THERAPEUTIC EFFECTIVENESS OF INTRAVENOUS IMMUNOGLOBULINE (IVIG) IN VERY LOW BIRTH WEIGHT NEWBORNS WITH SEPSIS

Abstract

Preterm newborns are susceptible of invasion by microorganisms due to immaturity of their immune system. This study aimed at assessing the effect of IV immunoglobulins as supportive treatment in neonatal sepsis. Subjects and methods: 32 preterm newborns whose weight at delivery was under 1500 grams were prospectively studied for two years after they had developed sepsis in the Neonatal ICU of G.Grant B.Hospital in Concepción. Sepsis was defined as the presence of positive hemoculture, compatible clinical signs and/or symptoms and corroborating laboratory tests. The 32 newborns had been randomly assigned to two groups: 16 newborns received the regular antibacterial treatment (Group I) and the remaining 16, were given 500mg/kg/day IVIG for 7 days (Group II) in addition to antibiotics. Serum IgG levels were tested during and at the end of treatment by Group I, and on a daily basis in those in Group II. Collateral effects from IVIG infusion were monitored by clinical observation and laboratory tests (CBC, transaminases blood, creatinine). Results: Average delivery weights were 1124 grams and 1095 grams for Group I and II, respectively. No sex predominance occurred in either group. Average basal serum IgG level was 486 mg in Group II and increased to 852 mg (p<0.01) after the first IVIG dosage. Significant correlation (r = 0.94) was found between IgG levels in serum and days of treatment. The mortality rate was 31.356 in Group I and 6.3% in Group II (p<0.03). No untoward effects were observed after IVIG infusion.IVIG administration may be an efficient, low risk supportive therapy in the treatment of neonatal sepsis.