeds School of Medicine, Leeds, UK
  3. 3 Department of Anaesthesia, Royal Aberdeen Childrens Hospital, Aberdeen, UK
  4. 4 Department of Anaesthesia & Intensive Care - Paediatric Section, Odense University Hospital, Odense, Denmark
  5. 5 Department of Anaesthesiology, Insitute for Clinical Research, University of Southern Denmark, Odense, Denmark
  1. Correspondence to Dr Amanda Jane Friend, Department of Paediatrics, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK; amanda.friend{at}nhs.net

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Study design

Design: Cohort study

Study question

Patients: All children born in Sweden between 1973 and 1993 who had a single anaesthetic exposure before age 4 years (33514 children).

Comparison: 159 619 matched children who had not been exposed to anaesthesia.

Outcomes: Average (mean) grades in school at age 16 years and IQ test scores at age 18 years obtained at the time of military conscription.

Main results

OutcomesMean (95% CI)
Mean reduction in school grades at age 16 years compared with unexposed children0.41% (0.7% to 0.12%)
Mean reduction in IQ scores at age 18 years compared with unexposed children0.97% (0.15% to 1.78%)
 OR (95% CI)
Likelihood of having grades below the 10th centile at age 16 years compared with unexposed children1.02 (0.98 to 1.07)
Likelihood of having no recorded school grades at age 16 years compared with unexposed children1.29 (1.17 to 1.42)

Conclusion

Although general anaesthesia under the age of 4 years was associated with a statistically significant reduction in school grades at age 16 years and IQ scores at …

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