03470nam a22001577a 4500001001300000003000400013005001700017008004100034245015600075520291900231580006403150650002303214650002403237700002803261700002303289D0001J000644DOH20210515132405.0210515b           ||||| |||| 00| 0 eng d00aHyperbilirubinemia in glucose-6-phosphate dehydrogenase-deficient neonates born in the Makati Medical Center /cAllan Robert B. Racho, Mary Joyce L. Dy3 aOBJECTIVE: To determine the association between G-6-PD deficiency and hyperbilirubinemia among neonates born in the Makati Medical Center from August 1998 to December 2001 and confirmed to be deficient of the enzyme by quantitative assay.

DESIGN: A retrospective cross-sectional study. Setting: The Makati Medical Center, a tertiary hospital in Manila.

PATIENTS: All term neonates born in the Makati Medical Center from August 1998 to December 2001 who underwent Newborn screening, and who were confirnifd to be G-6-PD-deficient by enzyme assay. Exclusion criteria included sepsis, significant cephalhematoma or traumatic delivery, and/or Rh incompatibility. Other potential confounders such as ABO incompatibility setup and exclusive breastfeeding were not excluded but stratified statistical analysis was done. Fifty three G-6-PD deficient neonates were included, and 49 of them were analyzed. Sixty-nine G-6-PD-normal neonates served as subjects for comparison.

METHODS: In-patient charts of these neonates were reviewed. Onset of jaundice and level of bilirubin obtained from them were noted and analyzed. These values were compared between the enzyme-deficient and the non-deficient groups. Furthermore, among the G-6-PD-deficient group, the enzyme level of each neonate was obtained from the National Institutes of Health (NIH) and this was correlated with the level of bilirubin they reached during their stay at the nursery. Some specific DNA mutations seen were also obtained from NIH and were described.

RESULTS: The prevalence of G-6-PD deficiency in the Makati Medical Center is one in 110. It occurred in 80 percent of males and 20 percent of females. The incidence of hyperbilirubinemia among G-6-PD-deficient neonates was found to be 37 percent,compared to the incidence of 10 percent among G-6-PD-normal neonates (Chi-square, 12.13; P-value, 0.0005). There was a strong association found between G-6-PD deficiency and neonatal hyperbilirubinemia. The mean bilirubin level reached by the G-6-PD-deficient neonates during their stay at the nursery was 13.8 +/- 3.7 mg/dL while that of G-6-PD-normal neonates was 12.7 +/- 2.5 mg/dL. (T-value, 1.06; P-value, 0.29). Hence, the bilirubin level of G-6-PD-deficient neonates was not significantly quantitatively higher than that of G-6-PD-normal neonates. Among the G-6-PD-deficient group, the neonates with lower enzyme levels did not necessarily have higher bilirubin levels, thus there was no correlation established between enzyme and bilirubin levels. ABO incompatibility and exclusive breastfeeding were not found to have an effect on the relationship that was established between G-6-PD deficiency and hyperbilirubinemia.

CONCLUSION: In conclusion, G-6-PD deficient neonates go into hyperbilirubinemia more often than do G-6-PD-normal neonates, but the bilirubin level is not necessarily higher among the former than the latter group. (Author)  a

Makati Medical Center Proceedings, 2004 (18) pages  61-67 2aHyperbilirubinemia 2aGlucose-6-Phosphate1 aRacho, Allan Robert B. 1 aDy, Mary Joyce L.