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贝伐单抗治疗早产儿视网膜病变:2年神经发育随访

Bevacizumab for Retinopathy of Prematurity: 2-Year Neurodevelopmental Follow-up.

作者信息

Zayek Michael, Parker Kaitlyn, Rydzewska Monika, Rifai Aref, Bhat Ramachandra, Eyal Fabien

机构信息

Division of Neonatology, Department of Pediatrics, University of South Alabama, Mobile, Alabama.

Department of Pediatrics, Neonatal Medicine, Crozer-Keystone Health System, Upland, Pennsylvania.

出版信息

Am J Perinatol. 2021 Sep;38(11):1158-1166. doi: 10.1055/s-0040-1710556. Epub 2020 May 23.

Abstract

OBJECTIVE

This study aimed to determine whether infants who were treated with intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP) were at higher risk of death or neurodevelopmental impairment (NDI) when compared with infants who were not treated with IVB (Laser only).

STUDY DESIGN

This retrospective study included 146 infants born from 2009 through 2016 with a birth weight (BW) <1,000 g, gestational age <27 weeks, and required ROP therapy. Death and NDI rates were assessed at 18 to 24 months' corrected age.

RESULTS

Rates of death or severe NDI were 62 and 53% in the IVB ( = 61) and Laser only ( = 85) groups, respectively. This difference was not statistically different despite sample selection bias in treating growth-restricted infants with IVB, BW (median [IQR]) was 481 (420-583) versus 547 (473-640) g in IVB and Laser only groups, respectively,  = 0.003. The adjusted odds ratio and 95% confidence interval of death or severe NDI was 0.86 (0.33-2.20).

CONCLUSION

Bevacizumab therapy for ROP did not affect survival and neurodevelopment of extremely preterm infants.

KEY POINTS

· Intravitreal bevacizumab therapy for retinopathy of prematurity may be safe in periviable preterm infants.. · Intravitreal bevacizumab therapy does not increase mortality rate in periviable preterm infants.. · Intravitreal bevacizumab therapy does not increase adverse neurodevelopmental outcome in periviable infants..

摘要

目的

本研究旨在确定与未接受玻璃体内注射贝伐单抗(IVB)治疗(仅接受激光治疗)的婴儿相比,接受IVB治疗早产儿视网膜病变(ROP)的婴儿死亡或神经发育障碍(NDI)风险是否更高。

研究设计

这项回顾性研究纳入了146例2009年至2016年出生、出生体重(BW)<1000g、胎龄<27周且需要ROP治疗的婴儿。在矫正年龄18至24个月时评估死亡和NDI发生率。

结果

IVB组(n = 61)和仅接受激光治疗组(n = 85)的死亡或严重NDI发生率分别为62%和53%。尽管在治疗生长受限婴儿时存在样本选择偏倚,但这一差异无统计学意义,IVB组和仅接受激光治疗组的BW(中位数[四分位间距])分别为481(420 - 583)g和547(473 - 640)g,P = 0.003。死亡或严重NDI的调整优势比和95%置信区间为0.86(0.33 - 2.20)。

结论

贝伐单抗治疗ROP不影响极早产儿的生存和神经发育。

关键点

· 玻璃体内注射贝伐单抗治疗早产儿视网膜病变对接近可存活孕周的早产儿可能是安全的。· 玻璃体内注射贝伐单抗治疗不会增加接近可存活孕周早产儿的死亡率。· 玻璃体内注射贝伐单抗治疗不会增加接近可存活孕周婴儿不良神经发育结局的发生率。

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