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

Background: Infants with infantile hemangioma (IH) have been effectively treated with propranolol or atenolol. Concerns were raised about the mental health of these 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-center 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 (NEPSY-II-NL), and parent-reported emotional and behavioral functioning (CBCL), and health-related quality of life (KIDSCREEN-27). Parents’ outcome was parenting stress (OBVL).

Results: Data of 105 children (36 propranolol, 69 atenolol; 6.0 to 11.8 years) were analyzed. Mental health outcomes did not differ between both beta-blocker groups. Although overall functioning was in line with norms, children presented specific problems concerning affect recognition, and 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 towards 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 beta-blocker treatment.

背景：婴儿血管瘤（infantile hemangioma，IH）患儿可通过普萘洛尔或阿替洛尔获得有效治疗。鉴于普萘洛尔存在中枢神经系统影响，且婴儿血管瘤具有外观可见性，学界对该类患儿学龄期的心理健康状况提出了担忧。
目的：本研究旨在对比因婴儿血管瘤接受普萘洛尔或阿替洛尔治疗的患儿及其家长在学龄期的心理健康状况。
方法：本研究为双中心横断面研究，纳入年龄≥6岁、婴儿期因婴儿血管瘤接受普萘洛尔或阿替洛尔治疗的儿童。儿童的评估指标包括基于表现的情绪识别能力（NEPSY-II-NL）、家长报告的情绪与行为功能量表（CBCL）以及健康相关生活质量量表（KIDSCREEN-27）；家长的评估指标为育儿压力量表（OBVL）。
结果：本研究共纳入105名儿童（普萘洛尔组36例，阿替洛尔组69例；年龄6.0~11.8岁）并对其数据进行分析。两类β受体阻滞剂治疗组的心理健康结局无显著差异。尽管整体功能与常模相符，但患儿在情绪识别能力方面存在特定问题，家长报告显示患儿存在注意力及社会生活质量相关问题。家长则表现出躯体症状、抑郁症状及亲子关系问题的发生率升高。
结论：因婴儿血管瘤接受普萘洛尔或阿替洛尔治疗的患儿，其学龄期心理健康状况无显著差异。尽管整体心理健康问题检出率较低，但仍存在部分特定问题需要后续随访。对患儿的随访应重点关注其情绪识别能力、注意力及日常社会功能。可通过在患儿接受β受体阻滞剂治疗期间及治疗后提供心理健康支持，改善家长所报告的相关问题。