Does anesthetic type matter for C-sections? Neuraxial versus general anesthesia impact on children’s long-term development

Cesarean anesthesia choice may have long-term implications for neurological development in children. This nationwide retrospective cohort study 1 from South Korea examined 735 280 cesarean births (2010–2014) to evaluate whether neuraxial anesthesia (NA) or general anesthesia (GA) is associated with long-term neurodevelopmental disorders (LNDDs). After 1:1 propensity score matching, 273 266 births were analyzed. Children exposed to NA had a lower incidence of LNDDs (3.53 per 1000 person-years) compared with those exposed to GA (3.99 per 1000 person-years). NA was associated with a reduced risk of LNDDs (HR 0.87), including intellectual disabilities (HR 0.83) and psychological development disorders (HR 0.88). These associations were consistent across multiple analytic strategies, including full cohort multivariable models and discordant sibling analysis. While these findings are exploratory rather than causal, they suggest a modest protective association of NA and underscore the need for future research integrating detailed perinatal and anesthetic exposure data.