Hyperbilirubinemia in African American neonates: clinical issues and current challenges.
African American neonates evidence a low incidence of hyperbilirubinemia yet account for more than 25% of the reported kernicterus cases in the USA. Glucose-6-phosphate dehydrogenase (G6PD) deficiency accounts for approximately 60%, and late preterm gestation and ABO hemolytic disease approximately 40% of these cases. Females heterozygous for G6PD A- harbor a population of G6PD-deficient red blood cells and are at risk for hyperbilirubinemia. Pre-discharge bilirubin measurement coupled with gestational age enhances the identification of neonates at hyperbilirubinemia risk. Parental education at the time of birth hospitalization discharge combined with timely follow-up may help to reduce the risk of developing hazardous hyperbilirubinemia.
Watchko
Jon F
JF
Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA. jwatchko@mail.magee.edu
D000328:Adult; D001741:Black or African American; D001663:Bilirubin / Q000097:blood; D005260:Female; D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000201:enzymology / Q000208:ethnology*; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy
D005954:Glucosephosphate Dehydrogenase; C482910:glucose-6-phosphate dehydrogenase A-; D001663:Bilirubin