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Glucose-6-Phosphate Dehydrogenase Screening in Israel-Arab and Palestinian-Arab Neonates
Rawan Abu Omar1, Nurit Algur2, Orli Megged3
1Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel.
Insights
Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency occurs in 3.5% of Arab newborns, increasing jaundice risk and phototherapy need. Neonatal G-6-PD screening is now routine for this population.
Area of Science:
- Neonatal Medicine
- Clinical Genetics
- Public Health
Background:
- Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is an inherited condition affecting red blood cells.
- Jaundice is common in newborns, but G-6-PD deficiency can exacerbate its severity and complications.
- Screening for G-6-PD deficiency is recommended in populations with a high prevalence.
Purpose of the Study:
- To determine the frequency of G-6-PD deficiency in Arab newborns in Jerusalem.
- To assess the incidence of clinically significant jaundice and phototherapy requirements in this population.
- To evaluate the need for G-6-PD screening in this specific ethnic group.
Main Methods:
- Umbilical cord blood was tested for G-6-PD enzyme activity in 286 male newborns.
- G-6-PD deficiency was defined as enzyme levels below 7.0 U/gHb.
- Transcutaneous bilirubin monitoring was performed daily, with serum bilirubin tests for elevated levels.
Main Results:
- The prevalence of G-6-PD deficiency was 3.5% (10 out of 286 newborns).
- Newborns with G-6-PD deficiency had a 3.45 times higher risk of clinically significant jaundice.
- Thirty percent of G-6-PD deficient newborns required phototherapy based on established guidelines.
Conclusions:
- The prevalence of G-6-PD deficiency in this Arab neonatal population meets WHO screening criteria (3-5%).
- Clinically significant jaundice is more common in G-6-PD deficient newborns compared to controls.
- Routine neonatal G-6-PD screening and parental education have been implemented at the medical center.
Objective:
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.
Study Design:
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.
Results:
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.
Conclusion:
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.
