Intravenous immunoglobulin to treat neonatal alloimmune haemolytic disease
- 22 August 2012
- journal article
- research article
- Published by Taylor & Francis Ltd in The Journal of Maternal-Fetal & Neonatal Medicine
- Vol. 25 (12), 2782-2785
- https://doi.org/10.3109/14767058.2012.718387
Abstract
Objective: To compare the efficacy of intravenous immunoglobulin (IVIg) and exchange transfusion (EXT) on rhesus haemolytic disease of the newborn (Rh-HDN) and evaluate treatment-related side effects. Methods: Retrospective chart review of two cohorts of newborns with Rh-HDN, treated with (Group 2) or without (Group 1) IVIg. Length of phototherapy, number of EXT, IVIg infusions, intrauterine and top-up red blood cells transfusions, need and permanence of umbilical venous catheter, and length of hospital stay, as well as treatment-related adverse events, were evaluated. Results: Charts of 88 newborns were reviewed (34 in Group 1, 54 in Group 2). Infants in Group 2 received a significantly lower number of EXT, had a lower risk of neurological impairment and needed an umbilical venous catheter for shorter, but required longer phototherapy, longer length of hospital stay, and more top-up transfusions. EXT was associated with a high number of adverse events. Two newborns treated with IVIg developed necrotizing enterocolitis (NEC). Conclusions: IVIg appear as an effective alternative to EXT, reducing the risk of neurological impairment and complications related to EXT. However, side effects of IVIg treatment (higher need of top-up transfusions and longer hospital stay) should be taken into account and the risk of NEC should be carefully monitored during treatment.Keywords
This publication has 15 references indexed in Scilit:
- Intravenous Immunoglobulin in Neonates With Rhesus Hemolytic Disease: A Randomized Controlled TrialPEDIATRICS, 2011
- Intravenous Immunoglobulin and Necrotizing Enterocolitis in Newborns With Hemolytic DiseasePEDIATRICS, 2010
- Necrotizing enterocolitis following the use of intravenous immunoglobulin for haemolytic disease of the newbornActa Paediatrica, 2009
- Intravenous immune globulin reduces the need for exchange transfusions in Rhesus and AB0 incompatibilityActa Paediatrica, 2008
- Intravenous Immunoglobulin in the Management of Hemolytic Disease of the NewbornNeonatal Network, 2005
- Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of GestationPediatrics, 2004
- Systematic review of intravenous immunoglobulin in haemolytic disease of the newbornArchives of Disease in Childhood: Fetal & Neonatal, 2003
- Rhesus disease: postnatal management and outcome.European Journal of Pediatrics, 1999
- Neonatal administration of high-dose intravenous immunoglobulin in rhesus hemolytic diseasejpme, 1995
- High-dose intravenous immune globulin therapy for hyperbilirubinemia caused by Rh hemolytic diseaseThe Journal of Pediatrics, 1992