The Study of G6PD Deficiency and Associated Factors With Complications in Neonates With Jaundice in the Neonatal Intensive Care Unit
Article Sidebar
Main Article Content
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a major cause of severe
neonatal jaundice. If not diagnosed and treated promptly, it can lead to
neurotoxicity and permanent brain damage. However, data regarding its
relationship with severe complications in the neonatal intensive care unit (NICU)
setting remains limited. This study aimed to determine the incidence of G6PD
deficiency and analyze the relationship between this condition and clinical factors
as well as other complications. This retrospective descriptive study included 128
jaundiced neonates who underwent G6PD enzyme testing at the NICU of
Ramathibodi Chakri Naruebodindra Hospital between January 1 and December 31,
2023. The research instrument was a personal and clinical data collection form,
which was validated for content by experts. Data were analyzed using descriptive
statistics, Fisher’s exact test, Pearson’s chi-squared test, and multiple logistic
regression to determine adjusted odds ratios (aOR) with 95% confidence intervals
(CI).
Among the 128 participants, the mean birth weight was 2,410.59 ± 976.68
grams, and the mean gestational age was 34.84 ± 4.71 weeks. The incidence of
G6PD deficiency was found to be 8.59% (11 cases). Multiple logistic regression
analysis revealed that G6PD deficiency was significantly associated with birth
asphyxia (aOR 16.54; 95% CI: 1.22–223.84, p = .035). Other factors, including
gender, intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA), and
hypoglycemia, showed no statistically significant association (p >.05). Close
monitoring and active screening for G6PD deficiency should be considered for all
high-risk neonates, particularly those with a history of birth asphyxia, timely
clinical management and prevent permanent neurological disability.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The content and information presented in articles published in the Vajira Nursing Journal reflect the views and responsibilities of the authors exclusively. The editorial board does not necessarily agree with or share any responsibility for these views.
All articles, information, content, images, etc., published in the Vajira Nursing Journal are the copyright of the journal. Any individual or organization wishing to reproduce, disseminate, or use any part or entirety of the published material must obtain prior written permission from the Vajira Nursing Journal.
References
Mitra S, Rennie J. Neonatal jaundice: aetiology, diagnosis and treatment. Pediatr Child Health. 2017;27(11):479-84.
Nkhoma ET, Poole C, Vannappagari V, Hall SA, Beutler E. The global prevalence of glucose-6-phosphate dehydrogenase deficiency: a systematic review and meta-analysis. Blood Cells Mol Dis. 2009;42(3):267-78.
Bureau of Policy and Strategy, Ministry of Public Health. Strategy, indicators, and guidelines for data collection, Ministry of Public Health, fiscal year 2009. Nonthaburi: Ministry of Public Health; 2009. (in Thai)
Chien YH, Lee NC, Wu ST, Liou JJ, Chen HC, Hwu WL. Changes in incidence and sex ratio of glucose-6-phosphate dehydrogenase deficiency by population drift in Taiwan. Southeast Asian J Trop Med Public Health. 2008;39(1):154-61.
Merino-Andres J, García-Caballero AC, de la Cruz-Bértolo J, Lorenzo-Alonso MJ, García-Alix A. Neonatal hyperbilirubinemia and repercussions on neurodevelopment. An Pediatr (Engl Ed). 2024;100(1):47-55.
Al-Bedaywi RRR, Salameh KMK, Abedin S, Viswanathan B, Khedr AA, Habboub LHM. Glucose-6-phosphate dehydrogenase deficiency and neonatal indirect hyperbilirubinemia: a retrospective cohort study among 40,305 consecutively born babies. J Perinatol. 2024;44:1035-41.
Xu JX, Lin F, Chen ZK, Luo ZY, Zhan XF, Wu JR, et al. Co-inheritance of G6PD deficiency and 211G to A variation of UGT1A1 in neonates with hyperbilirubinemia in eastern Guangdong. BMC Pediatr. 2021; 21(1):564.
Lee HY, Ithnin A, Azma RZ, Othman A, Salvador A, Cheah FC. Glucose-6-phosphate ehydrogenase deficiency and neonatal hyperbilirubinemia: Insights on pathophysiology, diagnosis, and gene variants in disease heterogeneity. Front Pediatr. 2022 May 24;10:875877. doi: 10.3389/fped.2022.875877.
Dissaneevate S, Wongsirichot T, Siriwat P, Jintanapanya N, Boonyakarn U, Janjindamai W, et al. A mobile computer-aided diagnosis of neonatal hyperbilirubinemia using digital image processing and machine learning techniques. Int J Innov Res Sci Stud. 2022;5(1):10-7.
Paopongsawan P, Kiatchoosakun P, Jirapradittha J, Chopchoen M. Prevalence of glucose-6-phosphate dehydrogenase deficiency in male newborn infants and its relationship with neonatal jaundice in Thailand. Am J Perinatol. 2023
Nuchprayoon I, Sanpavat S, Nuchprayoon S. Glucose-6-phosphate dehydrogenase (G6PD) mutations in Thailand. Hum Mutat. 2002;19(2):185-90.
Gottimukkala SB, Konagari S, Thadikonda V. Intermittent versus continuous phototherapy for neonatal non-haemolytic hyperbilirubinaemia. Cochrane Database Syst Rev. 2023;10 (10):CD011409.
Horn D, Ehret D, Gautham KS, Soll R. Sunlight for the prevention and treatment of hyperbilirubinemia in term and late preterm neonates. Cochrane Database Syst Rev. 2021;7(7):CD013277.
Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in term and late preterm infants: Epidemiology and clinical manifestations. UpToDate; 2020.
Allen KA, Brandon DH. Hypoxic ischemic encephalopathy: pathophysiology and experimental treatments. Newborn Infant Nurs Rev. 2011;11(3):125–33.
Zabeen B, Nahar J, Nabi N, Baki A, Tayyeb S, Azad K, et al. Risk factors and outcome of neonatal jaundice in a tertiary hospital. Ibrahim Med Coll J. 2010;4(2):70-3.
Wusthoff CJ, Loe IM. Impact of bilirubin-induced neurologic dysfunction on neurodevelopmental outcomes. Semin Fetal Neonatal Med. 2015;20(1):52-7.
Luzzatto L, Nannelli C, Notaro R. Glucose-6-phosphate dehydrogenase deficiency. Hematol Oncol Clin North Am. 2016;30(2):373-93.
Kassahun W, Tunta A, Abera A, Shiferaw M. G6PD deficiency among neonates with jaundice in Africa: systematic review and meta-analysis. Heliyon. 2023;9(7):e18437.
Vodret S. Neonatal Hyperbilirubinemia: in vivo Characterization of Mechanisms of Bilirubin Neurotoxicity and Pharmacological Treatments [PhD thesis]. The Open University; 2016.
Cunningham AD, Hwang S, Mochly-Rosen D. G6PD deficiency and the need for a novel treatment to prevent kernicterus. Clin Perinatol. 2016;43(2):341–54.
Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30:607-10.
Islam MT, Hoque SA, Nazir F, Bhuiyan MMR, Islam MN. Status of serum bilirubin, serum proteins and prothrombin time in babies with perinatal asphyxia. J Dhaka Natl Med Coll Hosp. 2013;18(2):43-6.
Deori R, Kalita S, Baruah SD. Association of Glucose-6-phosphate dehydrogenase deficiency and hyperbilirubinemia in neonates. IOSR J Dent Med Sci. 2018; 17(9):30–5.
