{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T02:13:30Z","timestamp":1778897610864,"version":"3.51.4"},"reference-count":152,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:p>Intravenous immunoglobulin (IVIG) was first administered to humans in the 1980s. The mechanism of action of IVIG is still a subject of debate but the pharmacokinetics have been well characterized, albeit outside of pregnancy. IVIG has been used in pregnancy to treat several nonobstetrical and obstetrical-related conditions. However, current evidence suggests that IVIG use during pregnancy can be recommended for 1) in utero diagnosis of neonatal alloimmune thrombocytopenia; 2) gestational alloimmune liver disease; 3) hemolytic disease of the fetus and newborn for early-onset severe intrauterine disease; 4) antiphospholipid syndrome (APS) when refractory to or contraindicated to standard treatment, or in catastrophic antiphospholipid syndrome; and 5) immune thrombocytopenia when standard treatment is ineffective or rapid increase of platelet counts is needed. All recommendations are based on case series and cohort studies without randomized trials usually because of the rare prevalence of the conditions, the high incidence of adverse outcomes if left untreated, and ethical concerns. In contrast, IVIG therapy cannot be recommended for recurrent pregnancy loss, and the use of IVIG in subgroups of those with recurrent pregnancy loss requires further investigations. For non\u2013obstetrical-related conditions, we recommend using IVIG as indicated for nonpregnant patients. In conclusion, the use of IVIG during pregnancy is an effective treatment in some obstetrical-related conditions with rare serious maternal side effects. However, the precise mechanisms of action and the long-term immunologic effects on the fetus and neonate are poorly understood and merit further investigations.<\/jats:p>","DOI":"10.1542\/neo.22-1-e7","type":"journal-article","created":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T10:20:17Z","timestamp":1609496417000},"page":"e7-e24","source":"Crossref","is-referenced-by-count":23,"title":["Update on the Use of Intravenous Immunoglobulin in Pregnancy"],"prefix":"10.1542","volume":"22","author":[{"given":"Rahul J.","family":"D\u2019Mello","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Detroit Medical Center, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaur-Dong","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and"},{"name":"Department of Physiology, Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puangphaka","family":"Chaiworapongsa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Henry Ford Hospital, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tinnakorn","family":"Chaiworapongsa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2021,1,1]]},"reference":[{"issue":"4","key":"2021121007400475500_B1","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.1067\/mai.2001.117821","article-title":"Obstetric uses of intravenous immunoglobulin: successes, failures, and promises","volume":"108","author":"Branch","year":"2001","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"2021121007400475500_B2","first-page":"632","article-title":"Absence of serum gamma globulins","volume":"84","author":"Bruton","year":"1952","journal-title":"AMA Am J Dis Child"},{"issue":"8232","key":"2021121007400475500_B3","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1016\/S0140-6736(81)92400-4","article-title":"High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood","volume":"1","author":"Imbach","year":"1981","journal-title":"Lancet"},{"key":"2021121007400475500_B4","unstructured":"US Food & Drug Administration. 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