This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kaplan, M.
Right arrow Articles by Brisk, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kaplan, M.
Right arrow Articles by Brisk, R.
Related Collections
Right arrow Gastrointestinal Tract

PEDIATRICS Vol. 105 No. 3 March 2000, pp. 533-537

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

Received May 7, 1999; accepted Aug 13, 1999.

Michael Kaplan*, Dagger , Cathy Hammerman*, Dagger , Roselyn Feldman*, and Rachel Brisk§

From the * Department of Neonatology, and the § Clinical Biochemistry Laboratory, Shaare Zedek Medical Center; and the Dagger  Faculty of Medicine of the Hebrew University, Jerusalem, Israel.

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 <50th percentile for age, the incidence of hyperbilirubinemia was low in the G-6-PD-deficient neonates, with no measurable incidence in the controls. The incidence of hyperbilirubinemia became clinically consequential, and significantly higher in the G-6-PD-deficient groups, when the percentiles were >= 50: for those in the 50% to 74% range the incidence was moderate (23%) for the G-6-PD-deficient and small (7%) for the control infants (relative risk, 3.29; 95% confidence interval, 1.01-10.67). Among those infants >= 75th percentile, 82% of the G-6-PD-deficient infants, compared with 25% of the control infants, were either already hyperbilirubinemic at the time of screening or subsequently developed hyperbilirubinemia (relative risk, 3.23; 95% confidence interval, 1.99-5.24).

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.  Key words:  bilirubin, neonatal jaundice, glucose-6-phosphate dehydrogenase deficiency, screening test.




This article has been cited by other articles:


Home page
 PediatricsHome page
R. Keren, X. Luan, S. Friedman, S. Saddlemire, A. Cnaan, and V. K. Bhutani
A Comparison of Alternative Risk-Assessment Strategies for Predicting Significant Neonatal Hyperbilirubinemia in Term and Near-Term Infants
Pediatrics, January 1, 2008; 121(1): e170 - e179.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
D Turner, C Hammerman, B Rudensky, Y Schlesinger, C Goia, and M S Schimmel
Procalcitonin in preterm infants during the first few days of life: introducing an age related nomogram
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2006; 91(4): F283 - F286.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. J. Maisels and E. Kring
Transcutaneous Bilirubin Levels in the First 96 Hours in a Normal Newborn Population of >=35 Weeks' Gestation
Pediatrics, April 1, 2006; 117(4): 1169 - 1173.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
T. B. Newman, P. Liljestrand, and G. J. Escobar
Combining Clinical Risk Factors With Serum Bilirubin Levels to Predict Hyperbilirubinemia in Newborns
Arch Pediatr Adolesc Med, February 1, 2005; 159(2): 113 - 119.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. J. Maisels
Conflict of Interest and Purpose in Bilirubin Screening: In Reply
Pediatrics, October 1, 2004; 114(4): 1133 - 1134.
[Full Text] [PDF]

Home page
 PediatricsHome page
Subcommittee on Hyperbilirubinemia
Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
Pediatrics, July 1, 2004; 114(1): 297 - 316.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. J. Maisels, E. M. Ostrea Jr, S. Touch, S. E. Clune, E. Cepeda, E. Kring, K. Gracey, C. Jackson, D. Talbot, and R. Huang
Evaluation of a New Transcutaneous Bilirubinometer
Pediatrics, June 1, 2004; 113(6): 1628 - 1635.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. Kaplan, C. Hammerman, and S. U. Sarici
Familial Hyperbilirubinemia in ABO-Incompatible Neonates
Pediatrics, December 1, 2003; 112(6): 1453 - 1454.
[Full Text] [PDF]

Home page
 PediatricsHome page
M. Kaplan, N. Algur, and C. Hammerman
Onset of Jaundice in Glucose-6-Phosphate Dehydrogenase-Deficient Neonates
Pediatrics, October 1, 2001; 108(4): 956 - 959.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. K. Stevenson, A. A. Fanaroff, M. J. Maisels, B. W. Y. Young, R. J. Wong, H. J. Vreman, J. R. MacMahon, C. Y. Yeung, D. S. Seidman, R. Gale, et al.
Prediction of Hyperbilirubinemia in Near-Term and Term Infants
Pediatrics, July 1, 2001; 108(1): 31 - 39.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. Kaplan and C. Hammerman
Glucose-6-Phosphate Dehydrogenase-Deficient Neonates: A Potential Cause for Concern in North America
Pediatrics, December 1, 2000; 106(6): 1478 - 1479.
[Full Text]