A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Spring, 2024 | Number 2, Volume 38

Prenatal anesthesia may increase odds of ASD

Prenatal exposure to anesthesia may increase the likelihood of a child developing an autism spectrum disorder (ASD), according to a new study from Columbia University.

In the study, Caleb Ing and colleagues compared 34,271 children exposed prenatally to anesthesia to 171,355 unexposed children, matching each exposed child with five controls. The mothers of the exposed children had undergone either an appendectomy or a cholecystectomy during pregnancy. The researchers controlled for a variety of factors, including age, race, ethnicity, state of residence, income, and Medicaid enrollment for disability or poverty.

The researchers found that prenatally exposed children were 31 percent more likely than controls to receive a diagnosis of a disruptive or internalizing behavioral disorder. (Disruptive behavioral disorders include attention-deficit/hyperactivity disorder as well as conduct, impulse control, or oppositional defiant disorders; internalizing behavioral disorders include bipolar disorder, depression, and anxiety). The increased likelihood of children being diagnosed with ASD was also 31%.

Study coauthor Guohua Li comments, “Our findings could help inform preoperative risk assessment in pregnant women, especially when the surgical procedure is elective or when viable treatment is available. Results of this study also give added impetus to research on safer anesthetic drugs and techniques.”

“However,” Ing says, “caution is advised, as many procedures in pregnant women may be necessary, and avoidance of necessary procedures can have detrimental effects on mothers and their children.”


“Behavioural disorders after prenatal exposure to anaesthesia for maternal surgery,” Caleb Ing, Jeffrey H. Silber, Deven Lackraj, Mark Olfson, Caleb Miles, Joseph G. Reiter, Siddharth Jain, Stanford Chihuri, Ling Guo, Cynthia Gyamfi-Bannerman, Melanie Wall, and Guohua Li, British Journal of Anaesthesia, February 28, 2024 (online). Address: Caleb Ing, [email protected].


“Uptick in behavioral disorders reported in children following prenatal exposure to anesthesia,” news release, Columbia University Mailman School of Public Health, February 29, 2024.