Zwiers C, et al. - Whether maternal treatment with intravenous immunoglobulins defers the development of severe fetal anemia and its consequences in a retrospective cohort to which 12 fetal therapy centers contributed was evaluated. The findings from the present study suggested that intravenous immunoglobulin treatment in mothers pregnant with a fetus at risk for hemolytic disease appeared to have a potentially clinically relevant, beneficial effect on the course and severity of the disease.

Methods

• For the purpose of this investigation, the researchers involved consecutive pregnancies of alloimmunized women with a history of severe hemolytic disease and by propensity analysis compared index pregnancies treated with intravenous immunoglobulins (n=24) with pregnancies managed without intravenous immunoglobulins (n=28).

Results

• According to the findings obtained, fetal anemia developed on average 15 days later compared to previous pregnancies (8% less often before 20 weeks’ gestation) in index pregnancies with intravenous immunoglobulin treatment.
• It was observed that in pregnancies without intravenous immunoglobulin treatment anemia developed 9 days sooner contrasted with previous pregnancies (10% more before 20 weeks), an adjusted 4-day between-group difference in favor of the immunoglobulin group (95%CI -10 to 18, P=.564).
• It was noted that in the subcohort in which immunoglobulin treatment was begun before 13 weeks, anemia developed 25 days later and 31% less before 20 weeks’ gestation (54% compared to 23%) than in the previous pregnancy.
• Findings revealed that fetal hydrops occurred in 4% of immunoglobulin-treated pregnancies and in 24% of those without intravenous immunoglobulin treatment (OR 0.03, 95%CI 0 to 0.5, P=.011).
• Data reported that exchange transfusions were given to 9% of neonates born from pregnancies with and in 37% without immunoglobulin treatment (OR 0.1, 95%CI 0 to 0.5, P=.009).