title: Latent Class Analysis of Neurodevelopmental Deficit After Exposure to Anesthesia in Early Childhood.
abstract: BACKGROUND
  Although some studies have reported an association between early exposure to anesthesia and surgery and long-term neurodevelopmental deficit, the clinical phenotype of children exposed to anesthesia is still unknown.
  
  
  METHODS
  Data were obtained from the Western Australian Pregnancy Cohort Study (Raine) with neuropsychological tests at age 10 years measuring language, cognition, motor function, and behavior. Latent class analysis of the tests was used to divide the cohort into mutually exclusive subclasses of neurodevelopmental deficit. Multivariable polytomous logistic regression was used to evaluate the association between exposure to surgery and anesthesia and each latent class, adjusting for demographic and medical covariates.
  
  
  RESULTS
  In our cohort of 1444 children, latent class analysis identified 4 subclasses: (1) Normal: few deficits (n=1135, 78.6%); (2) Language and Cognitive deficits: primarily language, cognitive, and motor deficits (n=96, 6.6%); (3) Behavioral deficits: primarily behavioral deficits, (n=151, 10.5%); and (4) Severe deficits: deficits in all neuropsychological domains (n=62, 4.3%). Language and cognitive deficit group children were more likely to have exposure before age 3 (adjusted odds ratio [aOR], 2.11; 95% confidence interval [CI], 1.17-3.81), whereas a difference in exposure was not found between Behavioral or Severe deficit children (aOR, 1.00; 95% CI, 0.58-1.73, and aOR, 0.85; 95% CI, 0.34-2.15, respectively) and Normal children.
  
  
  CONCLUSIONS
  Our results suggest that in evaluating children exposed to surgery and anesthesia at an early age, the phenotype of interest may be children with deficits primarily in language and cognition, and not children with broad neurodevelopmental delay or primarily behavioral deficits.
authors.affiliation: Departments of *Anesthesiology ††Anesthesiology and Pediatrics, Columbia University College of Physicians and Surgeons Departments of †Psychiatry and Biostatistics ‡Anesthesiology and Epidemiology ¶Anesthesiology and Biostatistics **Anesthesiology and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, New York, NY §Telethon Kids Institute #School of Medicine and Pharmacology, The University of Western Australia ∥Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, WA, Australia.
authors.forename: Caleb
authors.initials: C
authors.lastname: Ing
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.forename: Charles J
authors.initials: CJ
authors.lastname: DiMaggio
authors.forename: Andrew J O
authors.initials: AJO
authors.lastname: Whitehouse
authors.forename: Mary K
authors.initials: MK
authors.lastname: Hegarty
authors.forename: Ming
authors.initials: M
authors.lastname: Sun
authors.forename: Britta S
authors.initials: BS
authors.lastname: von Ungern-Sternberg
authors.forename: Guohua
authors.initials: G
authors.lastname: Li
authors.forename: Lena S
authors.initials: LS
authors.lastname: Sun
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D002658:Developmental Disabilities / Q000139:chemically induced* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007805:Language Development Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D010641:Phenotype; D011247:Pregnancy; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D014904:Western Australia / Q000453:epidemiology