Early surgery in very preterm infants is associated with brain abnormalities on term MRI: a propensity score analysis

ObjectiveTo investigate the association between exposure to surgery under general anesthesia and brain abnormalities and neurodevelopmental outcomes in very preterm infants.Study designThis prospective observational study includes 392 infants born at or below 32 weeks' gestational age. Participants completed brain MRI at term-equivalent age and Bayley-III assessment at 2 years corrected age. We evaluated the independent effects of surgery on brain MRI abnormalities and neurodevelopmental outcomes after propensity score matching.ResultsAll infants completed brain MRI, and 341 (87%) completed neurodevelopmental testing. Forty-five received surgery. Surgery was associated with worse MRI abnormalities (p < 0.0001) but with none of the developmental outcomes after propensity score matching. The global brain abnormality score was associated with the Bayley Cognitive (p = 0.005) and Motor (p = 0.028) composite scores.ConclusionsVery preterm infants exposed to surgery under general anesthesia were at higher risk of brain abnormalities on MRI at term.

Automated summary

This study aims to investigate the association between surgery under general anesthesia and brain abnormalities and neurodevelopmental outcomes in very preterm infants. The results showed that infants who underwent surgery had worse MRI abnormalities, but there was no association with developmental outcomes after propensity score matching.