Efficacy of two dose regimes of intravenous immunoglobulin in Rh hemolytic disease of newborn--a randomized controlled trial.

Abstract

OBJECTIVE:

To compare the effect of two dose regimes of IVIg (0.5 g/kg vs. 1g/kg given soon after birth) on duration of phototherapy in Rh-isoimmunized neonates 32 week and above gestation.

DESIGN:

Randomized controlled trial.

SETTING:

Tertiary care hospital.

SUBJECTS:

Rh positive blood group neonates of gestation 32 weeks and above born to Rh negative mothers having positive Direct Coombs test and without any major malformation.

INTERVENTION:

Intravenous immunoglobulin (IVIg) infusion over 2 h either 0.5 g/kg (low dose group, n=19) or 1.0 g/kg (high dose group, n=19).

PRIMARY OUTCOME VARIABLE:

Duration of phototherapy.

RESULTS:

The mean duration of phototherapy was 77.3+/-57.2 h in low dose group versus 55.4+/-49 h in high dose group (mean difference=21.9; 95% CI-13.1 to 56.9). There was no difference in need for exchange transfusion (21% in both the groups) and requirement of packed red blood cells transfusion (12 transfusions in both groups). The duration of hospital stay was similar [8.4+/-6.9 and 13.6+/-14.8 days, respectively (mean difference=-5.1; 95% CI-12.8 to 2.5)]. No adverse effects of IVIg administration were noted.

CONCLUSION:

Two regimens of IVIg (0.5 g/Kg or 1 g/Kg) had comparable effect on duration of phototherapy, duration of hospital stay and exchange transfusion requirement, in Rh isoimmunized neonates of gestation 32 weeks and above.

• Authors: G Girish, D Chawla, R Agarwal, V K Paul, A K Deorari
• Journal: Indian pediatrics (Indian Pediatr) Vol. 45 Issue 8 Pg. 653-9 (Aug 2008) ISSN: 0019-6061 [Print] India
• PMID: 18723908 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Immunoglobulins, Intravenous
• Rh-Hr Blood-Group System

Topics

• Erythroblastosis, Fetal (drug therapy)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Infant, Newborn
• Rh-Hr Blood-Group System