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Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn
  1. R Gottstein,
  2. R W I Cooke
  1. Neonatal Unit, Liverpool Women’s Hospital, Liverpool, UK
  1. Correspondence to:
    Dr Gottstein, Neonatal Unit, Liverpool Women’s Hospital, Crown Street, Liverpool L8 7SS, UK;
    rgottstein{at}btinternet.com

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.

  • intravenous immunoglobulin
  • rhesus haemolytic disease
  • ABO incompatibility
  • exchange transfusion
  • 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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