Construction and Characterization of a Population-Based Cohort to Study the Association of Anesthesia Exposure with Neurodevelopmental Outcomes
Construction and Characterization of a Population-Based Cohort to Study the Association of Anesthesia Exposure with Neurodevelopmental Outcomes
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DOI：
10.1371/journal.pone.0155288
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发表时间：
2016-05-11
期刊：
影响因子：
3.7
通讯作者：
Warner, David O.
中科院分区：
文献类型：
--
作者：
Hu, Danqing;Flick, Randall P.;Warner, David O.
在动物和人类研究中，早期暴露于全身麻醉与不良神经发育结果有关，但其中一些研究使用了不再临床使用的麻醉剂。在这篇手稿中，我们描述了用于构建一个新的以人群为基础的研究队列的方法，以研究早期麻醉暴露和随后的神经发育结果之间的关系。确定了1996年1月1日至2000年12月31日在明尼苏达州奥姆斯特德县出生的所有儿童的出生队列。对于每个人，确定了5岁或6岁时在独立学区(ISD)的入学状况以及3岁之前的所有麻醉剂暴露经历。根据接受全身麻醉的倾向，通过匹配参加ISD的儿童来创建研究队列。通过比较出生和父母的信息、合并症和社会经济状况，进行了三项分析来描述研究队列的特征。第一项分析比较了参加和未参加ISD的出生队列儿童的特征。第二个分析评估了倾向匹配方案在创建除了麻醉暴露之外在测量特征上相似的儿童组方面的成功。第三项分析基于倾向匹配，比较了有麻醉暴露的儿童的特征，这些儿童是否包括在最终队列中。这些分析的结果表明，对照组之间只有微小的差异，因此这些不太可能影响我们未来对麻醉剂暴露和神经发育结果的分析。
Exposure to general anesthesia at an early age has been associated with adverse neurodevelopmental outcomes in both animal and human studies, but some of these studies employed anesthetic agents that are no longer in clinical use. In this manuscript, we describe the methods used to construct a new population-based study cohort to study the association between early anesthetic exposure and subsequent neurodevelopmental outcomes. A birth cohort of all children born in Olmsted County, MN from January 1, 1996 to December 31, 2000 was identified. For each, school enrollment status in the Independent School District (ISD) 535 at age 5 or 6 and all episodes of anesthetic exposure before age 3 were identified. A study cohort was created by matching children enrolled in ISD 535 based on the propensity of receiving general anesthesia. Three analyses were performed to characterize the study cohort by comparing the birth and parental information, comorbidities, and socioeconomic status. The first analysis compared the characteristics of birth cohort children who were and were not enrolled in ISD 535. The second analysis evaluated the success of the propensity matching schemes in creating groups of children that were similar in measured characteristics except for anesthesia exposure. The third analysis compared the characteristics of children with anesthesia exposures who were and were not included in the final cohort based on propensity matching. Results of these analyses demonstrate only slight differences among the comparison groups, and therefore these are unlikely to compromise our future analysis of anesthetic exposure and neurodevelopmental outcomes.