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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment
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Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment

机译：早产儿的神经发育成果，治疗早产的视网膜病变

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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 = 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 = 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.
机译：目的：在极早产儿中，我们评估是否与手术治疗早产儿视网膜病变（ROP），贝伐单抗相比治疗与儿童早期不良后果。方法：本研究是前瞻性收集的数据对早产儿进行回顾性分析（22-26 + 6/7周孕龄）婴幼儿收治儿童健康和人类发展新生儿研究网络中心的尤尼斯·肯尼迪·施莱佛国立贝伐单抗或接收谁手术专门为ROP。主要终点是死亡或在18至26个月的矫正年龄严重的神经发育受损（NDI）（婴儿的贝利量表和幼儿发展，第三版认知或运动综合得分= 2，双目失明或听力障碍）。结果：组群（N = 405; 214 [53％]的男孩;中值[四分位数间距]孕龄：24.6 [23.9-25.3]周）包括谁收到181（45％）的婴儿贝伐单抗和224（55％）谁接受ROP手术。贝伐单抗治疗的婴儿具有较低的中位数（四分位数间距）出生体重（640 [541-709]对660 [572.5-750]克; P = 0.02）和常规通风的更长的持续时间（35 [21-58]对33 [18-49]天; P = 0.04）和补充氧气（112 [94-120]对105 [84.5-120]天; P = 0.01）。死亡或严重的NDI（调整比值比[aOR为1.42; 95％置信区间[CI] 0.94至2.14）和严重NDI（AOR 1.14; 95％CI 0.76至1.70）组间没有差异。死亡的赔率（AOR 2.54 [95％CI 1.42至4.55; P = 0.002），认知得分= 2（AOR 1.73 [95％CI 1.04至2.88; P = 0.04）与贝伐单抗疗法均显著高。结论：早产儿的多中心队列，ROP的治疗方法并没有用死亡或NDI差异有关，但贝伐单抗组有较高的死亡率和幼儿差认知结果。这些数据揭示了ROP治疗的严格考核的需要。

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