The Relationship Between Intravenous Immunoglobulin For Hemolytic Disease Of Newborn And Necrotizing Enterocolitis

Objectives:To evaluate whether the usage of intravenous immunoglobulin(IVIG)for hemolytic disease of newborn(HDN) was a risk factor of necrotizing enterocolitis(NEC).Methods:A retrospective cohort study was conducted based on propensity score matching(PSM). Infants who had hemolytic disease due to blood group incompatibility were enrolled in the study. All infants were divided into two groups depending on IVIG usage. The incidence of NEC between the two groups was compared. Meanwhile, the risk factors of NEC in patients with hemolytic disease were analyzed by case-control study in the PS-matched cases.Results:Among 1217 infants, 40 cases were diagnosed with NEC and 309 patients received IVIG. After 1:2 PS-matching, one hundred and ninety-nine pairs were matched, 25 cases with NEC and 572 cases without NEC. The results showed the incidence of NEC in IVIG group was not higher than that in the other group, 4.5%(9/199) vs. 4.0%(16/398),(P=0.773). The risk factors of NEC in patients with hemolytic disease included premature, low birth weight, multiple pregnancy, premature rupture of membranes, antenatal glucocorticoid, parenteral nutrition, congenital heart disease, maximum bilirubin value. Logistic regression analysis showed congenital heart disease was the independent risk factor for HDN patients occurring NEC(OR: 4.021, 95%CI: 1.286-12.578).Conclusions:The usage of IVIG for HDN did not increase the incidence of NEC,those patients combing congenital heart disease were more likely to occur NEC.