Intravenous immunoglobulin prophylaxis for infection in very low birth-weight infants
V Ratrisawadi1, T Srisuwanporn, Y Puapondh
1Neonatal Unit, Children Hospital, Bangkok, Thailand.
Insights
Intravenous immunoglobulin effectively prevents early-onset sepsis in very low birth weight infants. Both 250 mg/kg and 500 mg/kg doses showed similar infection and mortality reduction compared to no treatment.
Area of Science:
- Neonatal Medicine
- Immunology
- Pediatric Infectious Diseases
Background:
- Sepsis poses a significant threat to very low birth weight infants.
- Preventive strategies are crucial to reduce neonatal morbidity and mortality.
Purpose of the Study:
- To evaluate the efficacy of intravenous immunoglobulin (IVIG) in preventing early-onset sepsis in very low birth weight infants.
- To compare the effectiveness of two different IVIG dosages (250 mg/kg and 500 mg/kg) against a control group.
Main Methods:
- A randomized controlled trial involving 102 very low birth weight infants.
- Infants were allocated into three groups: two receiving different IVIG doses and one control group.
- Data on infection rates and mortality were collected during the early neonatal period.
Main Results:
- Both IVIG treatment groups (250 mg/kg and 500 mg/kg) exhibited significantly lower infection rates (14.7%) compared to the control group (38.2%).
- No significant difference in infection rates was observed between the two IVIG dosage groups.
- Mortality rates were lower in the IVIG-treated groups compared to the control group.
Conclusions:
- Intravenous immunoglobulin at dosages of 250 mg/kg and 500 mg/kg is effective in preventing early-onset sepsis in very low birth weight infants.
- The 250 mg/kg dosage is as effective as the 500 mg/kg dosage for sepsis prevention in this vulnerable population.
- IVIG administration is a viable strategy to reduce sepsis-related complications and mortality in neonates.
Abstract:
The effectiveness of intravenous immunoglobulin for prevention of sepsis in very low birth weight infants was studied on 102 neonates at the Children Hospital, Bangkok from February 1988 to February 1990. Infants were randomly allocated into 3 groups of 35 each. Group I and group II received 250 mg/kg and 500 mg/kg of immunoglobulin intravenously respectively within four hours of life. Group III was not given immunoglobulin and served as the control group. It was found that during the early neonatal period the infection rate of group I (14.7%) and group II (14.7%) was significantly lower than that of group III (38.2%). There was no difference in the infection rate of group I and group II. The mortality rate was also higher in group III than in group I and group II. It suggested that the intravenous immunoglobulin dosage of 250 mg per kilogram body weight is effective as well as dosage of 500 mg per kilogram body weight in prevention of sepsis in very low birth weight infants during the early neonatal period.
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