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American Journal of Perinatology· 2026Q2

Association Between the Number of US Food and Drug Administration–Warned Anesthetic Exposures and Full-Scale Intelligence Quotient at Age 3 Years in Very Preterm Infants

Marika K. Grant, Joanna J Fifen, Andrew Walker, Amina A. Benlamri et al.

Short summary

Exposure to 1, 2, or ≥ 3 different FDA-warned anesthetic/sedative agents in very preterm infants (< 29 weeks GA) was not associated with a clinically meaningful decrease in full-scale IQ (FSIQ) points at 36 months corrected age.

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Key points

  • No clinically meaningful decrease in FSIQ was associated with 1, 2, or ≥ 3 different FDA-warned anesthetic/sedative agents in very preterm infants.
  • Adjusted FSIQ point differences were -3 (95% CI -7 to 2), -4 (95% CI -9 to 1), and -7 (95% CI -15 to 1) for 1, 2, and ≥ 3 exposures, respectively.
  • The study included 435 infants born < 29 weeks gestational age, assessed at 36 months corrected age.
  • FDA-warned agents included volatile anesthetics, propofol, benzodiazepines, ketamine, chloral hydrate, and barbiturates.

AI-generated from the title and abstract; the full text is not read.

Abstract

Abstract In 2016, the US Food and Drug Administration (FDA) warned that general anesthetics and sedative agents in children younger than 3 years may impair neurodevelopment. Very preterm infants could be especially vulnerable because of brain immaturity. We examined the association between the number of US FDA-warned anesthetic and sedative agents and full-scale intelligence quotient (FSIQ) at age 3 years in infants born < 29 weeks' gestational age (GA). In this retrospective study, all infants born (< 29 weeks' gestation) between January 2006 and December 2012 were evaluated for exposure to FDA-warned anesthetic and sedative agents from birth through 45 weeks' postconceptual age. The agents included volatile anesthetics, propofol, benzodiazepines, ketamine, chloral hydrate, and barbiturates. Exposure count was defined by the number of different agents administered: 1 exposure (1 agent); 2 exposures (2 agents); and ≥ 3 exposures (≥ 3 agents), irrespective of the number of procedures. We analyzed the association between FSIQ and exposure count using imputed and complete case univariable and multivariable linear regressions adjusted for neonatal and maternal factors. Of 650 eligible infants, 435 (67%) had FSIQ assessed at 3 years. Imputed adjusted associations (95% confidence interval, p-value) between FSIQ and exposure to 1, 2, or ≥ 3 different agents were − 3 (− 7 to 2, p = 0.284), − 4 (− 9 to 1, p = 0.101), and − 7 (− 15 to 1, p = 0.079) points, respectively. Exposure to 1, 2, or ≥ 3 different FDA-warned anesthetic and sedative agents (volatile anesthetics, propofol, benzodiazepines, barbiturates, and ketamine) in very preterm infants born < 29 weeks' GA was not associated with a clinically meaningful decrease in FSIQ points at 36 months' corrected age.

The authors' abstract, as published at the source. American Journal of Perinatology, 2026 · DOI ↗

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Field: Developmental Neuroscience

Developmental NeuroscienceNeuroscience