Literature DB >> 21272067

Is phototherapy exposure associated with better or worse outcomes in 501- to 1000-g-birth-weight infants?

Susan R Hintz1, David K Stevenson, Qing Yao, Ronald J Wong, Abhik Das, Krisa P Van Meurs, Brenda H Morris, Jon E Tyson, William Oh, W Kenneth Poole, Dale L Phelps, Georgia E McDavid, Cathy Grisby, Rosemary D Higgins.   

Abstract

AIM: To compare risk-adjusted outcomes at 18- to 22-month-corrected age for extremely low birth weight (ELBW) infants who never received phototherapy (NoPTx) to those who received any phototherapy (PTx) in the NICHD Neonatal Research Network randomized trial of Aggressive vs. Conservative Phototherapy.
METHODS: Outcomes at 18 to 22-month-corrected age included death, neurodevelopmental impairment (NDI) and Bayley Scales Mental Developmental Index (MDI). Regression models evaluated the independent association of PTx with adverse outcomes controlling for centre and other potentially confounding variables.
RESULTS: Of 1972 infants, 216 were NoPTx and 1756 were PTx. For the entire 501- to 1000-g-BW cohort, PTx was not independently associated with death or NDI (OR 0.85, 95% CI: 0.60-1.20), death or adverse neurodevelopmental endpoints. However, among infants 501-750 g BW, the rate of significant developmental impairment with MDI < 50 was significantly higher for NoPTx (29%) than PTx (12%) (p = 0.004).
CONCLUSIONS: Phototherapy did not appear to be independently associated with death or NDI for the overall ELBW group. Whether PTx increases mortality could not be excluded because of bias from deaths before reaching conservative treatment threshold. The higher rate of MDI < 50 in the 501- to 750-g-BW NoPTx group is concerning and consistent with NRN Trial results.
© 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

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Year:  2011        PMID: 21272067      PMCID: PMC3505994          DOI: 10.1111/j.1651-2227.2011.02175.x

Source DB:  PubMed          Journal:  Acta Paediatr        ISSN: 0803-5253            Impact factor:   2.299


  23 in total

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