Hematological and Biochemical Markers in Glucose 6 Phosphatase Dehydrogenase (G6PD) Deficient Neonates

Abstract

Objectives: This study aimed to analyze the association of hematological and biochemical markers with G6PD deficiency in neonates

Methodology: This comparative cross sectional study was conducted at The CITI Lab Rawalpindi from January 2024 to June 2025.  After obtaining patient history we evaluated 127 patients. Laboratory analysis included complete blood count (CBC) and reticulocyte count using a Beckman Coulter Unicel DXH 800 analyzer, bilirubin estimation (total bilirubin, direct bilirubin and indirect bilirubin) and G6PD enzyme estimation was done using Cobas C311 Roche analyzer.

Results: 127 cases were analyzed and out of these12 neonates were G6PD deficient (9.4%).  2 (3.2%) out of 62 non hyperbilirubinemia neonates (control group) and 10(15.4%) out of 65 hyperbilirubinemic neonates (study group) were deficient. The peak bilirubin level in G6PD deficient group was (21.2 mg/dl) higher than that of the normal G6PD group (10.72 mg/dl). The average age of neonates was 6.93 days. 87 of the 127 neonates were male (68.5%) and the male to female ratio was 2.2:1. No significant difference was found between Hemoglobin (Hb), Mean corpuscular volume (MCV), Mean Corpuscular hemoglobin (MCH), Mean corpuscular hemoglobin concentration (MCHC) and Red blood cells (RBCs) in both the groups.

Conclusion: G6PD deficiency was seen in 9.4% neonates. The incidence of G6PD deficiency was higher in the study group as compared to the control group. G6PD deficiency prevalence was higher in males. G6PD deficiency was not associated with hemolysis in our study suggesting other mechanisms of hyperbilirubinemia exist in these neonates. Cut off value of indirect bilirubin of 17.5 mg/dl was suggested above which all the neonates should be screened for G6PD deficiency.

Keywords: Glucose 6 phosphate dehydrogenase (G6PD), Enzymopathy, Hyperbilirubinemia, Neonatal jaundice, Newborn screening.