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.