PREVENTION OF NECROTIZING ENTEROCOLITIS IN EXTREMELY LOW-BIRTH-WEIGHTINFANTS BY IGG FEEDING

Oral immunoglobulin has been described as preventing necrotizing enter ocolitis(NEC) in preterm infants. To prevent NEC in extremely low birt h weight infants (ELBW), we have carried out oral Ige prophylaxis sinc e April 1991. The efficacy of this prophylaxis was examined in a study comparing historical cohorts. ELBW infants delivered in the Departmen t of Obstetrics and Gynaecology of the University of Ulm and treated u ntil day 28 in the level III intensive care nursery, Division of Neona tology, University of Ulm were included. Cohort 1, born between 1.1.19 88 and 31.3.1991, received no oral IgG and served as a control [n = 84 , gestational age: median 26 weeks, range 24-34; birth weight: 811 g, 490-990], cohort 2, born between 1.4.1991 and 31.12.1995 [n = 137, ges tational age: 26 weeks, 22-32; birth weight: 760 g, 362-995], received 6 x 100 mg/kg human IgG (Beriglobin) orally on days 1-28. NEC, stage 2a and higher according to the modified classification of Bell, was ob served in 9 of 84 (10.7%) infants of cohort 1 and in 11 of 137 (8%) in fants of cohort 2 until day 28. The difference did not reach statistic al significance (P=0.63 Fisher's exact test). Conclusion In this histo rical cohort study, ELBW infants were not protected against NEC by ora l IgG, The present published evidence does not allow recommendation of oral human IgG administration in preterm infants as a prophylactic me asure against NEC.