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Efficacy of High-dose Intravenous Immunoglobulin Therapy for Hyperbilirubinemia Due Rh Hemolytic Disease

This study has been completed.
Instituto Fernandes Figueira
Information provided by (Responsible Party):
Maria Elisabeth Lopes Moreira, Oswaldo Cruz Foundation Identifier:
First received: February 6, 2006
Last updated: December 2, 2015
Last verified: December 2015
The use of intravenous immunoglobulin G (IVIG) therapy has been reported in hyperbilirubinemia of Rh hemolytic disease but we don't have enough evidences for it. Human Immunoglobulin is considered an alternative to delay the hemolytic process and consequently reduce the number of exchange transfusions and transfusions of red cells concentrate, thus diminishing the risk of transmitting transfusional therapies-related diseases. OBJECTIVE: To determine the effect of IVIG in decreasing the incidence and severity of neonatal immune hemolytic jaundice due to Rh hemolytic disease reducing the need for exchange transfusion as a primary goal in these babies. METHODS: This will be a randomized, double blind, clinical trial involving all newborns with risk of significant hyperbilirubinemia due to direct Coombs-positive Rh hemolytic disease. The primary goal will be need for exchange transfusion and others are: incidence of late anemia, kernicterus and deafness Babies were randomly assigned into two groups: group 1 (study group) received phototherapy plus IVIG (500 mg/kg); and group 2 (control group) received phototherapy and normal saline solution (10 ml/Kg) in the first 6 hours of life. Exchange transfusion was carried out in any group if at any time the bilirubin level reached 340 micromol/l (20 mg/dl) or more, or rose by 8.5 micromol/l per h (0.5 mg/dl per h). Adverse effects will be related in two groups. Parents informed consent will be asked in pre-natal time.

Condition Intervention Phase
Erythroblastosis, Fetal
Drug: Intravenous Immunoglobulin
Drug: Normal saline solution
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Phase 4 Study of Use of High-dose Intravenous Immune Globulin for Prevent Hyperbilirubinemia Due Rh Hemolytic Disease in Newborns Infants

Resource links provided by NLM:

Further study details as provided by Oswaldo Cruz Foundation:

Primary Outcome Measures:
  • Need of Exchange Transfusion [ Time Frame: 10 DAYS OF LIFE ]

Enrollment: 92
Study Start Date: October 2006
Study Completion Date: August 2010
Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Experimental group
Intravenous Immunoglobulin
Drug: Intravenous Immunoglobulin
Intravenous Immunoglobulin
Other Name: Immunoglobulin
Placebo Comparator: CONTROL GROUP
Normal Saline solution
Drug: Normal saline solution
Normal saline solution 10 ml/Kg
Other Name: saline solution

  Show Detailed Description


Ages Eligible for Study:   up to 6 Hours   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • All newborns with a gestational age equal or higher than 32 weeks, with a Rh (D) positive blood type, children of sensitized Rh (D) negative mothers, regardless if they were submitted or not to an intra-uterus transfusion.

Exclusion Criteria:

  • Newborns in serious condition, hydropic, hemodynamically instable or with indication for exchange transfusion at birth. The indications for exchange transfusion at birth are: presence of bilirubin in the umbilical cord higher or equal to 4mg%; hydrops, cardiac insufficiency secondary to severe anemia.
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Please refer to this study by its identifier: NCT00288600

Maria Elisabeth L Moreira
Rio de janeiro, Brazil, 22420040
Sponsors and Collaborators
Oswaldo Cruz Foundation
Instituto Fernandes Figueira
Principal Investigator: Maria EL Moreira, MD Oswaldo Cruz Foundation
  More Information

Responsible Party: Maria Elisabeth Lopes Moreira, MD, PhD, Oswaldo Cruz Foundation Identifier: NCT00288600     History of Changes
Other Study ID Numbers: ivig01
Study First Received: February 6, 2006
Results First Received: July 20, 2015
Last Updated: December 2, 2015

Keywords provided by Oswaldo Cruz Foundation:
Immunoglobulins, Intravenous
Erythroblastosis, Fetal
Exchange Transfusion, Whole Blood

Additional relevant MeSH terms:
Erythroblastosis, Fetal
Pathologic Processes
Fetal Diseases
Pregnancy Complications
Hematologic Diseases
Infant, Newborn, Diseases
Immune System Diseases
Pharmaceutical Solutions
Immunoglobulins, Intravenous
Rho(D) Immune Globulin
Immunologic Factors
Physiological Effects of Drugs processed this record on April 27, 2017