General Anesthesia During the Third Trimester: Any Link to Neurocognitive Outcomes?

Abstract

Rodent studies on the effect of general anesthesia during the third trimester on neurocognitive outcomes are mixed, but primate studies suggest that a clinically relevant exposure to anesthetic agents during the third trimester can trigger neuronal and glial cell death. Human studies are conflicting and the evidence is weak. This is an up-to-date review of the literature on the neurodevelopmental effects of anesthetic agents administered during the third trimester. Early brain development and critical periods of neurodevelopment as it relates to neurotoxicity are highlighted. Rodent, nonhuman primate, and population studies are discussed and placed in the context of clinical practice.

Keywords: Developmental neurotoxicity of anesthetics; Fetal neurodevelopment; Fetal surgery; Maternal anesthesia; Prenatal exposure; Third trimester anesthesia.