{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:23Z","timestamp":1792787783794,"version":"4.5.0"},"reference-count":56,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Science and Technology Projects in Guangzhou","award":["2023A03J0619"],"award-info":[{"award-number":["2023A03J0619"]}]},{"name":"National Natural Science Foundation of China","award":["81503167"],"award-info":[{"award-number":["81503167"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Foreign Expert Project of the Ministry of Science and Technology of China","award":["DL2023199003L"],"award-info":[{"award-number":["DL2023199003L"]}],"id":[{"id":"https:\/\/ror.org\/02kv4zf79","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Innovation and Entrepreneurial Training Program for Undergraduate Students","award":["202310559035 and 801677"],"award-info":[{"award-number":["202310559035 and 801677"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"DOI":"10.1186\/s12871-026-04096-0","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:06:18Z","timestamp":1783922778000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early childhood exposure to general anesthesia and subsequent risk of learning disabilities: a systematic review and meta-analysis of cohort studies"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4487-9325","authenticated-orcid":false,"given":"Huimin","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4569-871X","authenticated-orcid":false,"given":"Yadong","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4072-6773","authenticated-orcid":false,"given":"Hao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0837-5133","authenticated-orcid":false,"given":"Xin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6042-6503","authenticated-orcid":false,"given":"Hoi Yan","family":"Mak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2029-6772","authenticated-orcid":false,"given":"Hamdan","family":"Hamdan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-9801","authenticated-orcid":false,"given":"Chaoxuan","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"issue":"5398","key":"4096_CR1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1126\/science.283.5398.70","volume":"283","author":"C Ikonomidou","year":"1999","unstructured":"Ikonomidou C, Bosch F, Miksa M, Bittigau P, V\u00f6ckler J, Dikranian K, Tenkova TI, Stefovska V, Turski L, Olney JW. Blockade of NMDA receptors and apoptotic neurodegeneration in the developing brain. Sci (New York NY). 1999;283(5398):70\u20134.","journal-title":"Sci (New York NY)"},{"issue":"3","key":"4096_CR2","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1093\/bja\/aew473","volume":"119","author":"MC Alvarado","year":"2017","unstructured":"Alvarado MC, Murphy KL, Baxter MG. Visual recognition memory is impaired in rhesus monkeys repeatedly exposed to sevoflurane in infancy. Br J Anaesth. 2017;119(3):517\u201323.","journal-title":"Br J Anaesth"},{"issue":"3","key":"4096_CR3","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1523\/JNEUROSCI.23-03-00876.2003","volume":"23","author":"V Jevtovic-Todorovic","year":"2003","unstructured":"Jevtovic-Todorovic V, Hartman RE, Izumi Y, Benshoff ND, Dikranian K, Zorumski CF, Olney JW, Wozniak DF. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J neuroscience: official J Soc Neurosci. 2003;23(3):876\u201382.","journal-title":"J neuroscience: official J Soc Neurosci"},{"issue":"8","key":"4096_CR4","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1016\/j.neuropharm.2007.09.005","volume":"53","author":"Y Li","year":"2007","unstructured":"Li Y, Liang G, Wang S, Meng Q, Wang Q, Wei H. Effects of fetal exposure to isoflurane on postnatal memory and learning in rats. Neuropharmacology. 2007;53(8):942\u201350.","journal-title":"Neuropharmacology"},{"issue":"2","key":"4096_CR5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.ntt.2011.01.001","volume":"33","author":"MG Paule","year":"2011","unstructured":"Paule MG, Li M, Allen RR, Liu F, Zou X, Hotchkiss C, Hanig JP, Patterson TA, Slikker W Jr., Wang C. Ketamine anesthesia during the first week of life can cause long-lasting cognitive deficits in rhesus monkeys. Neurotoxicol Teratol. 