Journal article
Oral clefts and academic performance in adolescence: the impact of anesthesia-related neurotoxicity, timing of surgery and type of oral clefts
The Cleft palate-craniofacial journal, Vol.54(4), pp.371-380
07/2017
DOI: 10.1597/15-185
PMCID: PMC6687065
PMID: 27043652
Abstract
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 noncleft control group to investigate whether outcome depends on timing and number of operations during childhood and/or type of oral cleft.
Design: Nationwide register-based follow-up study.
Setting: Danish birth cohort 1986 to 1990.
Participants: Five hundred fifty-eight 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 measure(s): Test score in the Danish standardized ninth-grade exam and proportion of nonattainment, defined as "results for ninth-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 nonattainment 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.
Details
- Title: Subtitle
- Oral clefts and academic performance in adolescence: the impact of anesthesia-related neurotoxicity, timing of surgery and type of oral clefts
- Creators
- Nicola G Clausen - Department of Anesthesia and Intensive Care, Sdr Boulevard 29, 5000 Odense; Institute for Clinical Research -Anesthesiology, University of Southern, DenmarkDorthe A Pedersen - Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense C, DenmarkJacob K Pedersen - Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense C, DenmarkSusanne E Møller - Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense C, DenmarkDorthe Grosen - 5th year resident, Department of Paediatrics, Lillebaelt Hospital, Kolding; Epidemiology, Institute of Public Health, University of Southern Denmark, Odense C, DenmarkGeorge L Wehby - Department of Health Management and Policy, College of Public Health, University of Iowa, 145 N. Riverside Dr., 100 College of Public Health Bldg.; Iowa City, IA 52242Kaare Christensen - Head of Research, Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense C, DenmarkTom G Hansen - Institute for Clinical Research Anesthesiology, University of Southern Denmark; consultant pediatric anesthesiologist, Department of Anesthesia & Intensive Care, Odense University Hospital, Odense C
- Resource Type
- Journal article
- Publication Details
- The Cleft palate-craniofacial journal, Vol.54(4), pp.371-380
- DOI
- 10.1597/15-185
- PMID
- 27043652
- PMCID
- PMC6687065
- NLM abbreviation
- Cleft Palate Craniofac J
- ISSN
- 1055-6656
- eISSN
- 1545-1569
- Language
- English
- Date published
- 07/2017
- Academic Unit
- Preventive and Community Dentistry; Health Management and Policy; Economics; Public Policy Center (Archive)
- Record Identifier
- 9984064197402771
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