Efficacy of intravenous immunoglobulin following plasma exchange in the management of ABO haemolytic disease of the newborn.

BACKGROUND AND

OBJECTIVES

To evaluate the efficacy of intravenous immunoglobulin (IVIG) after plasma exchange (PE) in neonates with ABO haemolytic disease of the newborn (ABO-HDN) by assessing serum biomarkers, neurodevelopment and quality of life.

MATERIALS AND

METHODS

A total of 162 neonates with ABO-HDN were randomly assigned to four groups: Control (n = 39), IVIG (n = 42), PE (n = 41) and IVIG + PE (n = 40). Serum markers, Neonatal Behavioural Neurological Assessment (NBNA), Echelle Douleur Inconfort Nouveau-Ne and Paediatric Quality of Life Inventory (PedsQL4.0) scores were evaluated.

RESULTS

The IVIG + PE group showed the most significant improvement in prealbumin (PA), total bile acid (TBA), total bilirubin (TBIL), procalcitonin (PCT), high-sensitivity C reactive protein (hs-CRP) and antibody titre levels (p < 0.05). Neurodevelopment, comfort and quality of life were significantly enhanced, with reduced jaundice duration and hospitalization time. Adverse event rates were lower in all treatment groups than in the control group (p < 0.05).

CONCLUSION

IVIG following PE improves serum biomarkers, antibody titre levels, neurodevelopment and quality of life in ABO-HDN, supporting its clinical application.