Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Vox Sang. 2022 Sep;117(9):1098-1104. doi: 10.1111/vox.13297. Epub 2022 May 25.
To assess whether the use of intravenous immunoglobulin (IVIG) in late-preterm and term newborns with haemolytic disease of the newborn (HDN) is associated with an increased risk of necrotizing enterocolitis (NEC).
A retrospective cohort study was conducted in a tertiary centre. Infants with HDN during early neonatal period (<7 days) who were of ≥34 weeks' gestation and born between January 2019 and October 2021 were included. Propensity score, interaction as well as univariate and multiple logistic regression analyses were employed.
One-thousand two-hundred and fifty-nine infants with HDN were enrolled, of whom 192 (15.3%) received IVIG. NEC was diagnosed in 29 (2.3%) patients with 5 (2.6%) in the IVIG group and 24 (2.2%) in the non-IVIG group. No significant association between IVIG administration and confirmed NEC was observed using univariate analysis (p > 0.05). The possible predictors of NEC, as assessed by multivariate analysis, were caesarean delivery, haemoglobin on admission <130 g/L and patent ductus arteriosus (PDA). There was no interactive effect of IVIG against NEC for prematurity, low birth weight, caesarean delivery, haemoglobin on admission <130 g/L and PDA.
In late-preterm and term infants with HDN, there was no evidence that the early use of IVIG led to the development of NEC.
评估晚期早产儿和足月儿中溶血性新生儿疾病（HDN）使用静脉注射免疫球蛋白（IVIG）是否与坏死性小肠结肠炎（NEC）风险增加有关。
在一家三级中心进行了一项回顾性队列研究。纳入了早期新生儿期（<7 天）患有 HDN、胎龄≥34 周且在 2019 年 1 月至 2021 年 10 月间出生的婴儿。采用倾向评分、交互作用以及单变量和多变量逻辑回归分析。
共纳入 1259 例 HDN 患儿，其中 192 例（15.3%）接受了 IVIG 治疗。29 例（2.3%）患儿确诊为 NEC，其中 IVIG 组 5 例（2.6%），非 IVIG 组 24 例（2.2%）。单变量分析未发现 IVIG 给药与确诊 NEC 之间存在显著关联（p>0.05）。多变量分析评估的 NEC 可能预测因素包括剖宫产、入院时血红蛋白<130g/L 和动脉导管未闭（PDA）。IVIG 对 NEC 的预防作用不受早产、低出生体重、剖宫产、入院时血红蛋白<130g/L 和 PDA 的影响，两者之间无交互作用。
在晚期早产儿和足月儿中，早期使用 IVIG 并未导致 NEC 的发生。
