Propranolol treatment of infantile hemangioma (IH) is not associated with developmental risk or growth impairment at age 4 years

Background: Long-term adverse effects of propranolol treatment for infantile hemangioma (IH) in young children have been suggested.

Objective: To compare growth and development in children treated with propranolol for IH with nontreated healthy controls.

Methods: Eighty two (73%) children with IH aged 43 to 51 months treated with propranolol for 6 months or longer, and without other developmental risk factors, were recruited (cases) and matched with 4 twin counterparts and 78 children from a community-based cohort (control subjects). Parents completed the 48-months Ages and Stages Questionnaire (ASQ). Percentages of children with abnormal ASQ results were compared using chi(2) analyses. Mean ASQ scores and growth were compared using Mann-Whitney U tests.

Results: Six (7.3%) cases had abnormal ASQ results, compared with 10 (12.2%) controls (P = .292). Mean ASQ total score (25th-75th percentile) was 52.9 (50.8-57.0) for cases and 51.9 (49.0-56.0) for controls (P = .383). Height and weight of cases and controls were comparable.

Limitations: A parent-completed screening instrument was used. The exclusion of children born at gestational age less than 36 weeks and/or children born small for gestational age partly limits generalizability.

Conclusion: We found no increased developmental risk or growth impairment at age 4 years in patients with IH treated with propranolol.