Intravenous immunoglobulin in isoimmune haemolytic disease of newborn: an updated systematic review and meta-analysis

Louis, Deepak; More, Kiran; Oberoi, Sapna; Shah, Prakesh S.

doi:10.1136/archdischild-2013-304878

Cited by 52 publications

(40 citation statements)

References 31 publications

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“…In a meta-analysis by Yang et al, immunoglobulins showed an increased risk for NEC (OR 4.53; 95% CI, 2.34-8.79; p < 0.001), but not for final mortality [39]. A recent systematic review advocates further well-designed studies before conclusive advice can be given about the treatment of HDFN with intravenous immunoglobulins [40].…”

Section: Intravenous Immunoglobulinmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

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Introduction: Hemolytic disease of the fetus and newborn (HDFN) occurs when fetal and neonatal erythroid cells are destroyed by maternal erythrocyte alloantibodies, it leads to anemia and hydrops in the fetus, and hyperbilirubinemia and kernicterus in the newborn. Postnatal care consists of intensive phototherapy and exchange transfusions to treat severe hyperbilirubinemia and top-up transfusions to treat early and late anemia. Other postnatal complications have been reported such as thrombocytopenia, iron overload and cholestasis requiring specific management. Areas covered: This review focusses on the current neonatal management and outcome of hemolytic disease and discusses postnatal treatment options as well as literature on long-term neurodevelopmental outcome. Expert commentary: Despite major advances in neonatal management, multiple issues have to be addressed to optimize postnatal management and completely eradicate kernicterus. Except for strict adherence to guidelines, improvement could be achieved by clarifying the epidemiology and pathophysiology of HDFN. Several pharmacotherapeutic agents should be further researched as alternative treatment options in hyperbilirubinemia, including immunoglobulins, albumin, phenobarbital, metalloporphyrins, zinc, clofibrate and prebiotics. Larger trials are warranted to evaluate EPO, folate and vitamin E in neonates. Long-term follow-up studies are needed in HDFN, especially on thrombocytopenia, iron overload and cholestasis.ARTICLE HISTORY

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Section: Intravenous Immunoglobulinmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

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“…The importance of Rh disease varies widely with the prevalence of Rh-negative maternal status, but the issue of affordable prophylaxis is clearly a priority for many LMICs. The lack of routine maternal and neonatal blood testing in many LMICs is also a barrier, and also impacts the management of ABO incompatibility as a risk factor for serious NNJ [7,32,53,56,57,58,59]. …”

Section: The Present and The Future In Preventing Serious Nnjmentioning

confidence: 99%

Neonatal Jaundice in Low- and Middle-Income Countries: Lessons and Future Directions from the 2015 Don Ostrow Trieste Yellow Retreat

Greco¹,

et al. 2016

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Severe neonatal hyperbilirubinemia, defined as total serum bilirubin (TSB) ≥20 mg/dl, is associated with a higher risk of permanent neurological sequelae and death. Jaundice can and should be promptly diagnosed and treated. Reliable methods for TSB assay are not always readily available, particularly in low- and middle-income countries, making the true incidence of severe neonatal jaundice (NNJ) difficult to estimate. To gather a more comprehensive picture, a symposium addressing NNJ worldwide was organized during the 2015 Don Ostrow Trieste Yellow Retreat. Data collected by several researchers in different regions of the world were presented and differences/similarities discussed. This report points out the need for: (1) a coordinated worldwide effort to define the burden and the causes of severe NNJ and its consequences; (2) aggressive educational programs for families and health personnel to facilitate timely care-seeking, and (3) accurate diagnostics and effective phototherapy.

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“…To be effective, a phototherapy device should produce specific blue-light wavelengths (peak emission: 450 ± 20 nm), preferably in a narrow bandwidth to about 80% of an infant's body surface area, and have intensive irradiance of at least 30 μW/cm 2 /nm (from either a single or multiple phototherapy units) (32). Intravenous immunoglobulins have been proposed as a useful therapy in reducing the need for ET/RET, but existing evidence remains inconclusive (33).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Repeat Exchange Transfusion for Severe Neonatal Hyperbilirubinemia*

Mabogunje

Emokpae²,

Olusanya³

2016

Pediatric Critical Care Medicine

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Intravenous immunoglobulin in isoimmune haemolytic disease of newborn: an updated systematic review and meta-analysis

Abstract: Efficacy of IVIg is not conclusive in Rh haemolytic disease of newborn with studies with low risk of bias indicating no benefit and studies with high risk of bias suggesting benefit. Role of IVIg in ABO disease is not clear as studies that showed a benefit had high risk of bias.

Cited by 52 publications

References 31 publications

Neonatal management and outcome in alloimmune hemolytic disease

Neonatal management and outcome in alloimmune hemolytic disease

Neonatal Jaundice in Low- and Middle-Income Countries: Lessons and Future Directions from the 2015 Don Ostrow Trieste Yellow Retreat

Predictors of Repeat Exchange Transfusion for Severe Neonatal Hyperbilirubinemia*

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