Obstetrical use of intravenous immunoglobulin: A single-centre retrospective study

INTRODUCTION: Intravenous immunoglobulin is widely used for various conditions but faces challenges such as limited supply, high cost, and substantial off-label use. Obstetrical intravenous immunoglobulin use remains underexplored, despite its relevance to maternal and neonatal care and resource management. METHODS: This single-center retrospective cohort study examined intravenous immunoglobulin administration in 136 pregnancies (122 patients) from 2007-2020, focusing on adherence to Health Canada licensed indications and Ontario Immunoglobulin Utilization Management Guidelines. RESULTS: Maternal thrombocytopenia (56.6 %) and treatment for fetal/neonatal alloimmune thrombocytopenia (16.2 %) were the most common indications, accounting for 16.9 % and 64.3 % of total intravenous immunoglobulin volume, respectively. Intravenous immunoglobulin use represented 1.6 % of the center's total consumption during the study period, with notable non-adherence to guidelines in 38.2 % (Health Canada) and 17.6 % (provincial guidelines) of pregnancies. CONCLUSION: Findings highlight the need for optimized intravenous immunoglobulin use in obstetrics and future research to ensure safety, efficacy, and evidence-based guidance in clinical practice and policy.