Does early surgery affect child development?

New research published in Anesthesiology linked EDI data with early health records to determine the role of early surgery in child development.

Research summary

  • Children who have surgery before primary school are at increased risk of early developmental vulnerability. But, the size of the risk is small.
  • Being younger than two at first surgery or having multiple surgeries did not increase the risk of worse development.

A brief summary of the research is also featured in the Editorial Views of the August edition of Anesthesiology.

What is the research about?

Early childhood is an important time for brain development. Changes to the brain during this time affect cognition, language, and social behavior. Some wonder if children are at risk of worse development when exposed to anesthesia and surgery during this period.

What did the researchers do?

James O’Leary and colleagues wanted to determine early surgery’s role in later development. To avoid limitations of earlier research the group used population-level data. The group linked EDI data with Institute for Clinical Evaluative Sciences (ICES) health data.

EDI data from 2004-2012 in Ontario included 374,577 children. Of these, 317,169 children were eligible for database linkage. A final sample of 259,247 (82%) linked to unique records in the healthcare databases.

Researchers used the ICES database to determine whether a child had any surgical procedure. They also recorded the age a child first had surgery, number of surgical procedures, and total length of hospital stay.

The researchers used EDI vulnerability as a measure of children’s development.

What did researchers find?

Developmental vulnerability for children who had surgery was 25.6%. Developmental vulnerability for children who did not have surgery was 25.0%.

The odds of later vulnerability were similar whether a child had surgery or not before age two. There was a small increase in the odds of later vulnerability for children older than two who had surgery. There was no difference in the risk of later vulnerability for children who had multiple surgeries.

What does the research mean?

The research suggestsanesthesia exposure and early surgery are not strong factors in development .