Neonatal hyperbilirubinemia in African American males: the importance of glucose-6-phosphate dehydrogenase deficiency.
OBJECTIVE
To perform risk factor analysis for the prediction of hyperbilirubinemia in an African American male neonatal cohort.


METHODS
A database of 500 previously published term and near-term African American male neonates was further analyzed to determine the role of risk factors for hyperbilirubinemia. Factors studied included birth weight >/=4.0 kg, gestational age </=37 weeks, breast-feeding, glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, and predischarge bilirubin >/=75(th) percentile. Hyperbilirubinemia was defined as any bilirubin value >/=95(th) percentile on the hour-of-life-specific bilirubin nomogram.


RESULTS
Forty-three (8.6%) neonates developed hyperbilirubinemia. At 48 +/- 12 hours, median transcutaneous bilirubin was 8.3 mg/dL, 75(th) percentile 10.0 mg/dL, and 95(th) percentile 12.6 mg/dL. Of the risk factors, only exclusive breast-feeding, G-6-PD deficiency and predischarge bilirubin >/=75(th) percentile were significant (Adjusted Odds Ratios [95% Confidence Intervals; CI] 3.15 [1.39-7.14], P = .006; 4.96 [2.28-10.80], P = .001; and 7.47 [3.50-15.94], P < .0001, respectively). G-6-PD-deficient neonates who were also premature and breast-feeding had the highest incidence of hyperbilirubinemia (60%).


CONCLUSIONS
African American male neonates may be at higher risk for hyperbilirubinemia than previously thought. Screening for G-6-PD deficiency and predischarge bilirubin determination may be useful adjuncts in hyperbilirubinemia prediction in these newborns.
Kaplan
Michael
M
Shaare Zedek Medical Center, Faculty of Medicine of the Hebrew University, Jerusalem, Israel. kaplan@cc.huji.ac.il
Herschel
Marguerite
M
Hammerman
Cathy
C
Hoyer
James D
JD
Heller
Gillian Z
GZ
Stevenson
David K
DK
D001663:Bilirubin / Q000097:blood; D044383:Black People; D001942:Breast Feeding; D015331:Cohort Studies; D019992:Databases as Topic; D005953:Glycogen Storage Disease Type I / Q000150:complications*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000208:ethnology / Q000209:etiology*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D008297:Male; D012307:Risk Factors; D001741:Black or African American
D001663:Bilirubin