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Neurodevelopmental outcomes following bevacizumab treatment for retinopathy of prematurity: a systematic review and meta-analysis

Journal of Perinatology volume 41, pages 1225–1235 (2021)Cite this article

Subjects

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.

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Fig. 1: Flow diagram.
Fig. 2: Forest plot.
Fig. 3: Forest plot.

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Funding

This research was funded by the Deanship of Scientific Research at Princess Nourah Bint Abdulrahman University through the Fast track Research Funding Program. The funder had no role in conceiving the study design, collection, analysis and interpretation of the data, and decision to publish the study.

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Author notes

  1. These authors contributed equally and share first authorship: Monika Kaushal, Waseemoddin Patel, Abdul Razak

Authors and Affiliations

  1. Department of Pediatrics, Emirates specialty hospital, Dubai Healthcare City, United Arab Emirates

    Monika Kaushal & Ayush Kaushal

  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

    Abdul Razak & Waseemoddin Patel

  3. Clinical Library, Sidra Medicine, Doha, Qatar

    Abdul Kareem Pullattayil

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  1. Monika Kaushal
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Contributions

MK and WP had full access to the data and take responsibility for the data integrity including accuracy of the data analysis. Concept/design: AR, MK, WP, AK, AKP. Acquisition, analysis, and interpretation of data: AR, MK, WP, AK, and AKP. Initial drafting of the manuscript: AR and MK. Critical revision for important intellectual content: AR. Statistical analysis: AR, MK, and WP. Administrative, technical, or material support: AR. Study supervision: AR.

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Correspondence to Abdul Razak.

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Kaushal, M., Razak, A., Patel, W. et al. Neurodevelopmental outcomes following bevacizumab treatment for retinopathy of prematurity: a systematic review and meta-analysis. J Perinatol 41, 1225–1235 (2021). https://doi.org/10.1038/s41372-020-00884-9

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  • DOI: https://doi.org/10.1038/s41372-020-00884-9

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