Oral clefts and academic performance in adolescence: the impact of anesthesia-related neurotoxicity, timing of surgery and type of oral clefts

Details

• Journal Article:
  Cleft Palate Craniofac J
• Personal Author:
  Clausen, Nicola G. ; Pedersen, Dorthe A. ; Pedersen, Jacob K. ; Møller, Susanne E. ; Grosen, Dorthe ; Wehby, George L. ; Christensen, Kaare ; Hansen, Tom G.
• Description:
  Objective ; Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP) and cleft lip and cleft palate (CLP) with a non-cleft control group to investigate, whether outcome depends on timing and number of operations during childhood and/or type of oral cleft. ; Design ; Nation-wide, register-based follow-up study. ; Setting ; Danish birth cohort 1986–1990 ; Participants ; 558 children with isolated CL (n=171), CLP (n=222) or CP (n=195), of which 509 children had been exposed to anesthesia and one or more cleft operation(s), and a 5% sample of the birth cohort (n=14,677). ; Main Outcome Measures(s) ; Test-score in the Danish standardized 9th grade exam and proportion of non-attainment, defined as ‘results for 9th grade exam unavailable’. Data adjusted for sex, birth weight, parental age and parental level of education. ; Results ; Compared to controls, children with CL achieved higher scores (mean difference 0.12, 95% CI −0.05; 0.29) and children with CLP presented with lower scores (mean difference −0.06, 95% CI −0.21; 0.09), albeit both statistically insignificant. Children with CP achieved significantly lower scores, mean difference −0.20 (95% CI −0.38; −0.03). Odds ratios for non-attainment at final exam were: CL 0.79 (95% CI 0.46; 1.35), CLP 1.07 (95% CI 0.71; 1.61), CP 2.59 (95% CI 1.78; 3.76). ; Conclusions ; Oral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data it cannot be completely excluded.
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• Subjects:
  • Academic Performance
  • Adolescent
  • Age Factors
  • Anesthesia, General
  • Anesthetics
  • Cleft Lip
  • Cleft Palate
  • Cognition Disorders
  • Denmark
  • Female
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• Keywords:
  • oral clefts
  • craniofacial surgery
  • general anesthesia
  • neurotoxicity
  • anesthesia-related neurotoxicity
  • outcome
  • neurodevelopment
  • age
  • infants
  • neonates
• Source:
  Cleft Palate Craniofac J. 54(4):371-380
• DOI:
  http://dx.doi.org/10.1597/15-185
• Pubmed ID:
  27043652
• Pubmed Central ID:
  PMC6687065
• Document Type:
  Text ; Journal Article
• Funding:
  R01 DD000295/DD/NCBDD CDC HHSUnited States/
• Genre:
  Journal Article
• Volume:
  54
• Issue:
  4
• Download URL:
  https://stacks.cdc.gov/view/cdc/80597/cdc_80597_DS1.pdf
• File Type:
  [PDF - 119.63 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:49782f53793a0e37439d413292ccb40a419a28f2975fa4e63d6672452b6119af48b16b2a27c3aa0131be9118cddbee19be4112038e81530afe0976955ea8b3dc