Effect of Anesthesia During Pregnancy, Delivery, and Childhood on Autism Spectrum Disorder: A Systematic Review and Meta-analysis.
Large review finds no reliable link between anesthesia at any age and autism.
01Research in Context
What this study did
He et al. (2024) pooled every study that tracked kids who had anesthesia. They looked at three windows: while the mom was pregnant, during birth, and anytime in childhood.
The team ran a meta-analysis. That means they combined numbers from many papers to see if any clear link to autism appeared.
What they found
No strong signal showed up. Anesthesia during labor or childhood did not line up with later autism.
A weak hint popped up for pregnancy exposure, but the authors say other factors could explain it. The data stay inconclusive.
How this fits with other research
The result lines up with Davison et al. (1995). That early paper also found little difference in birth events across autism subtypes.
Rana et al. (2024) looked at different prenatal risks—maternal anxiety and newborn jaundice—and did find links to sensory issues. The contrast shows anesthesia is not shaping development the way those factors do.
Other 2024 and 2021 studies on obesity, gluten antibodies, and birth spacing keep pointing to pregnancy as a sensitive window, yet none single out anesthesia. Simin et al. close that gap by showing the signal is too faint to trust.
Why it matters
You can reassure families. Kids who needed anesthesia for ear tubes or a C-section delivery do not face a known autism risk. Shift your interview questions toward the risks that hold data, like maternal health or very short birth intervals, and skip long hunts for surgery history unless medical teams need it.
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02At a glance
03Original abstract
To investigate the association between exposure to anesthesia during three periods of pregnancy, delivery, and childhood and autism spectrum disorder (ASD). PubMed, Scopus, Web of Science, Embase, Google Scholar, PsycArticles, and PsycINFO were searched from the date of database inception to 1 December 2022. Studies reported the association between exposure to anesthesia during pregnancy, delivery, and childhood and ASD were included. Extracted variables included hazard ratio (HR), relative risk or odds ratio, standard error, and 95% confidence interval (CI). Effect estimates were pooled using random-effects meta-analysis. In total, 16 studies including 8,156,608 individuals were included in the meta-analysis. Labor epidural anesthesia during delivery was associated with ASD in the general population (adjusted HR = 1.16, 95% CI, 1.06-1.28) but not in the sibling population (adjusted HR = 1.06, 95% CI, 0.98-1.15). Other anesthesia during delivery was not associated with ASD (general population: adjusted HR = 1.08, 95% CI, 0.99-1.17; sibling population: adjusted HR = 1.20, 95% CI, 0.81-1.79). Three studies suggested that exposure to anesthesia during pregnancy was associated with ASD in offspring (adjusted HR = 2.15, 95% CI, 1.32-3.48). There was no significant association between exposure to general anesthesia during childhood and ASD (adjusted HR = 1.02, 95% CI, 0.60-1.72). This meta-analysis did not confirm the association between exposure to anesthesia during labour and ASD. Previous observational studies used the neurotoxicity of anesthesia to biologically explain significant associations, but in fact different controls for confounding factors led to differences in associations. The evidence for pregnancy and childhood was limited given the small number of studies in these periods.
Journal of autism and developmental disorders, 2024 · doi:10.1016/j.biopha.2016.12.062