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

Ohlsson A, Lacy JB
Published Online: 
2 July 2013

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 immunoglobulin (substance in the blood that can fight infection) from the mother to the fetus mainly occurs after 32 weeks' gestation, and infants do not begin to produce immunoglobulin until several months after birth. Theoretically, the adverse effects of infection could be reduced by the preventive administration of intravenous immunoglobulin. To date, approximately 5000 infants have been enrolled in studies conducted to evaluate the effects of prophylactic use of intravenous immunoglobulin on neonatal outcomes. Intravenous administration of immunoglobulin results in a 3% reduction in blood-borne infection and a 4% reduction in serious infection. Intravenous administration of immunoglobulin is not associated with reductions in other important neonatal outcomes or in length of hospital stay. Most important, 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% to 4% reduction in nosocomial infection without a reduction in mortality or other important clinical outcomes is of marginal importance.