Intravenous Immunoglobulin in Neonates: Current Perspective

Abstract

IVIG is being used off-label in newborns for sepsis prophylaxis, treatment of neonatal alloimmune diseases such as HDN & NAIT.Though earlier studies supported IVIG prophylaxis in neonatal sepsis prevention, latest INIS Trial showed that IVIG is not recommended to prevent neonatal sepsis. Use in treatment of sepsis remains controversial. Cochrane systematic review suggested a beneficial effect on mortality. Significant reduction in mortality occurred with addition of IgM-enriched IVIG. Nowadays IVIG is being increasingly used in Hemolytic Disorders mainly blood group incompatibility. It has been found to reduce multiple exchange transfusions, length of hospital stay & duration of phototherapy. Possible side effects include fever, allergic reactions, hypoglycaemia, hypotension, haemolysis, fluid overload & anaphylaxis. Pending FDA approval, prompt & judicious administration of IVIG with close monitoring for any adverse events is mandatory.