Risk of Autism Associated with Prenatal Exposure to Anesthetics

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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NIMED03_080

تاریخ نمایه سازی: 7 آبان 1398

Abstract:

Autism spectrum disorder(ASD) which is defined as an impairment in social functions and interaction is considered as a developmental disorder with symptoms appearing mostly in the first 2 years of life. Symptoms may include difficulty of communication, decrease in the inability to function in social environments, and different sensory input as compared to normal. Prenatal Exposures to certain drugsand medications have been previously found to increase the risk of developmental and behavioral dysfunctions.With the increasing rate of c sections and in turn the use of anesthetics in the country, it is important to evaluate how significantly associated autism and anesthetics are. Materials and Methods: Databases of PubMed, ScienceDirect and Scopus were searched up to April 2019 for the MeSH terms \ Autism\ , \ Prenatal Exposure\ and Anesthesia independently by two individuals. Results: From a total of 382 referrals, 26articles and books were retrieved based on the criteria. Studies on animals exposed to anesthetics before birth have shown a decrease in memory, cognition and overall function of the brain. This decrease is caused through a mechanism in which NMDA receptor agonistsand GABA receptor antagonists trigger cell death by translocation of mitochondrial membrane proteins such as Bax which sequentially activates caspase-3. With the majority of anesthetics containing at least one of these agents, these findings could be interpreted as anindication of the mentioned association. Clinical cohort studies conducted across the world on human subjects have also been affirmative to these results despite a few that have found no association at all. Furthermore, newborns delivered by C-section with general or regional anesthesia have shown a higher incidence of autism with a risk of 1.52. Conclusion: The majority of studies indicate that newborns exposed to anesthetic agents are at a higher risk of subsequently being diagnosed with ASD, however, future investigations are required due to some studies opposed to the above. Natural vaginal delivery is recommended to avoid this risk, unless medically contraindicated, and therefore, educating mothers in the country is a requirement. Moreover, regional anesthesia is a better substitution for general anesthesia, in case of NVD contraindication due to the less associated risk

Authors

Niloofar Nezaminia

Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran

Arefeh Kadkhodaei

Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran