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Prevention of necrotizing enterocolitis in neonates at risk by oral administration of monomeric IgG
F F Rubaltelli1, F Benini, M Sala
1Department of Pediatrics, University of Padova, Italy.
Insights
Oral immunoglobulin (IgG) may prevent necrotizing enterocolitis (NEC) in preterm infants. This study found no NEC cases in formula-fed, low-birth-weight infants receiving oral IgG during their first two weeks.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Immunology
Background:
- Necrotizing enterocolitis (NEC) is a significant cause of illness in premature, low-birth-weight (LBW) infants.
- Maternal breast milk is often unavailable for these vulnerable newborns.
Purpose of the Study:
- To evaluate the effectiveness of oral immunoglobulin (IgG) in preventing NEC in formula-fed LBW infants.
- To assess the impact of monomeric IgG supplementation on NEC incidence.
Main Methods:
- A randomized clinical trial involving 132 formula-fed newborns (birth weight ≤1,500 g or gestational age ≤34 weeks).
- The intervention group (65 neonates) received 500 mg of oral IgG daily for the first two weeks of life.
- A control group received no oral IgG supplementation.
Main Results:
- None of the infants in the oral IgG group developed NEC within the first 15 days.
- Four cases of NEC were confirmed in the untreated control group during the same period.
- The study suggests a potential protective effect of oral IgG against NEC.
Conclusions:
- Oral monomeric IgG administration shows promising results in preventing NEC in LBW infants.
- Further research with larger sample sizes is warranted to confirm these findings.
Abstract:
Necrotizing enterocolitis (NEC) represents one of the major causes of morbidity in low-birth-weight (LBW) preterm infants. This randomized clinical trial evaluated the efficacy of an oral immunoglobulin preparation (containing monomeric IgG in a concentration of 90%) in reducing the incidence of NEC in infants of LBW for whom maternal breast milk was not available. One hundred and thirty-two formula-fed newborns with a birth weight less than or equal to 1,500 g or a gestational age less than or equal to 34 weeks were randomly studied. Five hundred mg of IgG pro die, subdivided into 5 doses, were given orally to the test group of 65 neonates during the first 2 weeks of life. Although the number of infants included in this group is limited, the results of this study are encouraging: during the first 15 days after birth, none of the subjects developed NEC, while 4 cases were confirmed in the untreated control group. It, therefore, seems possible that oral monomeric IgG administration may prevent the development of NEC in LBW infants.