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Premature infants are at risk for infection. They are born with low blood levels of immunoglobulin-G (IgG), as this antibody is transferred through the placenta during the last trimester of pregnancy. These already low levels decrease even further during the first three months of life. IgG has been administered to premature newborns in order to prevent infection. A pilot study was designed to evaluate the effectiveness of intravenous IgG (IVIG) in the prevention of nosocomial (hospital-associated) infection. In this prospective study, 115 patients were randomly assigned to either a treatment or control group. A third group of 85 infants, not included in the study at parental request, were followed and analyzed separately. The birth weights ranged from 600 to 2000 grams (one lb five oz to four lbs six oz) and gestational age was 30 to 31 weeks. The infants in the treatment group were administered IVIG in doses to maintain a blood level of IgG at approximately 700 mg/dl. Infections occurred in seven of the control group and nine of the nonparental consent group. No infections occurred in the IVIG treatment group. All babies in the control group who developed infection were found at that time to have IgG blood levels of 400 mg/dl or less. One patient in the treatment group developed rapid heart beat during IVIG, which disappeared when the IVIG was discontinued. These data suggest that maintaining a therapeutic (700 mg/dl) level of IgG in the blood during hospitalization may decrease the incidence of nosocomial infection in low-birth-weight babies.