Journal article
Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment
Pediatrics (Evanston), Vol.144(2), e20183537
08/2019
DOI: 10.1542/peds.2018-3537
PMCID: PMC6855825
PMID: 31337693
Abstract
Among extremely preterm infants, we evaluated whether bevacizumab therapy compared with surgery for retinopathy of prematurity (ROP) is associated with adverse outcomes in early childhood.
This study was a retrospective analysis of prospectively collected data on preterm (22-26 + 6/7 weeks' gestational age) infants admitted to the
National Institute of Child Health and Human Development Neonatal Research Network centers who received bevacizumab or surgery exclusively for ROP. The primary outcome was death or severe neurodevelopmental impairment (NDI) at 18 to 26 months' corrected age (Bayley Scales of Infant and Toddler Development, Third Edition cognitive or motor composite score <70, Gross Motor Functional Classification Scale level ≥2, bilateral blindness or hearing impairment).
The cohort (
= 405; 214 [53%] boys; median [interquartile range] gestational age: 24.6 [23.9-25.3] weeks) included 181 (45%) infants who received bevacizumab and 224 (55%) who underwent ROP surgery. Infants treated with bevacizumab had a lower median (interquartile range) birth weight (640 [541-709] vs 660 [572.5-750] g;
= .02) and longer durations of conventional ventilation (35 [21-58] vs 33 [18-49] days;
= .04) and supplemental oxygen (112 [94-120] vs 105 [84.5-120] days;
= .01). Death or severe NDI (adjusted odds ratio [aOR] 1.42; 95% confidence interval [CI] 0.94 to 2.14) and severe NDI (aOR 1.14; 95% CI 0.76 to 1.70) did not differ between groups. Odds of death (aOR 2.54 [95% CI 1.42 to 4.55];
= .002), a cognitive score <85 (aOR 1.78 [95% CI 1.09 to 2.91];
= .02), and a Gross Motor Functional Classification Scale level ≥2 (aOR 1.73 [95% CI 1.04 to 2.88];
= .04) were significantly higher with bevacizumab therapy.
In this multicenter cohort of preterm infants, ROP treatment modality was not associated with differences in death or NDI, but the bevacizumab group had higher mortality and poor cognitive outcomes in early childhood. These data reveal the need for a rigorous appraisal of ROP therapy.
Details
- Title: Subtitle
- Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment
- Creators
- Girija Natarajan - Wayne State UniversitySeetha Shankaran - Wayne State UniversityTracy L Nolen - RTI InternationalAmaanti Sridhar - RTI InternationalKathleen A Kennedy - The University of Texas Health Science CenterSusan R Hintz - Lucile Packard Children's HospitalDale L Phelps - University of Rochester Medical CenterSara B DeMauro - University of PennsylvaniaWaldemar A Carlo - University of Alabama at BirminghamMarie G Gantz - RTI InternationalAbhik Das - RTI InternationalRachel G Greenberg - Duke UniversityNoelle E Younge - Duke UniversityJoseph M Bliss - Women & Infants Hospital of Rhode IslandRuth Seabrook - Nationwide Children's HospitalPablo J Sánchez - Nationwide Children's HospitalMyra H Wyckoff - The University of Texas Southwestern Medical CenterEdward F Bell - University of IowaBetty R Vohr - Women & Infants Hospital of Rhode IslandRosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.144(2), e20183537
- DOI
- 10.1542/peds.2018-3537
- PMID
- 31337693
- PMCID
- PMC6855825
- NLM abbreviation
- Pediatrics
- ISSN
- 1098-4275
- eISSN
- 1098-4275
- Grant note
- UG1 HD068244 / NICHD NIH HHS UG1 HD027851 / NICHD NIH HHS UG1 HD053089 / NICHD NIH HHS UG1 HD040492 / NICHD NIH HHS UG1 HD027904 / NICHD NIH HHS UG1 HD068284 / NICHD NIH HHS M01 RR008084 / NCRR NIH HHS UG1 HD027880 / NICHD NIH HHS UG1 HD053109 / NICHD NIH HHS U10 HD021373 / NICHD NIH HHS U10 HD036790 / NICHD NIH HHS U10 HD040689 / NICHD NIH HHS K23 DK120960 / NIDDK NIH HHS UG1 HD068263 / NICHD NIH HHS UG1 HD021385 / NICHD NIH HHS U10 HD068278 / NICHD NIH HHS UG1 HD068270 / NICHD NIH HHS UG1 HD087229 / NICHD NIH HHS UL1 TR001111 / NCATS NIH HHS UG1 HD040689 / NICHD NIH HHS UL1 TR001117 / NCATS NIH HHS UG1 HD034216 / NICHD NIH HHS UG1 HD027856 / NICHD NIH HHS UG1 HD021364 / NICHD NIH HHS UG1 HD027853 / NICHD NIH HHS UG1 HD068278 / NICHD NIH HHS
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353946802771
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