Abstract：
BACKGROUND: Intravenous immunoglobulin G (IVIG) is used to treat blood-type incompatibility hemolytic disease of newborns (BTHDN). Although IVIG\'s efficacy for treating BTHDN has been challenged, as an updated systematic review suggests, IVIG could significantly reduce exchange transfusions. We conducted a mail-in questionnaire survey to ascertain actual use of IVIG for BTHDN in Japan.
METHODS: The survey, conducted in 2014, included infants born between January 1, 2009, and December 31, 2013. Questionnaires were sent to the heads of neonatal intensive care units (NICUs) at perinatal centers of the Japan Neonatologist Association.
RESULTS: A total of 195 centers (64.6%) responded to the questionnaire. During the study period, 170 centers (87.2%) reported incidences of BTHDN. Among these centers, there were 1726 diagnosed cases of BTHDN in neonates. Of these cases, 419 infants were treated with IVIG in 127 centers, representing approximately 74.7% of all centers. After the exclusion of cases with missing data and those where consent for data usage was not obtained, a total 916 infants were included in this study. Of these, 219 (23.9%) were treated with IVIG after phototherapy, and 187 (20.4%) of these infants did not require further blood exchange transfusion. The IVIG dosages ranged from 40 to 1200 mg/kg/dose, but the majority were between 500 and 1000 mg/kg/dose, with a median of 800 mg/kg/dose. About 20% of the infants treated with IVIG showed late-onset anemia and required treatment. Adverse events were reported in less than 1% of infants.
CONCLUSIONS: For the treatment of BTHDN, IVIG administration was widely used in NICUs in Japan without severe adverse events.
METHODS: The survey, conducted in 2014, included infants born between January 1, 2009, and December 31, 2013. Questionnaires were sent to the heads of neonatal intensive care units (NICUs) at perinatal centers of the Japan Neonatologist Association.
RESULTS: A total of 195 centers (64.6%) responded to the questionnaire. During the study period, 170 centers (87.2%) reported incidences of BTHDN. Among these centers, there were 1726 diagnosed cases of BTHDN in neonates. Of these cases, 419 infants were treated with IVIG in 127 centers, representing approximately 74.7% of all centers. After the exclusion of cases with missing data and those where consent for data usage was not obtained, a total 916 infants were included in this study. Of these, 219 (23.9%) were treated with IVIG after phototherapy, and 187 (20.4%) of these infants did not require further blood exchange transfusion. The IVIG dosages ranged from 40 to 1200 mg/kg/dose, but the majority were between 500 and 1000 mg/kg/dose, with a median of 800 mg/kg/dose. About 20% of the infants treated with IVIG showed late-onset anemia and required treatment. Adverse events were reported in less than 1% of infants.
CONCLUSIONS: For the treatment of BTHDN, IVIG administration was widely used in NICUs in Japan without severe adverse events.
摘要：
背景：静脉免疫球蛋白G（IVIG）用于治疗血型不相容性新生儿溶血病（BTHDN）。虽然IVIG治疗BTHDN的疗效受到挑战，正如最新的系统审查所表明的那样，IVIG可以显著减少交换输血。我们进行了邮寄问卷调查，以确定IVIG在日本的BTHDN的实际使用情况。
方法：调查，2014年进行,包括2009年1月1日至2013年12月31日出生的婴儿.问卷已发送给日本新生儿学家协会围产期中心的新生儿重症监护病房（NICU）负责人。
结果：共有195个中心（64.6%）回答了问卷。在学习期间,170个中心（87.2%）报告了BTHDN的发病率。在这些中心中,新生儿中有1726例诊断为BTHDN。在这些案件中,127个中心的419名婴儿接受了IVIG治疗，约占所有中心的74.7%。在排除数据缺失和未获得数据使用同意的情况后，本研究共纳入916例婴儿.其中,光疗后用IVIG治疗219例（23.9%），其中187例(20.4%)婴儿不需要进一步输血.IVIG的剂量范围为40至1200mg/kg/剂，但大多数在500到1000毫克/千克/剂之间，中位数为800mg/kg/剂。接受IVIG治疗的婴儿中约有20％表现为迟发性贫血，需要治疗。不良事件报告少于1%的婴儿。
结论：对于BTHDN的治疗，IVIG给药在日本的NICU中广泛使用，没有严重的不良事件。
方法：调查，2014年进行,包括2009年1月1日至2013年12月31日出生的婴儿.问卷已发送给日本新生儿学家协会围产期中心的新生儿重症监护病房（NICU）负责人。
结果：共有195个中心（64.6%）回答了问卷。在学习期间,170个中心（87.2%）报告了BTHDN的发病率。在这些中心中,新生儿中有1726例诊断为BTHDN。在这些案件中,127个中心的419名婴儿接受了IVIG治疗，约占所有中心的74.7%。在排除数据缺失和未获得数据使用同意的情况后，本研究共纳入916例婴儿.其中,光疗后用IVIG治疗219例（23.9%），其中187例(20.4%)婴儿不需要进一步输血.IVIG的剂量范围为40至1200mg/kg/剂，但大多数在500到1000毫克/千克/剂之间，中位数为800mg/kg/剂。接受IVIG治疗的婴儿中约有20％表现为迟发性贫血，需要治疗。不良事件报告少于1%的婴儿。
结论：对于BTHDN的治疗，IVIG给药在日本的NICU中广泛使用，没有严重的不良事件。
