Evaluation of neonatal indirect hyperbilirubinaemia at Zanjan Province of Iran in 2001-2003: prevalence of glucose-6-phosphate dehydrogenase deficiency.

INTRODUCTION Neonatal hyperbilirubinaemia, defined as a total serum bilirubin level above 5 mg/dL, is a frequent problem. This condition accounts for up to 75 percent of hospital readmissions in the first week of life. The purpose of this study was to evaluate the aetiology of indirect hyperbilirubinaemia and the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in newborns who were admitted to Vali-e-Asr Hospital in Zanjan City during the period 2001-2003. METHODS Medical records of 376 newborns who had been admitted for management of indirect hyperbilirubinaemia were reviewed. All necessary information, including the results of G6PD activity test (expressed as unit per gramme haemoglobin), were recorded on standardised questionnaires. RESULTS The subject group included 159 (42.3 percent) boys and 217 (57.7 percent) girls. The prevalence of sepsis, ABO incompatibility, Rhesus incompatibility, and cephalhaematoma, G6PD deficiency was 15.7 percent (59 neonates), 3.7 percent (14 neonates), 2.1 percent (eight neonates), 0.5 percent (two neonates), and 2.1 percent (eight neonates), respectively. The median (interquartile range) of the highest total bilirubin level was 18 (15.8-20) mg/dL and 18.4 (16.3-19.5) mg/dL in normal G6PD and G6PD-deficient newborns, respectively (p-value equals 0.7). CONCLUSION We recommend performing G6PD testing in all Iranian and Mediterranean newborns with indirect hyperbilirubinaemia, unless other investigators ascertain and document that this is unnecessary as a routine test.