REVIEW

Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn

R Gottstein, R W I Cooke

Neonatal Unit, Liverpool Women’s Hospital, Liverpool, UK

Correspondence to:
Correspondence to:
Dr Gottstein, Neonatal Unit, Liverpool Women’s Hospital, Crown Street, Liverpool L8 7SS, UK;
rgottstein{at}btinternet.com

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.

Keywords: intravenous immunoglobulin; rhesus haemolytic disease; ABO incompatibility; exchange transfusion

Abbreviations: IVIG, intravenous immunoglobulin; HDIVIG, high dose IVIG; HDN, haemolytic disease of the newborn; RR, relative risk; RD, risk difference; WMD, weighted mean difference; CI, confidence interval; NNT, number needed to treat

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Is Cochrane not in the archives?

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