2011;33(2):220\u201330.","journal-title":"Neurotoxicol Teratol"},{"issue":"3","key":"4096_CR6","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1097\/ALN.0b013e3181974fa2","volume":"110","author":"M Satomoto","year":"2009","unstructured":"Satomoto M, Satoh Y, Terui K, Miyao H, Takishima K, Ito M, Imaki J. Neonatal exposure to sevoflurane induces abnormal social behaviors and deficits in fear conditioning in mice. Anesthesiology. 2009;110(3):628\u201337.","journal-title":"Anesthesiology"},{"issue":"10172","key":"4096_CR7","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1016\/S0140-6736(18)32485-1","volume":"393","author":"ME McCann","year":"2019","unstructured":"McCann ME, de Graaff JC, Dorris L, Disma N, Withington D, Bell G, Grobler A, Stargatt R, Hunt RW, Sheppard SJ, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial. Lancet (London England). 2019;393(10172):664\u201377.","journal-title":"Lancet (London England)"},{"issue":"5","key":"4096_CR8","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1097\/ALN.0000000000003522","volume":"133","author":"GJ Walkden","year":"2020","unstructured":"Walkden GJ, Gill H, Davies NM, Peters AE, Wright I, Pickering AE. Early Childhood General Anesthesia and Neurodevelopmental Outcomes in the Avon Longitudinal Study of Parents and Children Birth Cohort. Anesthesiology. 2020;133(5):1007\u201320.","journal-title":"Anesthesiology"},{"issue":"1","key":"4096_CR9","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/ALN.0000000000002232","volume":"129","author":"DO Warner","year":"2018","unstructured":"Warner DO, Zaccariello MJ, Katusic SK, Schroeder DR, Hanson AC, Schulte PJ, Buenvenida SL, Gleich SJ, Wilder RT, Sprung J, et al. Neuropsychological and Behavioral Outcomes after Exposure of Young Children to Procedures Requiring General Anesthesia: The Mayo Anesthesia Safety in Kids (MASK) Study. Anesthesiology. 2018;129(1):89\u2013105.","journal-title":"Anesthesiology"},{"issue":"2","key":"4096_CR10","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1097\/ALN.0000000000001735","volume":"127","author":"D Hu","year":"2017","unstructured":"Hu D, Flick RP, Zaccariello MJ, Colligan RC, Katusic SK, Schroeder DR, Hanson AC, Buenvenida SL, Gleich SJ, Wilder RT, et al. Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort. Anesthesiology. 2017;127(2):227\u201340.","journal-title":"Anesthesiology"},{"issue":"3","key":"4096_CR11","doi-asserted-by":"publisher","first-page":"e476","DOI":"10.1542\/peds.2011-3822","volume":"130","author":"C Ing","year":"2012","unstructured":"Ing C, DiMaggio C, Whitehouse A, Hegarty MK, Brady J, von Ungern-Sternberg BS, Davidson A, Wood AJ, Li G, Sun LS. Long-term differences in language and cognitive function after childhood exposure to anesthesia. Pediatrics. 2012;130(3):e476\u2013485.","journal-title":"Pediatrics"},{"issue":"6","key":"4096_CR12","doi-asserted-by":"publisher","first-page":"e42","DOI":"10.3346\/jkms.2023.38.e42","volume":"38","author":"JY Song","year":"2023","unstructured":"Song JY, Cha HR, Lee SW, Ha EK, Kim JH, Han MY. Association Between Receipt of General Anesthesia During Childhood and Attention Deficit Hyperactive Disorder and Neurodevelopment. J Korean Med Sci. 2023;38(6):e42.","journal-title":"J Korean Med Sci"},{"issue":"4","key":"4096_CR13","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1097\/01.anes.0000344728.34332.5d","volume":"110","author":"RT Wilder","year":"2009","unstructured":"Wilder RT, Flick RP, Sprung J, Katusic SK, Barbaresi WJ, Mickelson C, Gleich SJ, Schroeder DR, Weaver AL, Warner DO. Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology. 2009;110(4):796\u2013804.","journal-title":"Anesthesiology"},{"key":"4096_CR14","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. 5th ed. text rev. Washington, DC: American Psychiatric Association Publishing; 2022.","DOI":"10.1176\/appi.books.9780890425787"},{"issue":"Suppl 1","key":"4096_CR15","doi-asserted-by":"publisher","first-page":"S46","DOI":"10.21037\/tp.2019.11.01","volume":"9","author":"PJ Chung","year":"2020","unstructured":"Chung PJ, Patel DR, Nizami I. Disorder of written expression and dysgraphia: definition, diagnosis, and management. Translational Pediatr. 