Background

Children's exposure to anaesthesia has been associated with risk of developing attention-deficit/hyperactivity disorder (ADHD). The goal of this study was to determine if selected patient characteristics moderate the association between exposure to anaesthesia and ADHD.

Methods

In a cohort of children born in between 2006 and 2012, exposure to anaesthesia before the age of 5 yr was categorised into unexposed, singly, or multiply exposed. Weighted proportional hazard regression was performed to evaluate the hazard ratios (HRs) of ADHD diagnosis related to anaesthesia exposure. Interaction analyses were performed to evaluate potential moderators.

Results

Among 185 002 children in the cohort, 9179 were diagnosed with ADHD. Compared with unexposed children, a single exposure to anaesthesia was associated with a HR of 1.39, (95% confidence interval [CI], 1.32–1.47) for ADHD. Multiple exposures were associated with a HR of 1.75 (95% CI, 1.62–1.87). In the analyses evaluating moderators of the association between exposure and ADHD, only the interaction for race was statistically significant (P=0.006); exposure increased the incidence of ADHD to a greater extent in non-White compared with White children. Among children with a single exposure, the age at exposure did not affect the relationship between exposure and incidence of ADHD (P=0.78).

Conclusions

Exposure of young children to anaesthesia and surgery is associated with an increased incidence of ADHD, with more exposures associated with greater risk. Compared with White children, non-White children are at greater risk for reasons that are unknown but need to be further explored.

中文翻译：

---

儿童注意力缺陷/多动障碍与麻醉和手术暴露之间关联的调节因子

背景

儿童接触麻醉与发展注意力缺陷/多动障碍 (ADHD) 的风险有关。本研究的目的是确定选定的患者特征是否会缓和麻醉暴露与 ADHD 之间的关联。

方法

在 2006 年至 2012 年间出生的一组儿童中，5 岁前的麻醉暴露被归类为未暴露、单一暴露或多重暴露。进行加权比例风险回归以评估与麻醉暴露相关的 ADHD 诊断的风险比 (HR)。进行交互分析以评估潜在的调节剂。

结果

在队列的 185002 名儿童中，9179 名被诊断出患有多动症。与未暴露的儿童相比，单次麻醉与 ADHD 的 HR 为 1.39（95% 置信区间 [CI]，1.32-1.47）相关。多次暴露与 HR 为 1.75（95% CI，1.62–1.87）相关。在评估暴露与 ADHD 之间关联的调节因素的分析中，只有种族的相互作用具有统计学意义（P = 0.006）；与白人儿童相比，暴露在更大程度上增加了非白人儿童多动症的发病率。在单次暴露的儿童中，暴露年龄不影响暴露与 ADHD 发病率之间的关系（P = 0.78）。

结论

幼儿接触麻醉和手术与 ADHD 的发病率增加有关，接触越多，风险越大。与白人儿童相比，非白人儿童面临更大的风险，原因尚不清楚，但需要进一步探索。