association between early exposure to general anesthesia and autism spectrum disorder: a case control study

Background: over the past decade, the safety of general anesthesia in the early life of humans has been questioned after the discovery that the developing brain of immature animals was affected by anesthetic agents.objectives: we investigated the association between early exposure to general anesthesia and autism development.materials & methods: this case-control study was conducted at the pediatric psychology clinic of an academic hospital affiliated with guilan university of medical sciences from december 2021 to april 2024. firstly, the responsible resident of anesthesiology sorted out the autism cases files that were diagnosed based on dsm-5 criteria. then, a questionnaire was filled out through a telephone interview. the data from 540 children were analyzed and general anesthesia exposure frequency distribution was compared between autism cases and controls. results: comparing the two groups, a significant difference was observed in terms of birth status (term/preterm) (p=0.031), history of receiving anesthesia under 4 years (p=0.039), age of receiving anesthesia (p=0.021), and type of surgery requiring anesthesia (elective/emergency) (p=0.022). multivariate analysis using logistic regression showed that only the variable of receiving anesthesia has a significant role in the incidence of autism behavioral disorders (p=0.043). accordingly, children with a history of receiving anesthesia were 1.47 times more likely to develop autism.conclusion: early exposure to general anesthesia might be a risk factor for later development of autism. further prospective, well-planned studies are needed to confirm these findings.