Maternal and fetal safety of intravenous immunoglobulin in women with reproductive failure

Abstract

Problem: Intravenous immunoglobulin G (IVIG) is an emerging regimen for women with reproductive failures (RF) during-or pre-pregnancy who have aberrant cellular immune reactions. Studies investigating teratogenicity of IVIG have been limited.Herein, we evaluated the fetal teratogenicity of IVIG and IVIG-related obstetric complications. Method of study:Women who used IVIG during pregnancy due to RF with cellular immune aberrances were enrolled from four medical centers in Korea. The pregnancy outcomes were collected.Results: A total of 370 RF women who used IVIG during their pregnancy were enrolled.Most of the patients started the IVIG therapy before 12 weeks of gestation and 229 women continued IVIG treatment beyond 12 weeks of gestation. The mean age of the subjects was 34.8 years and the mean total dosage of IVIG was 125.3 g. A total of 307 women had livebirths and six of them were twins. Of 301 singleton livebirths, obstetric complications were developed as follows: preterm births (12.0%), gestational diabetes (7.0%), preeclampsia (4.0%), placental abruption (1.3%), placenta previa (4.3%), and placenta accrete (1.7%). Total six cases (1.99%) had major fetal anomalies in livebirths. The incidence of birth defects is similar to those of the general population in Korea and the previous report in infertile women. No IVIG -related viral contamination was noted. Conclusion:IVIG use during pregnancy did not increase obstetric complications and fetal teratogenicity. This study can be an evidence of maternal and fetal safety of IVIG administration during pregnancy.

Efficacy of intravenous immunoglobulin (IVIg) on COVID-19-related neurological disorders over the last 2 years: an up-to-date narrative review

“…Even in the case of multidrug resistance, like the NORSE cases, a significant response was obtained, indicating its superiority over symptomatic disease-specific drugs and suggesting the complex pathways of COVID-19-induced encephalitis. In most treated cases, IVIg therapy did not present adverse reactions and has been proven safe during pregnancy (Han et al, 2021 ). Considering the possibility of side effects consequent to the administration of high-dose corticosteroids (Yasir et al, 2022 ), IVIg represents a valid and safe alternative to other common therapies.…”

Case Series of Successful Intravenous Immunoglobulin (IVIG) Treatment in 4 Pregnant Patients with Severe COVID-19-Induced Hypoxia

“…IVIG is not approved in the United States by the Food and Drug Administration (FDA) for the treatment of patients with severe COVID-19 hypoxia, nor is it recommended by the Centers of Disease Control (CDC) in the United States [ 8 ]. However, IVIG has been deemed safe in pregnancy as used for years to treat a variety of autoimmune conditions [ 9 ]. Here, we report our successful treatment of 4 severely- and critically ill COVID-19 pregnant patients with IVIG.…”