title: Morphological features of the neonatal brain following exposure to regional anesthesia during labor and delivery.
abstract: BACKGROUND
  Recent animal and human epidemiological studies suggest that early childhood exposure to anesthesia may have adverse effects on brain development. As more than 50% of pregnant women in the United States and one-third in the United Kingdom receive regional anesthesia during labor and delivery, understanding the effects of perinatal anesthesia on postnatal brain development has important public health relevance.
  
  
  METHODS
  We used high-resolution magnetic resonance imaging (MRI) to assess the effects of regional anesthesia during labor and delivery as part of a larger study of perinatal exposures on the morphological features of the neonatal brain. We mapped morphological features of the cortical surface in 37 healthy infants, 24 exposed and 13 unexposed to regional anesthesia at delivery, who were scanned within the first 6 weeks of life.
  
  
  RESULTS
  Infants exposed to maternal anesthesia compared with unexposed infants had greater local volumes in portions of the frontal and occipital lobes bilaterally and right posterior portion of the cingulate gyrus. Longer durations of exposure to anesthesia correlated positively with local volumes in the occipital lobe.
  
  
  CONCLUSIONS
  Anesthesia exposure during labor and delivery was associated with larger volumes in portions of the frontal and occipital lobes and cingulate gyrus in neonates. Longitudinal MRI studies are needed to determine whether these morphological effects of anesthesia persist and what their consequences on cognition and behavior may be.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Marisa N
authors.initials: MN
authors.lastname: Spann
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Dana
authors.initials: D
authors.lastname: Serino
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Ravi
authors.initials: R
authors.lastname: Bansal
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Hao
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Nati
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Toth
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Kirwan
authors.initials: K
authors.lastname: Walsh
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: I-Chin
authors.initials: IC
authors.lastname: Chiang
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchez-Peña
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Alayar
authors.initials: A
authors.lastname: Kangarlu
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Yunsuo
authors.initials: Y
authors.lastname: Duan
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Satie
authors.initials: S
authors.lastname: Shova
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Jane
authors.initials: J
authors.lastname: Fried
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 74, New York, NY, 10032, United States.
authors.forename: Gregory Z
authors.initials: GZ
authors.lastname: Tau
authors.affiliation: Division of Neonatology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 3959 Broadway Avenue, CHONY BHN 12, New York, NY 10032, United States.
authors.forename: Tove S
authors.initials: TS
authors.lastname: Rosen
authors.affiliation: Institute for the Developing Mind, Children's Hospital Los Angeles and Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of the University of Southern California, 4650 Sunset Boulevard, MS# 135, Los Angeles, CA 90027, United States. Electronic address: bpeterson@chla.usc.edu.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000379:methods*; D001519:Behavior; D001921:Brain / Q000033:anatomy & histology* / Q000187:drug effects* / Q000473:pathology; D001931:Brain Mapping; D036861:Delivery, Obstetric; D005260:Female; D006179:Gyrus Cinguli / Q000033:anatomy & histology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007743:Labor, Obstetric / Q000187:drug effects*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011247:Pregnancy; D055815:Young Adult
keywords: Anesthesia; Brain; Infant; MRI; Morphology