Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infants

Infants may acquire infections while in the womb or in the hospital after birth, especially if they require intensive care. Such infections may cause serious illness or death. Transport of immunoglobulins (substances in the blood that can fight infections) from the mother to the fetus mainly occurs after 32 weeks gestation and infants do not begin to produce immunoglobulins until several months after birth. Theoretically, the adverse effects of infections could be reduced by the preventive administration of intravenous immunoglobulin. To date, approximately 5,000 infants have been enrolled in studies to evaluate the effect of prophylactic use of intravenous immunoglobulins on neonatal outcomes. Intravenous administration of immunoglobulins results in a 3% reduction in blood born infections and a 4% reduction in any serious infection. Intravenous administration of immunoglobulins is not associated with reductions in other important neonatal outcomes or length of hospital stay. Most importantly, intravenous immunoglobulin administration does not have any important effect on mortality. Prophylactic use of IVIG is not associated with any short term serious side effects. From a clinical perspective, a 3 - 4% reduction in nosocomial infections without a reduction in mortality or other important clinical outcomes is of marginal importance.