2020;9(Suppl 1):S46\u201354.","journal-title":"Translational Pediatr"},{"issue":"45","key":"4096_CR16","first-page":"767","volume":"109","author":"L Kaufmann","year":"2012","unstructured":"Kaufmann L, von Aster M. The diagnosis and management of dyscalculia. Deutsches Arzteblatt Int. 2012;109(45):767\u201378.","journal-title":"Deutsches Arzteblatt Int"},{"issue":"6","key":"4096_CR17","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1016\/j.pcl.2008.08.001","volume":"55","author":"L Lagae","year":"2008","unstructured":"Lagae L. Learning disabilities: definitions, epidemiology, diagnosis, and intervention strategies. Pediatr Clin North Am. 2008;55(6):1259\u201368.","journal-title":"Pediatr Clin North Am"},{"issue":"4","key":"4096_CR18","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1080\/03054985.2020.1765756","volume":"46","author":"MJ Snowling","year":"2020","unstructured":"Snowling MJ, Hulme C, Nation K. Defining and understanding dyslexia: past, present and future. Oxf Rev Educ. 2020;46(4):501\u201313.","journal-title":"Oxf Rev Educ"},{"issue":"3","key":"4096_CR19","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1097\/DBP.0b013e318209edef","volume":"32","author":"DC Geary","year":"2011","unstructured":"Geary DC. Consequences, characteristics, and causes of mathematical learning disabilities and persistent low achievement in mathematics. J Dev Behav pediatrics: JDBP. 2011;32(3):250\u201363.","journal-title":"J Dev Behav pediatrics: JDBP"},{"issue":"1","key":"4096_CR20","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1037\/amp0000452","volume":"75","author":"EL Grigorenko","year":"2020","unstructured":"Grigorenko EL, Compton DL, Fuchs LS, Wagner RK, Willcutt EG, Fletcher JM. Understanding, educating, and supporting children with specific learning disabilities: 50 years of science and practice. Am Psychol. 2020;75(1):37\u201351.","journal-title":"Am Psychol"},{"issue":"3","key":"4096_CR21","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1097\/00004583-198905000-00003","volume":"28","author":"LB Silver","year":"1989","unstructured":"Silver LB. Psychological and family problems associated with learning disabilities: assessment and intervention. J Am Acad Child Adolesc Psychiatry. 1989;28(3):319\u201325.","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"5","key":"4096_CR22","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/YCO.0b013e3283566843","volume":"25","author":"K Vedi","year":"2012","unstructured":"Vedi K, Bernard S. The mental health needs of children and adolescents with learning disabilities. Curr Opin Psychiatry. 2012;25(5):353\u20138.","journal-title":"Curr Opin Psychiatry"},{"issue":"9\u201310","key":"4096_CR23","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1017\/S1355617717001084","volume":"23","author":"JM Fletcher","year":"2017","unstructured":"Fletcher JM, Grigorenko EL. Neuropsychology of Learning Disabilities: The Past and the Future. J Int Neuropsychological Society: JINS. 2017;23(9\u201310):930\u201340.","journal-title":"J Int Neuropsychological Society: JINS"},{"issue":"7","key":"4096_CR24","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1097\/DBP.0b013e3181ee4b70","volume":"31","author":"BS Hensler","year":"2010","unstructured":"Hensler BS, Schatschneider C, Taylor J, Wagner RK. Behavioral genetic approach to the study of dyslexia. J Dev Behav pediatrics: JDBP. 2010;31(7):525\u201332.","journal-title":"J Dev Behav pediatrics: JDBP"},{"issue":"1","key":"4096_CR25","doi-asserted-by":"publisher","first-page":"e001810","DOI":"10.1136\/bmjpo-2022-001810","volume":"7","author":"P Rees","year":"2023","unstructured":"Rees P, Callan C, Chadda K, Vaal M, Diviney J, Sabti S, Harnden F, Gardiner J, Battersby C, Gale C, et al. School-age outcomes of children after perinatal brain injury: a systematic review and meta-analysis. BMJ Paediatrics Open. 2023;7(1):e001810.","journal-title":"BMJ Paediatrics Open"},{"key":"4096_CR26","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1002\/cad.20291","volume":"2019165","author":"EG Willcutt","year":"2019","unstructured":"Willcutt EG, McGrath LM, Pennington