Predischarge Bilirubin Screening in Glucose-6-Phosphate Dehydrogenase-Deficient Neonates

Abstract

Objective. To assess the validity of predischarge serum bilirubin values in determining or predicting hyperbilirubinemia in glucose-6-phosphate dehydrogenase (G-6-PD)-deficient neonates, and to facilitate appropriate discharge planning. Methods. Serum total bilirubin values were determined between 44 and 72 hours of life in a cohort of term, healthy neonates at high-risk for G-6-PD deficiency but with no other risk factors for hyperbilirubinemia. Percentile-based bilirubin nomograms were constructed for G-6-PD-deficient infants and normal infants according to age at sampling. The incidence of hyperbilirubinemia (serum bilirubin value ≥256 μmol/L [15 mg/dL]) for each group was determined according to the percentiles for that group. Results. In both G-6-PD-deficient neonates (n = 108) and control neonates (n = 215) with serum bilirubin values Conclusions. Timed, predischarge serum bilirubin screening can be used to identify G-6-PD-deficient neonates at low, intermediate, or high-risk of developing severe neonatal hyperbilirubinemia, and thus offer a selective approach to the discharge and follow-up surveillance of these infants.