Long-term follow-up of children with infantile hemangioma: Multidisciplinary reflections

Beta-blockers have been used worldwide to treat IH since 2008, but research into the long-term effects has been limited. This thesis presents the results from the largest long-term follow-up to date, including school-aged children who had been treated with either propranolol or atenolol for IH during infancy. No long-term differences were found between the beta-blocker groups in the following four domains: neurocognitive functioning, physical health, mental health, and esthetic outcome. Although the children were generally healthy, some specific and worrying effects were observed. Males treated with beta-blockers had substantially lower CPI scores (difference >10 IQ points) than females treated with beta-blockers or males from the population norm group. Children treated with beta-blockers showed elevated blood pressure and more problems in the area of affect recognition, parent-reported attention functioning, and parent-reported social quality of life. Furthermore, parents of treated children reported more parent-child relationship problems, increased depressive mood, and more physical health problems. These effects emphasize that prescribers and parents of patients should cautiously weigh the risk and benefits before starting treatment of IH with beta-blockers.