BF, Keenan JM, DeFries JC, Olson RK, Wadsworth SJ. Understanding Comorbidity Between Specific Learning Disabilities. New Dir Child Adolesc Dev. 2019;2019(165):91\u2013109.","journal-title":"New Dir Child Adolesc Dev"},{"issue":"7","key":"4096_CR27","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/DBP.0b013e3181ef42a1","volume":"31","author":"EG Willcutt","year":"2010","unstructured":"Willcutt EG, Pennington BF, Duncan L, Smith SD, Keenan JM, Wadsworth S, Defries JC, Olson RK. Understanding the complex etiologies of developmental disorders: behavioral and molecular genetic approaches. J Dev Behav pediatrics: JDBP. 2010;31(7):533\u201344.","journal-title":"J Dev Behav pediatrics: JDBP"},{"issue":"6","key":"4096_CR28","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1213\/ANE.0b013e318299a7c2","volume":"117","author":"CL Bong","year":"2013","unstructured":"Bong CL, Allen JC, Kim JT. The effects of exposure to general anesthesia in infancy on academic performance at age 12. Anesth Analg. 2013;117(6):1419\u201328.","journal-title":"Anesth Analg"},{"issue":"5","key":"4096_CR29","doi-asserted-by":"publisher","first-page":"e1053","DOI":"10.1542\/peds.2011-0351","volume":"128","author":"RP Flick","year":"2011","unstructured":"Flick RP, Katusic SK, Colligan RC, Wilder RT, Voigt RG, Olson MD, Sprung J, Weaver AL, Schroeder DR, Warner DO. Cognitive and behavioral outcomes after early exposure to anesthesia and surgery. Pediatrics. 2011;128(5):e1053\u20131061.","journal-title":"Pediatrics"},{"issue":"6","key":"4096_CR30","doi-asserted-by":"publisher","first-page":"e2217427","DOI":"10.1001\/jamanetworkopen.2022.17427","volume":"5","author":"C Reighard","year":"2022","unstructured":"Reighard C, Junaid S, Jackson WM, Arif A, Waddington H, Whitehouse AJO, Ing C. Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis. JAMA Netw open. 2022;5(6):e2217427.","journal-title":"JAMA Netw open"},{"issue":"1","key":"4096_CR31","doi-asserted-by":"publisher","first-page":"e85760","DOI":"10.1371\/journal.pone.0085760","volume":"9","author":"X Wang","year":"2014","unstructured":"Wang X, Xu Z, Miao CH. Current clinical evidence on the effect of general anesthesia on neurodevelopment in children: an updated systematic review with meta-regression. PLoS ONE. 2014;9(1):e85760.","journal-title":"PLoS ONE"},{"issue":"5","key":"4096_CR32","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00540-015-2030-z","volume":"29","author":"H Zhang","year":"2015","unstructured":"Zhang H, Du L, Du Z, Jiang H, Han D, Li Q. Association between childhood exposure to single general anesthesia and neurodevelopment: a systematic review and meta-analysis of cohort study. J Anesth. 2015;29(5):749\u201357.","journal-title":"J Anesth"},{"key":"4096_CR33","first-page":"n160","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ (Clinical Res ed. 2021;372:n160.","journal-title":"BMJ (Clinical Res ed"},{"issue":"6","key":"4096_CR34","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1016\/j.bja.2017.11.107","volume":"120","author":"NG Clausen","year":"2018","unstructured":"Clausen NG, K\u00e4hler S, Hansen TG. Systematic review of the neurocognitive outcomes used in studies of paediatric anaesthesia neurotoxicity. Br J Anaesth. 2018;120(6):1255\u201373.","journal-title":"Br J Anaesth"},{"issue":"2","key":"4096_CR35","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1016\/j.bja.2020.10.022","volume":"126","author":"C Ing","year":"2021","unstructured":"Ing C, Jackson WM, Zaccariello MJ, Goldberg TE, McCann ME, Grobler A, Davidson A, Sun L, Li G, Warner DO. Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis. Br J Anaesth. 2021;126(2):433\u201344.","journal-title":"Br J Anaesth"},{"key":"4096_CR36","doi-asserted-by":"publisher","first-page":"111585","DOI":"10.1016\/j.jclinane.2024.111585","volume":"98","author":"H Zhou","year":"2024","unstructured":"Zhou H, Sun W, Ning L, Kang J, Jin Y, Dong C. Early exposure to general anesthesia may contribute to later attention-deficit\/hyperactivity disorder (ADHD): A systematic review and meta-analysis of cohort studies. J Clin Anesth. 