Oral Clefts and Academic Performance in Adolescence: The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts

Objective:  Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to investigate whether outcome depends on timing and number of operations during childhood and/or type of oral cleft. Design:  Nationwide register-based follow-up study. Setting:  Danish birth cohort 1986 to 1990. Participants:  Five hundred fifty-eight children with isolated CL (n = 171), CLP (n = 222), or CP (n = 195), of which 509 children had been exposed to anesthesia and one or more cleft operation(s), and a 5% sample of the birth cohort (n = 14,677). Main Outcome Measure(s):  Test score in the Danish standardized ninth-grade exam and proportion of nonattainment, defined as “results for ninth-grade exam unavailable.” Data adjusted for sex, birth weight, parental age, and parental level of education. Results:  Co...