The central hypothesis is that surgery and anesthesia exposure in children with immature structural and functional brain development has long-term adverse effects on child development at school-entry compared with children not exposed to anesthesia. The secondary hypothesis is that frequency of surgery and anesthesia exposure in children with immature structural and functional brain development has a dose-dependent association with worsened child development outcomes at school-entry. The overall objective is to investigate the association between surgery/anesthesia exposure(s) in children in Ontario and major child development outcomes (physical health and well being, social competence, emotional maturity, and language and cognitive development) at school entry as measured by the Early Development Instrument.
Study Type
OBSERVATIONAL
Enrollment
188,628
Surgical interventions in early childhood (prior to completion of Early Development Instrument)
The Hospital for Sick Children
Toronto, Ontario, Canada
Early developmental vulnerability
Any major domain of the Early Development Instrument in the lowest 10th percentile
Time frame: Assessed between five and six years of age
Performance in specific Early Development Instrument domains
Vulnerability (percentage in lowest 10th centile); mean score
Time frame: Assessed between five and six years of age
Multiple challenge index
Vulnerability (percentage in lowest 10th centile) in ≥9 sub-domains of the Early Development Instrument
Time frame: Assessed between five and six years of age
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