Obasa Temitope Olorunsola, Adesiyun Omotayo Olukemi, Mokuolu Olugbenga Ayodeji, Ojuawo Ayodele Isaac
Neonatal Intensive Care Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Pediatr Rep. 2012 Jan 2;4(1):e7. doi: 10.4081/pr.2012.e7. Epub 2012 Mar 20.
Glucose-6-phosphate (G6P) is an enzyme in the hexose monophosphate shunt required for the production of reducing equivalents needed to mop up free radicals. thereby keeping hemoglobin in its free state. Deficiency of the enzyme can cause severe neonatal jaundice. The aim of this study was to compare G6PD levels in pre-term and term babies, and evaluate the extent to which G6PD deficiency determines the severity of jaundice in various gestational age groups. Samples of cord blood collected from consecutively delivered babies in the University of Ilorin Teaching Hospital, Nigeria, were assayed for G6PD levels, and the babies were observed for jaundice during the first week of life. Those who developed jaundice had serial serum bilirubin measured. Nine hundred and thirty-three babies had G6PD assayed, with 348 being G6PD deficient, giving a hospital based prevalence of 37.3%. Of the 644 who were followed up, 143 (22.2%) were pre-term and 501(77.8%) were term babies. Babies with gestational age (GA) 27-29 weeks had the highest G6PD levels. However, there was no significant variation among the different gestational age groups (F=0.64, P=0.64). Jaundice occurred more in pre-term compared to term babies with a relative risk of 2.41 (χ(2)=60.95, P=0.00001). Occurrence of jaundice in pre-term babies was irrespective of G6PD status (χ(2)=0.2, P=0.66, RR=1.09, CI=0.83<RR<1.43). There is an inverse relationship between gestational age and the occurrence of jaundice (R(2)=-0.874). Pre-term babies are more likely to have higher G6PD levels, but occurrence of jaundice in pre-term babies is irrespective of G6PD status. More severe jaundice (especially for gestational age) occurring in pre-term babies requires critical care.
葡萄糖-6-磷酸脱氢酶（G6PD）是磷酸戊糖途径中的一种酶，该途径可产生清除自由基所需的还原当量，从而使血红蛋白保持游离状态。该酶缺乏可导致严重的新生儿黄疸。本研究旨在比较早产儿和足月儿的G6PD水平，并评估G6PD缺乏在不同孕周组中对黄疸严重程度的影响程度。在尼日利亚伊洛林大学教学医院连续分娩的婴儿中采集脐带血样本，检测G6PD水平，并在出生后第一周观察婴儿是否出现黄疸。对出现黄疸的婴儿进行系列血清胆红素检测。共检测了933例婴儿的G6PD，其中348例G6PD缺乏，基于医院的患病率为37.3%。在随访的644例婴儿中，143例（22.2%）为早产儿，501例（77.8%）为足月儿。孕龄（GA）27 - 29周的婴儿G6PD水平最高。然而，不同孕周组之间无显著差异（F = 0.64，P = 0.64）。与足月儿相比，早产儿黄疸发生率更高，相对风险为2.41（χ(2)=60.95，P = 0.00001）。早产儿黄疸的发生与G6PD状态无关（χ(2)=0.2，P = 0.66，RR = 1.09，CI = 0.83 < RR < 1.43）。孕周与黄疸发生率呈负相关（R(2)= - 0.874）。早产儿更可能具有较高的G6PD水平，但早产儿黄疸的发生与G6PD状态无关。早产儿出现的更严重黄疸（尤其是对于孕周而言）需要重症监护。
