Article Text

NECROTISING ENTEROCOLITIS AFTER ADMINISTRATION OF INTRAVENOUS IMMUNOGLOBULIN IN VERY LOW BIRTH WEIGHT PRETERMS: A RETROSPECTIVE STUDY
  1. R Viellevoye1,
  2. V Rigo1,
  3. J Rigo1
  1. 1Neonatal Intensive Care Unit, Department of Pediatrics, CHR Citadelle, Liege, Belgium

Abstract

Background Necrotising enterocolitis (NEC) is a major cause of mortality and morbidity in very low birth weight (VLBW) preterms. Pathogenesis remains unclear. Recently, we observed a few NEC occurring within the 48 h following prophylactic administration of intravenous immunoglobulin (IVIgG). The aim of the present study was to evaluate the influence of IVIgG administration on the incidence of NEC in our neonatal intensive care unit (NICU).

Method Discharge letters from all infants admitted to our NICU between January 2004 and March 2007 were reviewed. Charts from infants with NEC were analysed and classified according to birth weight, gestational age, postnatal age and NEC stage. In addition, IVIgG administration was also recorded from pharmacology data.

Results Between January 2004 and March 2007, 1711 newborns were admitted to our NICU: 241 (14%) VLBW <1500 g and 1470 (86%) ⩾1500 g newborns. 36 NEC were observed in 26 VLBW and 10 ⩾1500 g representing a relative incidence of 10.79% in VLBW and 0.68% in ⩾1500 g. 273 of the 1711 newborns received at least one administration of IVIgG: 140 (58.9%) were VLBW and 133 (9.05%) ⩾1500 g. 11/26 VLBW received IVIgG before the onset of NEC with eight of them in the last 48 h, suggesting that 30.8% of our NEC in VLBW infants occurred in the 48 h following IVIgG administration.

Conclusion Our study suggests that IVIgG could play a significant role in the development of NEC in preterm infants, particularly VLBW infants, and would not be used for the prevention of nosocomial infection as suggested by the Cochrane review.

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