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Intravenous Immunoglobulin for Prophylaxis of Neoneatal Sepsis in the Premature Infants

Journal of the Korean Pediatric Society 1993;36(11):1534-1541.
Published online November 15, 1993.
Intravenous Immunoglobulin for Prophylaxis of Neoneatal Sepsis in the Premature Infants
K.H. Hur, S.H. Kim, H.S. Kim, M.J. Chey, K.H. Kim, H.S. Lee
Department of Pediatrics, Gil General Hospital, Incheon, Korea
미숙아 패혈증 예방을 위한 정맥용 면역글로불린(IVIG)의 이용 효과
허금희, 김성희, 김희섭, 최명재, 김길현, 이학수
중앙 길병원 소아과
Abstract
Newborn premature babies have low levels of transplacentally acquired maternal immunoglobulin which is mostly transferred after 32∼34weeks gestation, therefore they may have IgG deficiencies that incerase their susceptibillity to bacterial infection. We preformed this study to determine whether intravenous immunoglobulin (IVIG) therapy improves mortality or infection occurrence rate. From 1 october 1991 to 31 july 1992, 73premature newborn iffants with gestational age≤34weeks were enrolled : the treatment 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≤34weeks, 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 newborn. Larger studies are necessary to confirm these observations and to determine more effective dosing schedules and the optimal levels of orhanism-spectific antibodies. And srecific hyperimmnue or monoclonal antibody preparations may be required to provide reliable sources of effective prophylactic to premature neonate with high risk in bacteril sepsis.
Key Words: Neonate, Sepsis, Intravenous immunoglobulin, IgG (immunoglobulin G)


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