{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:49:15Z","timestamp":1791557355860,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Phototherapy remains the first\u2010line treatment of haemolytic disease of the newborn (HDN), a potentially life\u2010threatening condition caused by maternal alloimmunisation. Intravenous immunoglobulin (IVIG) has been proposed as an adjunct to reduce the need for exchange transfusion (ET), a procedure associated with significant risks. This meta\u2010analysis aims to evaluate the safety and efficacy of IVIG combined with phototherapy versus phototherapy alone in neonates with HDN. A comprehensive search of MEDLINE, EMBASE, CINAHL and the Cochrane Library was conducted up to 24 April 2025. Eligible studies included randomised controlled trials and observational cohorts evaluating IVIG in HDN. Data were pooled using random\u2010effects models. This study was prospectively registered in Prospective Register of Systematic Reviews (CRD420251025766). Nineteen studies involving 3673 neonates met the inclusion criteria. IVIG reduced the need for ET (odd ratio [OR]\u2009=\u20090.34; confidence interval [CI]: 0.2\u20130.8;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200988%) when used as an adjunct to phototherapy compared to phototherapy alone. Subgroup analysis suggested that the reduction in ET was more consistent in Rh\u2010mediated HDN (OR\u2009=\u20090.2; CI: 0.1\u20130.8;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200981%) than in ABO\u2010mediated HDN (OR\u2009=\u20090.76; CI: 0.1\u20134.1;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200989%). There were no differences in the length of hospital stay (mean difference [MD]\u2009=\u2009\u22120.1\u2009days; CI: \u22120.8 to 0.6;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200998%), duration of phototherapy (MD\u2009=\u2009\u22125.1\u2009h; CI: \u221215.7 to 5.4;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200998%) or incidence of adverse events (OR\u2009=\u20091.32; CI: 0.2\u201310.5;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200991%) between groups. Despite reducing ET requirements, adjunctive IVIG with phototherapy may not provide additional clinical benefits compared with phototherapy alone. Further high\u2010quality trials are needed to clarify optimal timing, dosing and patient selection.\n                  <\/jats:p>","DOI":"10.1111\/tme.70123","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:53:22Z","timestamp":1791554002000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravenous immunoglobulin as an adjunct to phototherapy in neonatal haemolytic disease: A systematic review and meta\u2010analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7977-9908","authenticated-orcid":false,"given":"Megan","family":"Roberts","sequence":"first","affiliation":[{"name":"Manchester University NHS Foundation Trust Royal Manchester Children's Hospital  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7068-3228","authenticated-orcid":false,"given":"James W. F.","family":"Burns","sequence":"additional","affiliation":[{"name":"Bolton NHS Foundation Trust Royal Bolton Hospital  Bolton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5904-9927","authenticated-orcid":false,"given":"Alma","family":"Sato","sequence":"additional","affiliation":[{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dafni\u2010Stravroula","family":"Grammenou","sequence":"additional","affiliation":[{"name":"European University Cyprus Medical School  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-8093","authenticated-orcid":false,"given":"Emily E.","family":"Lugard","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2475-1372","authenticated-orcid":false,"given":"May Y.","family":"Hajeir","sequence":"additional","affiliation":[{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8509-7725","authenticated-orcid":false,"given":"Lamees M.","family":"Al Darwashi","sequence":"additional","affiliation":[{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0310-1213","authenticated-orcid":false,"given":"David","family":"Riese","sequence":"additional","affiliation":[{"name":"European University Cyprus Medical School  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Froneman","sequence":"additional","affiliation":[{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4193-9925","authenticated-orcid":false,"given":"Christian A.","family":"Than","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust Addenbrookes Hospital  Cambridge UK"},{"name":"School of Biomedical Sciences The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7229-5344","authenticated-orcid":false,"given":"Sandeep","family":"Potluri","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology Birmingham Children's Hospital NHS Foundation Trust  Birmingham UK"},{"name":"Department of Cancer and Genomic Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1182\/asheducation-2015.1.146","article-title":"Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn","volume":"2015","author":"Delaney M","year":"2015","journal-title":"Hematol Am Soc Hematol Educ Program"},{"issue":"9","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1038\/jp.2012.71","article-title":"An approach to the management of hyperbilirubinemia in the preterm infant less than 35\u2009weeks of gestation","volume":"32","author":"Maisels MJ","year":"2012","journal-title":"J Perinatol"},{"issue":"5","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1097\/ANC.0b013e31822ee62c","article-title":"Fundamentals of phototherapy for neonatal jaundice","volume":"11","author":"Stokowski LA","year":"2011","journal-title":"Adv Neonatal Care"},{"key":"e_1_2_12_5_1","unstructured":"NICE.Jaundice in newborn babies under 28\u2009days: recommendations [Internet]. NICE clinical guideline CG98. National Institute for Health and Care Excellence [updated 31 October 2023]. Accessed September 15 2025.2010. 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