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. 2003 Jan;88(1):F6-10.
doi: 10.1136/fn.88.1.f6.

Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn

R Gottstein  1 , R W I Cooke
Affiliations

Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn

R Gottstein et al. Arch Dis Child Fetal Neonatal Ed. 2003 Jan.

Abstract

Objectives: To assess the effectiveness of high dose intravenous immunoglobulin (HDIVIG) in reducing the need for exchange transfusion in neonates with proven haemolytic disease due to Rh and/or ABO incompatibility. To assess the effectiveness of HDIVIG in reducing the duration of phototherapy and hospital stay.

Design: Systematic review of randomised and quasi-randomised controlled trials comparing HDIVIG and phototherapy with phototherapy alone in neonates with Rh and/or ABO incompatibility.

Results: Significantly fewer infants required exchange transfusion in the HDIVIG group (relative risk (RR) 0.28 (95% confidence interval (CI) 0.17 to 0.47); number needed to treat 2.7 (95% CI 2.0 to 3.8)). Also hospital stay and duration of phototherapy were significantly reduced.

Conclusion: HDIVIG is an effective treatment.

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Figures

Figure 1
Figure 1
Number of infants requiring exchange transfusions when comparing high dose intravenous immunoglobulin (HDIVIG) with phototherapy alone.
Figure 2
Figure 2
Number of infants requiring exchange transfusion when comparing high dose intravenous immunoglobulin with phototherapy alone (Rh disease only).
Figure 3
Figure 3
Number of infants requiring multiple exchange transfusions when comparing high dose intravenous immunoglobulin with phototherapy alone.
Figure 4
Figure 4
Mean length of hospital stay when comparing high dose intravenous immunoglobulin with phototherapy alone. WMD, Weighted mean difference.
Figure 5
Figure 5
Mean duration of phototherapy when comparing high dose intravenous immunoglobulin with phototherapy alone. WMD, Weighted mean difference.
Figure 6
Figure 6
Number of infants requiring red cell transfusions for late anaemia when comparing high dose intravenous immunoglobulin with phototherapy alone.
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References

    1. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F173-5 - PubMed
    1. Arch Dis Child Fetal Neonatal Ed. 2002 Mar;86(2):F135-6 - PubMed
    1. Acta Paediatr. 1999 Feb;88(2):216-9 - PubMed
    1. Arch Dis Child Fetal Neonatal Ed. 1998 Jan;78(1):F62-6 - PubMed
    1. Br J Haematol. 1979 Jun;42(2):315-25 - PubMed

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