Title | Is phototherapy exposure associated with better or worse outcomes in 501- to 1000-g-birth-weight infants? |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Hintz SR, Stevenson DK, Yao Q, Wong RJ, Das A, Van Meurs KP, Morris BH, Tyson JE, Oh W, W Poole K, Phelps DL, McDavid GE, Grisby C, Higgins RD |
Corporate Authors | Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network |
Journal | Acta Paediatr |
Volume | 100 |
Issue | 7 |
Pagination | 960-5 |
Date Published | 2011 Jul |
ISSN | 1651-2227 |
Keywords | Developmental Disabilities, Humans, Infant, Infant, Extremely Low Birth Weight, Infant, Newborn, Mental Disorders, Phototherapy, Psychomotor Performance, Risk Adjustment, Treatment Outcome |
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. |
DOI | 10.1111/j.1651-2227.2011.02175.x |
Alternate Journal | Acta Paediatr |
PubMed ID | 21272067 |
PubMed Central ID | PMC3505994 |
Grant List | U10 HD027856 / HD / NICHD NIH HHS / United States U10 HD021373 / HD / NICHD NIH HHS / United States UL1 RR024139 / RR / NCRR NIH HHS / United States U10 HD021385 / HD / NICHD NIH HHS / United States U10 HD021364 / HD / NICHD NIH HHS / United States U10 HD027880 / HD / NICHD NIH HHS / United States U10 HD040521 / HD / NICHD NIH HHS / United States M01 RR008084 / RR / NCRR NIH HHS / United States U10 HD040461 / HD / NICHD NIH HHS / United States M01 RR016587 / RR / NCRR NIH HHS / United States U10 HD040689 / HD / NICHD NIH HHS / United States U10 HD040492 / HD / NICHD NIH HHS / United States U10 HD027853 / HD / NICHD NIH HHS / United States U10 HD027904 / HD / NICHD NIH HHS / United States U10 HD021397 / HD / NICHD NIH HHS / United States KL2 RR024149 / RR / NCRR NIH HHS / United States U10 HD027871 / HD / NICHD NIH HHS / United States UL1 RR024160 / RR / NCRR NIH HHS / United States UL1 RR024148 / RR / NCRR NIH HHS / United States M01 RR007122 / RR / NCRR NIH HHS / United States U10 HD027851 / HD / NICHD NIH HHS / United States U10 HD034216 / HD / NICHD NIH HHS / United States U10 HD036790 / HD / NICHD NIH HHS / United States U10 HD040498 / HD / NICHD NIH HHS / United States M01 RR006022 / RR / NCRR NIH HHS / United States |