Glucose-6-phosphate Dehydrogenase Deficiency and Severity of Neonatal jaundice: a Prospective Study from Port Harcourt.

Abstract

Abstract  Background: Port Haercourt, capital of Rivers state of Nigeria, is the genere of an oil  exploration industry, babies born in the environment could stand the risk exposure deterogenic agents.Infants who are Glucose-6-phosphate Dehydrogenase(GAPD)  defiencient may develop  jaundice when exposed to these noxious substances. The aim of this study was to determine the severity of Jaundice among GSPD deficient neonates at the University of Port-Harcourt Teaching Hospital, Port-Harcourt (UPTIT.

Methods: A prospective study of 400 jaundiced neonates admitted into the Special Care Baby Unit (SCBU) of the UTTH from June 1 to  December 31, 2006, was carried out. Physical examination of all the babies admitted, with special reference to jaundice, was done. A  structured questionnaire was used to collect data on mother and neonate; such data included sociodemogrphics, exposure no icerogenic substances, history of peripurture pyrexia, prolonged rapture of foetal membrane, agent poser of jaundice, history of seizure, mode of  treatment of jaundice and outcome. Two mils of venous blood withdrawn from each neonate was put in an  EDTA Bottle and immediately sent to the laboratory for quantitative GSPD  enzyme assay based  on the method of Kumbery. Servia bilicubin  level was estimated using the Van Berghdiaza reaction. Data were arranged in frequency tables and discrete variables were compared  using Chi-square statistic, while continuous variables were corrpared using the student t test, in all instances, a p value of less than CCS was regarded as statisisticaly significant.

Results: Out of the 400 jaundiced neonates, 215 (52.5 percent) were G6PD deficient, while 190 (7.5 percent) had normal G6PD activity. There were 145 (69. 0 percent) G6PD deficient males and 55 (31.0 percent) females. One hundred and Thirty-five (64.3 percent) of the G6PD deficient neonates were severely jaundiced (10% males and 29 feriales). A greater proportion of those with severe jaundice were 120 (X = 14.45; dE; - 0.0013). Eighty four (43.0 percent) of the G6PD defiicient neonates were exposed to icterogenic substances. Sixty eight (81.0 percent) of those  so exposed were severely jaundiced, while the jaundice wasn ot severe in 19 (19.0 percent). That association between exposure to icterogenic substances and severity of jaundice was statistically significant (X- 15.75: - 1;p-0.000727). Clinical features  of keruuser us were found in seven (1.2 percent) of the deficient neonates  while 15 (17.1 percent) died.

Conclusion: G6PD deficiency is commonly associated with severe neonatal jaundice, the severity of which is infuenced by gender and exposure to clerogenic substances. It is recommended that any neonates presenting with jaundice should be screen for G6PD states not only to define the actiology at hypetalubinscmia but also to prevent future bacurolytic episexles.

Keywords: Glucose-6-phosphate Dehydrogenase Deficiency,severe jaundice, neonate