Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel.
Clinical Biochemistry Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.
J Pediatr. 2015 Jul;167(1):169-72. doi: 10.1016/j.jpeds.2015.04.039. Epub 2015 Jun 5.
To evaluate the frequency of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, the incidence of clinically significant jaundice (any serum total bilirubin value >75th percentile on the hour-specific bilirubin nomogram), and the need for phototherapy in the pooled male Israeli-Arab and Palestinian-Arab population born at the Shaare Zedek Medical Center in Jerusalem, Israel.
Quantitative G-6-PD enzyme testing of umbilical cord blood was performed during birth hospitalization. G-6-PD deficiency was defined as any G-6-PD value <7.0 U/gHb. Transcutaneous bilirubin was performed daily during birth hospitalization, with serum total bilirubin testing in those with a transcutaneous bilirubin value >75th percentile.
Ten of 286 (3.5%) consecutively delivered male Arab newborns had G-6-PD deficiency. Clinically significant jaundice was higher in the population with G-6-PD deficiency compared with normal controls (relative risk, 3.45; 95% CI, 1.24-9.58). Thirty percent of the newborns with G-6-PD deficiency met American Academy of Pediatrics indications for phototherapy according to the high-risk (middle) curve on the phototherapy graph.
The frequency of G-6-PD deficiency in the Arab neonatal population delivering at this medical center meets World Health Organization criteria for neonatal G-6-PD screening (3%-5%). As in other ethnic groups, clinically significant jaundice is more frequent in newborns of this ethnic group with G-6-PD deficiency compared with G-6-PD-normal controls. Neonatal G-6-PD screening for both males and females of this population subgroup, in conjunction with parental education regarding the dangers of the condition and its prophylaxis, has now been incorporated into our institution's routine G-6-PD screening program.
评估葡萄糖-6-磷酸脱氢酶(G-6-PD)缺乏症的频率、临床显著黄疸(小时特异性胆红素列线图第 75 百分位以上的任何血清总胆红素值)的发生率以及在出生于以色列耶路撒冷 Shaare Zedek 医疗中心的以色列阿拉伯裔和巴勒斯坦阿拉伯裔男性群体中进行光疗的需求。
在出生住院期间对脐带血进行定量 G-6-PD 酶检测。G-6-PD 缺乏症定义为任何 G-6-PD 值<7.0 U/gHb。在出生住院期间每天进行经皮胆红素检测,对于经皮胆红素值>75 百分位的患者进行血清总胆红素检测。
286 例连续分娩的男性阿拉伯新生儿中有 10 例(3.5%)存在 G-6-PD 缺乏症。与正常对照组相比,G-6-PD 缺乏症人群的临床显著黄疸发生率更高(相对风险,3.45;95%CI,1.24-9.58)。根据光疗图高风险(中)曲线,G-6-PD 缺乏症新生儿中有 30%符合美国儿科学会光疗指征。
该医疗中心阿拉伯新生儿人群的 G-6-PD 缺乏频率符合世界卫生组织新生儿 G-6-PD 筛查标准(3%-5%)。与其他种族群体一样,该种族群体中 G-6-PD 缺乏症新生儿的临床显著黄疸更为常见,与 G-6-PD 正常对照组相比。该人群亚组的男婴和女婴均进行新生儿 G-6-PD 筛查,并对父母进行有关该疾病的危险及其预防的教育,现已纳入我们机构的常规 G-6-PD 筛查计划。