IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 3 Ver.11 March. (2018), PP 01-03 www.iosrjournals.org DOI: 10.9790/0853-1703110103 www.iosrjournals.org 1 | Page A comparative study of peak total serum bilirubin level in glucose-6-phosphate dehydrogenase deficient and glucose-6- phosphate dehydrogenase normal neonates in neonatal hyperbilirubinemia Dr. Ashok Singh 1 , Dr. Mrinalini Das 2 1 (Junior Resident, Department of Pediatrics, GMCH,Guwahati, India) 2 (Associate Professor, Department of Pediatrics, GMCH, Guwahati, India) Abstract: Introduction: Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is an inherited deficiency that may cause neonatal jaundice, as has been found in several countries and different ethnic groups.G6PD is an enzyme essential for basic cellular functions including protection of red cell proteins from oxidative damage. G6PD deficiency is the most common red cell enzyme abnormality associated with hemolysis as well as with neonatal jaundice and also associated with kernicterus and even death. It is a genetically inherited sex-linked abnormality. Methods: The study was done on 994 clinically icteric babies without other risk factors for neonatal jaundice, admitted in Neonatal Intensive Care Unit of GMCH, Guwahati over a period of 1 year. Investigations included direct and indirect serum bilirubin levels, blood group of mother and baby, direct coomb’s test, haemoglobin, blood smear examination, reticulocyte count, and G6PD status. Data was collected and adequate intervention was done depending on indication. Data was analysed by software SPSS version 20. Results- In G6PD deficient neonates (146), mean peak TSB level was 23.96 ± 4.173 mg/dl whereas in G6PD normal neonates, it was 19.93 ± 3.848 mg/dl. The P-value calculated is < 0.0001 which is extremely significant. Conclusions: The prevalence of severe NHB with G6PD deficiency among neonates in North East region is relatively high and babies with G6PD deficiency have a higher chance of severe hyperbilirubinemia and developing complications like kernicterus and poor neurodevelopmental outcome. Therefore, screening of newborns for G6PD deficiency need to be done in all newborns, so that G6PD deficiency can be identified and adequate intervention can be done timely. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 03-03-2018 Date of acceptance: 23-03-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Glucose-6-Phosphate Dehydrogenase (G6PD) is an enzyme essential for basic cellular functions including protection of red cell proteins from oxidative damage. G6PD deficiency is the most common red cell enzyme abnormality associated with hemolysis as well as with neonatal jaundice and also associated with kernicterus and even death. Neonatal hyperbilirubinemia occurs in 2.5-6 % neonates in India. Neonatal hyperbilirubinemia has been attributed to isoimmune incompatibility, low birth weight, prematurity, abnormal parturition, G6PD deficiency, infection, liver diseases, drugs and maternal causes. (1) Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common erythro-enzymopathy (2) affecting 10% of the world population. It plays a protective role against malaria (3) .One third of children with G6PD deficiency develop neonatal jaundice which when severe and if untreated could give rise to kernicterus, a well known cause of death and neurodevelopmental handicap. (4) G6PD deficiency is present in all the tribal groups studied from North-East India. (5) In Assam, systematic neonatal or infantile screening is not yet implemented and thus, many parents are unaware of their children’s health status. Without knowing the risk, they are exposed to ingestion of food or drugs which can aggravate hemolysis. Considering these consequences, risk of bilirubin encephalopathy and in severe cases death, especially in a resource limited state like Assam, the study was taken up. Aim of the study-To compare the peak total serum bilirubin level in neonatal hyperbilirubinemia in G6PD deficient newborns and G6PD normal newborns admitted for neonatal jaundice in a tertiary care hospital in North-East India.