Prenatal and postnatal prophylaxis of infections in preterm neonates

Abstract

Administration of gamma-globulin for intravenous administration (IVIG) to preterm neonates (0.3 g/day in neonates below 1000 g; 0.5 g/day in neonates over 1000 g for 6 consecutive days) led to a significant rise in circulating serum IgG levels. After 6 days of IVIG administration, the IgG serum levels reached an average of 11 to 12 g/liter, values usually seen in normal term infants. The mortality rate of the preterm infants with septicemia decreased from 44% in the infants receiving only antibiotics to 8% in the infants treated by IVIG together with the same antibiotic. The IVIG preparation was well-tolerated by all newborns. Blood gas analysis, clinical examination, monitoring of respiration, pulse and body temperature revealed no untoward reactions attributable to IVIG. Follow-up at an average age of 2.5 years showed no evidence of harmful effects of IVIG treatment in the neonatal period. In a recently concluded study no differences in the levels of various liver enzymes in infants treated with IVIG and in untreated infants was found 6 weeks after administration of IVIG. In another group of preterm infants with perinatal infections who received IVIG after birth, the serum IgG levels were determined at 3 to 4 and 6 to 8 weeks of age. At 3 to 4 weeks no difference was found in the serum IgG levels in infants with or without recurrent infections. At 6 to 8 weeks the serum IgG levels were slightly decreased in infants with recurrent as compared to those without recurrent infections.(ABSTRACT TRUNCATED AT 250 WORDS)