Mental health of school-aged children treated with propranolol or atenolol for infantile hemangioma and their parents

Mireille M Hermans, Renske Schappin, Peter C J de Laat, Elodie J Mendels, Johannes M P J Breur, Hester R Langeveld, Martine F Raphael, Marlies de Graaf, Corstiaan C Breugem, Saskia N de Wildt, Jolanda M E Okkerse, Suzanne G M A Pasmans*, André B Rietman

*Corresponding author for this work

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Abstract

Background: Infants with infantile hemangioma (IH) have been effectively treated with propranolol or atenolol. Concerns were raised about the mental health of these The trial registration: Netherlands Trial Register Trial NL7703.children at school age, due to central nervous system effects of propranolol and visible nature of IH. Objective: This study aimed to compare the mental health at school age of children treated with propranolol to children treated with atenolol for IHs and their parents. Methods: This two-centered cross sectional study included children aged =6 years and treated with either propranolol or atenolol for IH during infancy. Children’s outcomes were performance-based affect recognition (Dutch version of the Developmental Neuropsychological Assessment-II [NEPSY-II-NL]), parent-reported emotional and behavioral functioning (Child Behavioral Checklist [CBCL]), and health-related quality of life (KIDSCREEN27). Parents’ outcome was parenting stress (Parenting Stress Questionnaire [OBVL]). Results: Data of 105 children (36 propranolol, 69 atenolol; 6.0–11.8 years) were analyzed. Mental health outcomes did not differ between both ß-blocker groups. Although overall functioning was in line with norms, children presented specific problems concerning affect recognition, parent-reported attention, and social quality of life. Parents showed increased physical symptoms, depressive symptoms, and parent-child relationship problems. Conclusion: No difference in mental health at school age was found between children treated with propranolol or atenolol for IH. Although few overall mental health problems were found, specific problems require follow-up. Follow-up of children should be directed toward affect recognition, attention, and social functioning in daily life. Problems reported by parents could be ameliorated by mental health support during and after their infant’s ß-blocker treatment.

Original languageEnglish
Pages (from-to)216-225
Number of pages10
JournalDermatology
Volume240
Issue number2
Early online date16 Jan 2024
DOIs
Publication statusPublished - Apr 2024

Keywords

  • Adrenergic beta-antagonists
  • Long-term adverse effects
  • Parenting
  • Psychosocial functioning
  • Vascular tissue neoplasms

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