2024;98:111585.","journal-title":"J Clin Anesth"},{"issue":"13","key":"4096_CR37","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1136\/bjsports-2021-104876","volume":"56","author":"M Han","year":"2022","unstructured":"Han M, Qie R, Shi X, Yang Y, Lu J, Hu F, Zhang M, Zhang Z, Hu D, Zhao Y. Cardiorespiratory fitness and mortality from all causes, cardiovascular disease and cancer: dose-response meta-analysis of cohort studies. Br J Sports Med. 2022;56(13):733\u20139.","journal-title":"Br J Sports Med"},{"key":"4096_CR38","unstructured":"Higgins JPTTJ, Chandler J, Cumpston M, Li T, Page MJ, et al. editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.5 (updated August 2024). Cochrane. 2024. https:\/\/www.cochrane.org\/handbook."},{"issue":"1","key":"4096_CR39","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12966-024-01586-7","volume":"21","author":"J Wu","year":"2024","unstructured":"Wu J, Feng Y, Zhao Y, Guo Z, Liu R, Zeng X, Yang F, Liu B, Gu J, Tarimo CS, et al. Lifestyle behaviors and risk of cardiovascular disease and prognosis among individuals with cardiovascular disease: a systematic review and meta-analysis of 71 prospective cohort studies. Int J Behav Nutr Phys Act. 2024;21(1):42.","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"19","key":"4096_CR40","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1001\/jama.280.19.1690","volume":"280","author":"J Zhang","year":"1998","unstructured":"Zhang J, Yu KF. What\u2019s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998;280(19):1690\u20131.","journal-title":"JAMA"},{"issue":"2","key":"4096_CR41","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1002\/jrsm.12","volume":"1","author":"M Borenstein","year":"2010","unstructured":"Borenstein M, Hedges LV, Higgins JP, Rothstein HR. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res synthesis methods. 2010;1(2):97\u2013111.","journal-title":"Res synthesis methods"},{"issue":"1","key":"4096_CR42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/CM9.0000000000002814","volume":"137","author":"C Zhai","year":"2024","unstructured":"Zhai C, Guyatt G. Fixed-effect and random-effects models in meta-analysis. Chin Med J. 2024;137(1):1\u20134.","journal-title":"Chin Med J"},{"key":"4096_CR43","doi-asserted-by":"publisher","unstructured":"Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Multiple outcomes or time-points within a study. In: Borenstein M, Hedges LV, Higgins JPT, Rothstein HR, editors. Introduction to Meta-Analysis. Chichester: John Wiley & Sons, Ltd; 2009. https:\/\/doi.org\/10.1002\/9780470743386.ch24.","DOI":"10.1002\/9780470743386.ch24"},{"issue":"4","key":"4096_CR44","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","volume":"64","author":"G Guyatt","year":"2011","unstructured":"Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383\u201394.","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"4096_CR45","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1111\/pan.13390","volume":"28","author":"FJ Schneuer","year":"2018","unstructured":"Schneuer FJ, Bentley JP, Davidson AJ, Holland AJ, Badawi N, Martin AJ, Skowno J, Lain SJ, Nassar N. The impact of general anesthesia on child development and school performance: a population-based study. Paediatr Anaesth. 2018;28(6):528\u201336.","journal-title":"Paediatr Anaesth"},{"key":"4096_CR46","doi-asserted-by":"crossref","unstructured":"Warner DO, Hu D, Zaccariello MJ, Schroeder DR, Hanson AC, Wilder RT, Sprung J, Flick RP. Association Between Behavioral and Learning Outcomes and Single Exposures to Procedures Requiring General Anesthesia Before Age 3: Secondary Analysis of Data From Olmsted County, MN. Anesth Analg. 2021;133(1):160\u20137.","DOI":"10.1213\/ANE.0000000000005180"},{"issue":"6","key":"4096_CR47","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1097\/ALN.0000000000000248","volume":"120","author":"CH Ing","year":"2014","unstructured":"Ing CH, DiMaggio CJ, Malacova E, Whitehouse AJ, Hegarty MK, Feng T, Brady JE, von Ungern-Sternberg BS, Davidson AJ, Wall MM, et al. Comparative analysis of outcome measures used in examining neurodevelopmental effects of early childhood anesthesia exposure. Anesthesiology. 