IgM-enriched intravenous immunoglobulin therapy in neonatal sepsis.

Despite the development of newer generation of antibiotics, mortality from neonatal sepsis remains high. In a prospective, randomized study, we investigated the use of IgM-enriched immunoglobulin therapy in neonatal sepsis. Two groups of 30 infants each (matched for gestational age, sex, weight, and other variables) were randomly allocated to receive either antibiotics alone (control group) or antibiotics plus 5 mL/kg/d for four days of IgM-enriched immunoglobulin intravenously (immunotherapy group). Mortality from sepsis in the control group was 20% (6/30), while in the immunotherapy group it was 3.3% (1/30). We conclude that IgM-enriched immunoglobulin therapy in conjunction with antibiotic therapy significantly reduces mortality from neonatal sepsis.

Trend in breech delivery in Saudi Arabia.

An analysis of 2,168 consecutive singleton breech deliveries showed significant improvement in neonatal mortality and morbidity rates for babies delivered by Caesarean section (CS) compared with vaginal delivery (p less than 0.001). The CS rate was 19%. The uncorrected perinatal mortality (PNM) rate was 90.4/1,000 which was 2.5 times higher than the overall hospital PNM rate. In the vaginal delivery group the neonatal death (NND) rate of 206/1,000 among low birth-weight infants (less than 2,500 g) was significantly higher than that of 18/1,000 among babies of greater than 2,500 g (p greater than 0.001). There was no significant difference in the NND rate between these 2 birth-weight groups delivered by CS (p greater than 0.3). Social conservatism, large family size and limited neonatal care facilities were deterrents to an increase in the Caesarean section rate.

Intravenous immunoglobulin for prevention of sepsis in preterm and low birth weight infants.

The effect of an intravenous polyvalent immunoglobulin preparation given prophylactically to prevent neonatal sepsis was tested in preterm and low birth weight infants. Infants matched for gestational age, sex and birth weight (+/- 250 g) were randomly allocated into 3 groups of 50 each, one group (Group C) being used as control. Group A received Intraglobulin (Biotest Pharma, West Germany), 120 mg/kg intravenously, within 2 to 4 hours of delivery; Group B received the same on days 1 and 8. The control group received no immunoglobulin. The frequency of infection and serum immunoglobulin concentrations were determined in each group. Infection rate in the control group was 16% (8 of 50) while in each of the treated groups it was 4% (2 of 50) (P less than 0.005). The immunoglobulin concentrations achieved in the treated group were significantly higher than the control group. No adverse effect of the therapy was noted during the study and at a 6-month follow-up. It is suggested that in nurseries where the infection rate is high, prophylactic intravenous polyvalent immunoglobulin therapy for the preterm and low birth weight infants may provide protection from infection.

A simple high calorie high protein feed for low birth weight infants in developing countries.

A simple high calorie high protein feed was devised by the addition of Caloreen and egg white to milk feeds for use in low birth weight infants (low birth weight--LBW). The growth rate was studied in 100 LBW infants. A weight gain of 203 g per week was obtained as compared to 110 g in the control group; growth was 8.6 mm in the study group as compared to 6.4 mm in the control group; the occipitofrontal circumference (OFC) was 0.67 mm in the study group and 0.38 mm in the control group. All differences were statistically significant.