Monika Kaushal1, Abdul Razak2, Waseemoddin Patel3, Abdul Kareem Pullattayil4, Ayush Kaushal1. 1. Department of Pediatrics, Emirates specialty hospital, Dubai Healthcare City, United Arab Emirates. 2. Division of Neonatology, Department of Pediatrics, Princess Nourah Bint Abdulrahman University, King Abdullah bin Abdulaziz University hospital, Riyadh, Kingdom of Saudi Arabia, Riyadh, Saudi Arabia. aabdulkhader@pnu.edu.sa. 3. Division of Neonatology, Department of Pediatrics, Princess Nourah Bint Abdulrahman University, King Abdullah bin Abdulaziz University hospital, Riyadh, Kingdom of Saudi Arabia, Riyadh, Saudi Arabia. 4. Clinical Library, Sidra Medicine, Doha, Qatar.
Abstract
OBJECTIVE: To systematically review the studies exploring the association between bevacizumab and neurodevelopmental outcomes. METHODS: Embase, Medline, CINAHL, and Cochrane Library databases were searched for studies examining neurodevelopmental outcomes of preterm infants treated with bevacizumab compared to laser ablation or cryotherapy for severe retinopathy of prematurity (ROP). RESULTS: Thirteen studies (clinical trial = 1; cohort studies = 12) were included. Random-effects model meta-analysis showed significant increased odds of cognitive impairment associated with bevacizumab treatment on both unadjusted (unadjusted odds ratio (OR) 1.61; 95% confidence interval (CI) 1.12, 2.30) and adjusted analyses (adjusted OR 1.90; 95% CI 1.22, 2.97). Infants treated with bevacizumab for severe ROP had significantly lower Bayley-III cognitive (mean difference (MD) -1.66; 95% CI -3.21, -0.12), and language composite scores (MD -5.50; 95% CI -8.24, -2.76) compared to infants treated with laser ablation or cryotherapy. CONCLUSION: Bevacizumab treatment for severe ROP is associated with increased risk of cognitive impairment and lower cognitive and language scores in preterm infants.
OBJECTIVE: To systematically review the studies exploring the association between bevacizumab and neurodevelopmental outcomes. METHODS: Embase, Medline, CINAHL, and Cochrane Library databases were searched for studies examining neurodevelopmental outcomes of preterm infants treated with bevacizumab compared to laser ablation or cryotherapy for severe retinopathy of prematurity (ROP). RESULTS: Thirteen studies (clinical trial = 1; cohort studies = 12) were included. Random-effects model meta-analysis showed significant increased odds of cognitive impairment associated with bevacizumab treatment on both unadjusted (unadjusted odds ratio (OR) 1.61; 95% confidence interval (CI) 1.12, 2.30) and adjusted analyses (adjusted OR 1.90; 95% CI 1.22, 2.97). Infants treated with bevacizumab for severe ROP had significantly lower Bayley-III cognitive (mean difference (MD) -1.66; 95% CI -3.21, -0.12), and language composite scores (MD -5.50; 95% CI -8.24, -2.76) compared to infants treated with laser ablation or cryotherapy. CONCLUSION: Bevacizumab treatment for severe ROP is associated with increased risk of cognitive impairment and lower cognitive and language scores in preterm infants.
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