Efficacy of intravenous immunoglobulin following plasma exchange in the management of <scp>ABO</scp> 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.