IVIG therapy in iso-immune hemolytic jaundice in full-term neonates

Previous studies have demonstrated the efficacy of intravenous immunoglobulin therapy (IVIG) in decreasing the severity of neonatal immune hemolytic jaundice, the need for exchange transfusion, duration of phototherapy and hospital stay.

A randomized clinical trial was conducted in Taleghani Hospital in Tehran, between April 2003 and May 2004. Eighty full term infants with ABO or RH incompatibility and hyperbilirubinemia within the first 24 hours of life, were randomly assigned in two equal groups of experiment and control. A single dose of IV immunoglobulin 1g/kg was administered to 40 neonates over 4-6 hours during the first 24 hours of life along with phototherapy. 40 neonates in the control group received phototherapy alone. All patients were closely evaluated with respect to their general status, severity of jaundice, need for transfusion, and IVIG complications. T test and chi-square were used for data analysis.

The IVIG–treated neonates had a smaller rise in their bilirubin levels, required significantly less phototherapy (91 hours vs. 141 hours, p=0.0001), a shorter duration of hospitalization, (p=0.0001), and fewer exchange transfusions, (p<0.05), than those in the control group. We found no IVIG-related side effects.

IVIG administration in newborns with ABO or RH hemolytic jaundice reduces the need for exchange transfusion, duration of phototherapy and hospital stay. However, further studies are required to determine the optimal dose and the frequency of infusions.