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Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.

Publication ,  Journal Article
Natarajan, G; Shankaran, S; Nolen, TL; Sridhar, A; Kennedy, KA; Hintz, SR; Phelps, DL; DeMauro, SB; Carlo, WA; Gantz, MG; Das, A; Younge, NE ...
Published in: Pediatrics
August 2019

OBJECTIVE: 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. METHODS: This study was a retrospective analysis of prospectively collected data on preterm (22-26 + 6/7 weeks' gestational age) infants admitted to the Eunice Kennedy Shriver 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). RESULTS: The cohort (N = 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; P = .02) and longer durations of conventional ventilation (35 [21-58] vs 33 [18-49] days; P = .04) and supplemental oxygen (112 [94-120] vs 105 [84.5-120] days; P = .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]; P = .002), a cognitive score <85 (aOR 1.78 [95% CI 1.09 to 2.91]; P = .02), and a Gross Motor Functional Classification Scale level ≥2 (aOR 1.73 [95% CI 1.04 to 2.88]; P = .04) were significantly higher with bevacizumab therapy. CONCLUSIONS: 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.

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Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

August 2019

Volume

144

Issue

2

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Retinopathy of Prematurity
  • Prospective Studies
  • Pediatrics
  • Neurodevelopmental Disorders
  • Male
  • Infant, Premature
  • Infant, Newborn
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Natarajan, G., Shankaran, S., Nolen, T. L., Sridhar, A., Kennedy, K. A., Hintz, S. R., … Higgins, R. D. (2019). Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment. Pediatrics, 144(2). https://doi.org/10.1542/peds.2018-3537
Natarajan, Girija, Seetha Shankaran, Tracy L. Nolen, Amaanti Sridhar, Kathleen A. Kennedy, Susan R. Hintz, Dale L. Phelps, et al. “Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.Pediatrics 144, no. 2 (August 2019). https://doi.org/10.1542/peds.2018-3537.
Natarajan G, Shankaran S, Nolen TL, Sridhar A, Kennedy KA, Hintz SR, et al. Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment. Pediatrics. 2019 Aug;144(2).
Natarajan, Girija, et al. “Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.Pediatrics, vol. 144, no. 2, Aug. 2019. Pubmed, doi:10.1542/peds.2018-3537.
Natarajan G, Shankaran S, Nolen TL, Sridhar A, Kennedy KA, Hintz SR, Phelps DL, DeMauro SB, Carlo WA, Gantz MG, Das A, Greenberg RG, Younge NE, Bliss JM, Seabrook R, Sánchez PJ, Wyckoff MH, Bell EF, Vohr BR, Higgins RD. Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment. Pediatrics. 2019 Aug;144(2).

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

August 2019

Volume

144

Issue

2

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Retinopathy of Prematurity
  • Prospective Studies
  • Pediatrics
  • Neurodevelopmental Disorders
  • Male
  • Infant, Premature
  • Infant, Newborn
  • Humans
  • Female