Oral Clefts and Academic Performance in Adolescence

The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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 MEASURES(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.

OriginalsprogEngelsk
TidsskriftCleft Palate - Craniofacial Journal
Vol/bind54
Udgave nummer4
Sider (fra-til)371-380
ISSN1055-6656
DOI
StatusUdgivet - 2017

Fingeraftryk

Cleft Palate
Cleft Lip
Parents
Odds Ratio
Outcome Assessment (Health Care)
Education
Control Groups

Citer dette

@article{868e968110f34622819ae8e1e26dfd0c,
title = "Oral Clefts and Academic Performance in Adolescence: The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts",
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 MEASURES(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.",
keywords = "Age, Anesthesia-related neurotoxicity, Craniofacial surgery, General anesthesia, Infants, Neonates, Neurodevelopment, Neurotoxicity, Oral clefts, Outcome",
author = "Clausen, {Nicola G} and Pedersen, {Dorthe A} and Pedersen, {Jacob K} and M{\o}ller, {Susanne E} and Dorthe Grosen and Wehby, {George L} and Kaare Christensen and Hansen, {Tom G}",
year = "2017",
doi = "10.1597/15-185",
language = "English",
volume = "54",
pages = "371--380",
journal = "Cleft Palate - Craniofacial Journal",
issn = "1055-6656",
publisher = "Allen Press, Inc.",
number = "4",

}

TY - JOUR

T1 - Oral Clefts and Academic Performance in Adolescence

T2 - The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts

AU - Clausen, Nicola G

AU - Pedersen, Dorthe A

AU - Pedersen, Jacob K

AU - Møller, Susanne E

AU - Grosen, Dorthe

AU - Wehby, George L

AU - Christensen, Kaare

AU - Hansen, Tom G

PY - 2017

Y1 - 2017

N2 - 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 MEASURES(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.

AB - 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 MEASURES(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.

KW - Age

KW - Anesthesia-related neurotoxicity

KW - Craniofacial surgery

KW - General anesthesia

KW - Infants

KW - Neonates

KW - Neurodevelopment

KW - Neurotoxicity

KW - Oral clefts

KW - Outcome

U2 - 10.1597/15-185

DO - 10.1597/15-185

M3 - Journal article

VL - 54

SP - 371

EP - 380

JO - Cleft Palate - Craniofacial Journal

JF - Cleft Palate - Craniofacial Journal

SN - 1055-6656

IS - 4

ER -