Unit NICU, Department of Pediatrics, UKMMC, 56000, Kuala Lumpur, Malaysia.
J Trop Pediatr. 2013 Aug;59(4):280-5. doi: 10.1093/tropej/fmt023. Epub 2013 May 2.
To investigate the risk factors associated with neonatal hyperbilirubinemia in Malaysian neonates.
A prospective study was conducted to investigate the effects of glucose-6-phosphate dehydrogenase (G6PD) mutation, variant uridine diphosphate glucuronosyltransferase UGT1A1 gene and hepatic organic anion transporter protein (OATP2) gene on a group of neonates. Hyperbilirubinemia was defined as a total serum bilirubin level of ≥250 µmol/l.
Of 318 neonates, 52 (16.4%) had hyperbilirubinemia. The incidence of G6PD mutation was 5.4% (15/280) among these infants. The incidence of G6PD mutation was significantly higher in the male neonates with hyperbilirubinemia (7.8%) when compared with the normal male neonates without hyperbilirubinemia (1.8%; p = 0.03). Logistic regression analysis showed that the significant risk factors for neonatal hyperbilirubinemia were Malay ethnicity [adjusted odds ratio (OR), 2.77; 95% confidence interval (CI): 1.31-5.86; p = 0.007] and G6PD mutation (adjusted OR, 3.29; 95% CI: 1.06-10.1820; p = 0.039). The gender, birth weight and gestation age of neonates, variant c.211G > A and variant of OATP2 gene were not significant.
Neonates with Malay ethnicity and G6PD mutation were at risk for hyperbilirubinemia.
探讨马来西亚新生儿高胆红素血症的相关危险因素。
前瞻性研究调查葡萄糖-6-磷酸脱氢酶（G6PD）突变、变异尿苷二磷酸葡萄糖醛酸基转移酶 UGT1A1 基因和肝有机阴离子转运蛋白（OATP2）基因对一组新生儿的影响。高胆红素血症定义为总血清胆红素水平≥250µmol/L。
在 318 名新生儿中，有 52 名（16.4%）患有高胆红素血症。这些婴儿中 G6PD 突变的发生率为 5.4%（15/280）。患有高胆红素血症的男性新生儿中 G6PD 突变的发生率明显高于无高胆红素血症的正常男性新生儿（7.8%比 1.8%；p=0.03）。Logistic 回归分析显示，新生儿高胆红素血症的显著危险因素为马来族裔[校正比值比（OR），2.77；95%置信区间（CI）：1.31-5.86；p=0.007]和 G6PD 突变（校正 OR，3.29；95%CI：1.06-10.1820；p=0.039）。新生儿的性别、出生体重和胎龄、c.211G > A 变异和 OATP2 基因变异均无显著意义。
马来族裔和 G6PD 突变的新生儿易发生高胆红素血症。
