Cultural practices and the use of icterogenic agents in glucose 6 phosphate dehydrogenase deficient neonates: Any effect?

Abstract

Background: Cultural practices involving the use of certain agents known to cause haemolysis in Glucose-6-phosphate dehydrogenase (G6PD) deficient individuals are common during perinatal and neonatal periods. This study was targeted at identifying some of these agents and their role in the development of hyperbilirubinaemia in G6PD deficient neonates in our environment with a view at raising public awareness for an acceptable neonatal outcome.
Materials and methods: One hundred and fifty neonates admitted into the Special Care Baby Units (SCBUs) of the Jos University Teaching Hospital, Bingham University Teaching Hospital, and the Plateau State Specialist Hospital with neonatal jaundice were enrolled for this study. Information on age, sex, history of drugs, chemicals and herbs used during or after pregnancy were obtained using a questionnaire. Five millilitres of the blood sample was collected into anticoagulated and plain sample bottles for Full Blood Count (FBC), Reticulocyte Count, Serum Bilirubin (SB) and G6PD assay.
Results: Mean age at presentation was 3.28 ± 3.11 days. Mean haemoglobin concentration of the neonates was 15.90 ± 2.23 g/dL while mean reticulocyte count, total leukocyte and platelet count were 2.42 ± 0.71%, 7.10 ± 2.76 (x 109/L) and 228.45 ± 85.57 respectively. Sixty-one (40.7 %) of the studied neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb. Mean total serum bilirubin was 205.01 ± 96.57μmol/L. Icterogenic agent use was identified in 70 (46.7%) of the study subjects with naphthalene balls used in 19 (12.7%) study subjects.
Conclusion: Icterogenic agents are being used for neonatal care in our environment despite the consequences of hyperbilirubinaemia in those with G6PD deficiency.

Keywords: Glucose-6-phosphate dehydrogenase deficiency, Hyperbilirubinaemia, Icterogenic agents, Neonates