2014;120(6):1319\u201332.","journal-title":"Anesthesiology"},{"issue":"12","key":"4096_CR48","doi-asserted-by":"publisher","first-page":"4540","DOI":"10.1007\/s10803-023-06169-2","volume":"54","author":"S He","year":"2024","unstructured":"He S, Zhou F, Tian G, Cui Y, Yan Y. Effect of Anesthesia During Pregnancy, Delivery, and Childhood on Autism Spectrum Disorder: A Systematic Review and Meta-analysis. J Autism Dev Disord. 2024;54(12):4540\u201354.","journal-title":"J Autism Dev Disord"},{"issue":"1","key":"4096_CR49","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1093\/pch\/pxad074","volume":"29","author":"M Skakum","year":"2024","unstructured":"Skakum M, Katako A, Mitchell-Dueck J, Ricci MF, Russell K. Risk of attention deficit hyperactivity disorder diagnosis following multiple exposures to general anesthesia in the paediatric population: A systematic review and meta-analysis. Paediatr Child Health. 2024;29(1):29\u201335.","journal-title":"Paediatr Child Health"},{"key":"4096_CR50","doi-asserted-by":"publisher","first-page":"717093","DOI":"10.3389\/fpsyt.2021.717093","volume":"12","author":"J Song","year":"2021","unstructured":"Song J, Li H, Wang Y, Niu C. Does Exposure to General Anesthesia Increase Risk of ADHD for Children Before Age of Three? Front Psychiatry. 2021;12:717093.","journal-title":"Front Psychiatry"},{"issue":"1","key":"4096_CR51","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1177\/10731911231194992","volume":"31","author":"JM Fletcher","year":"2024","unstructured":"Fletcher JM, Miciak J. Assessment of Specific Learning Disabilities and Intellectual Disabilities. Assessment. 2024;31(1):53\u201374.","journal-title":"Assessment"},{"issue":"7","key":"4096_CR52","first-page":"107","volume":"116","author":"S Haberstroh","year":"2019","unstructured":"Haberstroh S, Schulte-K\u00f6rne G. The Diagnosis and Treatment of Dyscalculia. Deutsches Arzteblatt Int. 2019;116(7):107\u201314.","journal-title":"Deutsches Arzteblatt Int"},{"issue":"41","key":"4096_CR53","first-page":"718","volume":"107","author":"G Schulte-K\u00f6rne","year":"2010","unstructured":"Schulte-K\u00f6rne G. The prevention, diagnosis, and treatment of dyslexia. Deutsches Arzteblatt Int. 2010;107(41):718\u201326. quiz 727.","journal-title":"Deutsches Arzteblatt Int"},{"issue":"10","key":"4096_CR54","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1093\/jpepsy\/jsad025","volume":"48","author":"JE Fardell","year":"2023","unstructured":"Fardell JE, Hu N, Wakefield CE, Marshall G, Bell J, Lingam R, Nassar N. Impact of Hospitalizations due to Chronic Health Conditions on Early Child Development. J Pediatr Psychol. 2023;48(10):799\u2013811.","journal-title":"J Pediatr Psychol"},{"issue":"3","key":"4096_CR55","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1136\/archdischild-2020-321285","volume":"107","author":"N Hu","year":"2022","unstructured":"Hu N, Fardell J, Wakefield CE, Marshall GM, Bell JC, Nassar N, Lingam R. School academic performance of children hospitalised with a chronic condition. Arch Dis Child. 2022;107(3):289\u201396.","journal-title":"Arch Dis Child"},{"issue":"6","key":"4096_CR56","first-page":"777","volume":"39","author":"V Laudenbach","year":"2020","unstructured":"Laudenbach V, Charollais A, Radi S, Stumpf MH, Vincent A, Kaltwasser I, Tomczyk T, Benichou J, Leroux P, Marret S. Conditions requiring hospitalisations, more than general anaesthesia itself, are associated with diagnosis of learning disorders in children. Anaesth Crit care pain Med. 2020;39(6):777\u201383.","journal-title":"Anaesth Crit care pain Med"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-026-04096-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-026-04096-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-026-04096-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:02:49Z","timestamp":1791334969000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12871-026-04096-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":56,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4096"],"URL":"https:\/\/doi.org\/10.1186\/s12871-026-04096-0","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"assertion":[{"value":"2 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"598"}}