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Role of Intravenous Immunoglobulin in Prevention of Late-Onset Infection in Low-Birth-Weight Neonates [with Discussion]

As a result of inadequate placental transport of maternal IgG, preterm neonates of

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Published in:	Reviews of infectious diseases 1990-05, Vol.12, p.S463-S469
Main Authors:	Baker, Carol J., Marcia A. Rench, Francisco J. D. Noya, Joseph A. Garcia-Prats, The Neonatal IVIG Study Group
Format:	Article
Language:	English
Subjects:	Agammaglobulinemia Birth weight Dosage Immunoglobulins Infants Infections Mortality Newborns Pregnancy Role of Intravenous Immunoglobulin Sepsis
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container_title	Reviews of infectious diseases
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creator	Baker, Carol J. Marcia A. Rench Francisco J. D. Noya Joseph A. Garcia-Prats The Neonatal IVIG Study Group
description	As a result of inadequate placental transport of maternal IgG, preterm neonates of
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Rench ; Francisco J. D. Noya ; Joseph A. Garcia-Prats ; The Neonatal IVIG Study Group</creator><creatorcontrib>Baker, Carol J. ; Marcia A. Rench ; Francisco J. D. Noya ; Joseph A. Garcia-Prats ; The Neonatal IVIG Study Group</creatorcontrib><description>As a result of inadequate placental transport of maternal IgG, preterm neonates of <32 weeks' gestation, especially those with birth weights <1,500 g, are profoundly hypogammaglobulinemic at birth, a condition that worsens during the first several weeks of life. This hypogammaglobulinemia is believed to contribute to their high frequency of late-onset sepsis, with its accompanying morbidity and mortality. Animal studies suggest that human immunoglobulin prepared for intravenous use (IVIG) improves host defense against pathogens that cause neonatal infections, but studies of IVIG in human neonates have been inconclusive because of the small numbers of infants included, lack of suitable controls, use of clinical rather than strict microbiologic definition of sepsis, and performance only in a single hospital outside the United States. A double-blind, randomized, placebo-controlled multicenter trial in the United States is in progress to determine the efficacy of IVIG in the prevention of late-onset infections in infants with birth weights between 500 and 1,750 g. Infants are infused with 500 mg of IVIG/kg or albumin-saline placebo at 3-7 days of age, 7 days later, and every 14 days for five doses. Efficacy parameters include mortality, number of proved infectious episodes (bacterial, fungal, or viral), and infection-related morbidity. 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Rench</creatorcontrib><creatorcontrib>Francisco J. D. Noya</creatorcontrib><creatorcontrib>Joseph A. Garcia-Prats</creatorcontrib><creatorcontrib>The Neonatal IVIG Study Group</creatorcontrib><title>Role of Intravenous Immunoglobulin in Prevention of Late-Onset Infection in Low-Birth-Weight Neonates [with Discussion]</title><title>Reviews of infectious diseases</title><description>As a result of inadequate placental transport of maternal IgG, preterm neonates of <32 weeks' gestation, especially those with birth weights <1,500 g, are profoundly hypogammaglobulinemic at birth, a condition that worsens during the first several weeks of life. This hypogammaglobulinemia is believed to contribute to their high frequency of late-onset sepsis, with its accompanying morbidity and mortality. Animal studies suggest that human immunoglobulin prepared for intravenous use (IVIG) improves host defense against pathogens that cause neonatal infections, but studies of IVIG in human neonates have been inconclusive because of the small numbers of infants included, lack of suitable controls, use of clinical rather than strict microbiologic definition of sepsis, and performance only in a single hospital outside the United States. A double-blind, randomized, placebo-controlled multicenter trial in the United States is in progress to determine the efficacy of IVIG in the prevention of late-onset infections in infants with birth weights between 500 and 1,750 g. Infants are infused with 500 mg of IVIG/kg or albumin-saline placebo at 3-7 days of age, 7 days later, and every 14 days for five doses. Efficacy parameters include mortality, number of proved infectious episodes (bacterial, fungal, or viral), and infection-related morbidity. 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Animal studies suggest that human immunoglobulin prepared for intravenous use (IVIG) improves host defense against pathogens that cause neonatal infections, but studies of IVIG in human neonates have been inconclusive because of the small numbers of infants included, lack of suitable controls, use of clinical rather than strict microbiologic definition of sepsis, and performance only in a single hospital outside the United States. A double-blind, randomized, placebo-controlled multicenter trial in the United States is in progress to determine the efficacy of IVIG in the prevention of late-onset infections in infants with birth weights between 500 and 1,750 g. Infants are infused with 500 mg of IVIG/kg or albumin-saline placebo at 3-7 days of age, 7 days later, and every 14 days for five doses. Efficacy parameters include mortality, number of proved infectious episodes (bacterial, fungal, or viral), and infection-related morbidity. 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subjects	Agammaglobulinemia Birth weight Dosage Immunoglobulins Infants Infections Mortality Newborns Pregnancy Role of Intravenous Immunoglobulin Sepsis
title	Role of Intravenous Immunoglobulin in Prevention of Late-Onset Infection in Low-Birth-Weight Neonates [with Discussion]
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