G6PD-deficient Infants Research Articles

VITAMIN E PROPHYLAXIS IN NEONATAL PHYSIOLOGIC AND G6PD DEFICIENCY HYPERBILIRUBINEMIA

To study the efficacy of parenteral vitamin E in minimizing neonatal hyperbilirubinemia in both G6PD deficient and normal term infants, a prospective controlled study was performed. Parenteral vitamin E, 20 units/Kg/day for 4 days, was administered from birth. No significant difference in gestational age, nor birth weight between Group A (G6PD-Rx), Group B (G6PD-no Rx), Group C (Normal-Rx) nor Group D (Normal-No Rx) were noted. Mean peak bilirubin was:Similarly the percentage of infants requiring phototherapy or exchange transfusion did not differ significantly. No complications from vitamin E therapy were noted.Thus parenteral prophylactic vitamin E was not efficacious in minimizing either neonatal physiologic hyperbilirubinemia or neonatal jaundice associated with G6PD deficiency in Israeli subjects. Noteworthy also is the lack of excessive hyperbilirubinemia in G6PD deficient compared to normal subjects in this study population.

Glucose-6-phosphate dehydrogenase status and neonatal jaundice.

Neonatal jaundice and its relationship to glucose-6-phosphate dehydrogenase (G6PD) status of healthy, term Chinese infants was evaluated in 220 G6PD-deficient infants, 26 intermediate infants who were observed for 3 weeks, and 116 normal (control) infants. Each infant was free of isoimmunisation, cephalhaematomas, or contusions. The mode of labour, method of delivery, and type of feeds had no appreciable effect on daily bilirubin levels. "Elevated" physiological jaundice was associated with normal and G6PD-deficient status; there was no increased haemolysis. G6PD-deficient status was associated with jaundice significantly raised especially in the first week of life, and prolonged beyond that of the "elevated" physiological jaundice. Significantly increased though mild haemolysis was observed. Close surveillance is therefore required for G6PD-deficient infants at least for the first week of life, the period of increased risk. With G6PD-intermediate infants, only the usual measures for normal infants are required.

Phototherapy for Neonatal Jaundice in Erythrocyte Glucose-6-Phosphate Dehydrogenase-Deficient Infants

The effectiveness of phototherapy in the management of neonatal hyperbilirubinemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient infants was studied. "Prophylactic" phototherapy for six continuous days commencing from the first day of life was effective in preventing a significant rise in bilirubin levels in 12 G6PD-deficient infants in the first three days, during which period a rapid rise was observed in a control group of G6PD-deficient infants. The hemoglobin levels on the first and eighth postnatal days were comparable in both groups. "Therapeutic" phototherapy proved equally effective in reducing bilirubin levels in 24 infants with nonhemolytic hyperbilirubinemia and an equal number of infants with hyperbilirubinemia associated with G6PD deficiency. Phototherapy was efficacious in the prevention or treatment of neonatal hyperbilirubinemia associated with G6PD deficiency; even if its use is prolonged it does not cause hemolysis in such infants.