Newborn premature babies have lwo levels of transplacentally acquired maternal immunoglobulin which is mostly transferred after 32∼34 weeks gestaton, therefore they may have IgG deficiencies that increase their susceptibility to bacterial
infection.
We performed this study to determine whether intravenous immunoglobulin (IVIG) therapy improves mortality or infection occurrance rate.
From 1 october 1991 to 31 July 1992, 73premature newborn infants with gestational age≤34weeks were enrolled: the theatment group, consisting of 43infants who received prophylactic intravenous immunoglobulin therapy (500mg/kg/week) and the
control
group, consisting of 30infants who did not receive. prophylactic intravenous administration of immunoglobulin to preterm infants with a gestational age≤34week, at a dose of 500mg/kg/week, results in maintenance of a satisfactory serum IgG level
throughout the high-risk period for infection. But the incidence rates of proven or very probable sepsis, mortality for sepsis and total mortality in the infants receiving intravenous immunoglobulin were not significant differences when compared
with
those in the control infants. No adverse effects were noted after immunoglobulin transfusions in our subjects.
In conclusion, our study does not show any decrease in bacterial infection rate or in mortality rate, and no study in the literature has shown absolute proof of the prophylactic efficacy of IVIG in premature newborns.
Larger studies are necessary to confirm these observations and to determine more effective dosing schedules and the optimal levels of orhanism-spectific antibodies. And specific hyperimmnue of monoclonal antibody preparations may be required to
provide
reliable sources of effective prophylactic to premature neonate with high risk in bacterial sepsis.
|