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Assessment of G6PD screening program in premature infants in a NICU
1Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR, USA.
Insights
The fluorescent spot test (FST) is appropriate for screening glucose-6-phosphate dehydrogenase deficiency (G6PDdef) in newborns. However, some at-risk premature male infants were not screened.
Area of Science:
- Neonatal Medicine
- Clinical Diagnostics
- Genetics
Background:
- Glucose-6-phosphate dehydrogenase deficiency (G6PDdef) screening is crucial in newborns.
- Premature infants may have higher G6PD levels, potentially affecting test accuracy.
- The fluorescent spot test (FST) is a common screening method.
Purpose of the Study:
- To evaluate the appropriateness of FST for diagnosing G6PDdef in premature infants (<35 weeks gestation).
- To assess the effectiveness of G6PDdef screening in the Neonatal Intensive Care Unit (NICU).
Main Methods:
- Retrospective chart review of male, inborn infants (<35 weeks) admitted to the NICU between 2008-2011.
- Comparison of G6PDdef incidence between the NICU and newborn nursery (NN) using binomial testing.
- Equivalence defined as <5% difference in G6PDdef incidence between NN and NICU.
Main Results:
- Out of 679 infants, 442 were screened, with an 11.3% incidence of G6PDdef.
- No significant difference in G6PDdef incidence was found between the NICU (11.3%) and the NN (11%).
- A notable proportion (12.2%) of Black/African American males did not undergo screening.
Conclusions:
- The FST is deemed appropriate for screening all at-risk newborns for G6PDdef.
- Gaps in screening were identified, with several at-risk premature male infants not being tested.
- Further efforts are needed to ensure comprehensive screening in vulnerable neonatal populations.
Objective:
Targeted screening for glucose-6-phosphate dehydrogenase deficiency (G6PDdef) using fluorescent spot test (FST) is done in our newborn nursery (NN) and now in our NICU. Premature infants have higher G6PD levels than term infants. FST may result in under diagnosis of G6PDdef in preterms. We sought to determine if FST is appropriate for diagnosis of G6PDdef at<35 weeks and assess screening in NICU.
Study Design:
Retrospective chart review of male, inborn infants<35 weeks in NICU from 2008 to 2011. Difference in G6PDdef incidence<5% between NN and NICU was acceptable for equivalence.
Results:
Out of 679 subjects, 442 were screened for G6PDdef and 11.3% had abnormal results. Binomial testing comparing 11.3% (95% confidence interval (CI) 8.5 to 14.6) incidence of G6PDdef in NICU and reported incidence in NN (11%) demonstrated no difference. 12.2% of Black/African American males were not screened.
Conclusion:
FST is appropriate for screening all at-risk newborns. A number of at-risk premature males were not screened.
