Effects of anesthesia and oral cleft types on academic achievement

ObjectiveResearch looking simultaneously at the effects of anesthesia and oral cleft types on academic achievement is scarce. Available results are contradictory: some studies suggest that anesthesia exposure is responsible for underachievement, and others that responsibility falls instead on the type of orofacial cleft. This study investigates the potential compound effects of exposure to anesthesia and orofacial cleft types on the risk of academic underachievement. DesignCentre Labio Palatin Albert Coninck, Cliniques universitaires Saint-Luc, Brussels, Belgium, nationwide register-based study. SettingBirth cohort 1995-2007. PatientsTwenty-nine children with isolated orofacial clefts exposed to anesthesia. InterventionsAverage duration of exposure to anesthesia before the Certificat d Etudes de Base (CEB) exam was 382 minutes. Main Outcome Measure(s)Scores obtained by patients at the CEB exam were compared with the scores of the 6th grade Belgian general population who passed the same exam controlling for gender, school year, year they passed the exam, medical illnesses, duration of exposure to anesthesia in minutes and socioeconomic confounders. ResultsDoubling the time of anesthesia exposure produces a 17 percentage point increase in the probability that patients will underachieve. Cleft lip reduces while cleft right-left increases the duration of anesthesia exposure relative to cleft lip palate. Results do not change when anesthesia exposure only up to 4 years and socioeconomic factors are considered. ConclusionsBoth exposure to anesthesia and different types of orofacial cleft may result in underachievement at the CEB exam.