The effect of immunoglobulin treatment for hemolysis on the incidence of necrotizing enterocolitis – a meta-analysis

Y. Yang, J.-J. Pan, X.-G. Zhou, X.-Y. Zhou, R. Cheng, Y.-H. Hu

Department of Neonates, Children’s Hospital of Nanjing Medical University, Nanjing, China. yy860507@126.com; chengrui350@163.com

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• Pharmacology

OBJECTIVE: The application of intravenous immune globulin (IVIG) has been recommended for treating hemolysis in neonates for several years. But in clinical work, more than one study reported that IVIG treatment maybe increased the risk of NEC in hemolytic patients. In light of this situation, we performed this meta-analysis.

MATERIALS AND METHODS: We searched in PubMed, Embase, Cochrane databases for English references, and in Wanfang, VIP, Cnki databases for Chinese references (all last launched on 2015/12/18). Ultimately, 5 studies (Including 4 Chinese articles) were incorporated into this meta-analysis. Odds ratio (OR) and weighted mean difference (WMD) were calculated using a random-effects or fixed-effects model, depending on the data type and heterogeneity of the included studies.

RESULTS: (1) Baseline data including gestational age, gender and TBil between IVIG and control groups were compared in hemolytic infants, and showed no significance. (2) With respect to possible inducement of NEC, SGA and formula feeding were found no significance between IVIG and control groups. In contrast, birth weight was found significantly different between the two groups (WMD = 33.35; 95% CI, 20.70-46.01; p < 0.00001). (3) Regarding the incidence of NEC and mortality, the result showed that there was a significant difference between the IVIG and the control groups in the risk of NEC (OR: 4.53; 95% CI, 2.34-8.79; p < 0.00001).

CONCLUSIONS: Our results indicate that IVIG treatment for hemolysis may increase the risk of NEC in infants. But it does not increase the risk of final mortality.

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