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Quantitative Assay of Glucose-6-Phosphate Dehydrogenase in Normal Non-Icteric Early Neonates: A Hospital-Based Study

Introduction: Glucose -6- phosphate dehydrogenase (G6PD) a housekeeping enzyme found in the mitochondria of all cells of the body plays a crucial role in preventing cells from oxidative damage by reactive oxygen species (ROS). As Red Blood Cell (RBC) lacks a sub-cellular structure like mitochondria, it is most vulnerable due to the lack of G6PD enzyme resulting in mild hemolytic jaundice to fetal death. The Prevalence of neonatal jaundice is most common but due to  lack of newborn screening for the G6PD test, neonates are misdiagnosed and the whole treatment becomes worthless. The main aim of this study was to evaluate the level of G6PD in normal early neonates.
Methods: This was a cross-sectional study conducted on 43 normal early neonates of the Indian sub-population from January to June 2019 at the Laboratory Department, Padmashree institute of clinical research, Bangalore, India. Blood parameters like G6PD levels, direct and total bilirubin, and hemoglobin levels of the normal neonates were measured. This study was approved by the ethical board of the hospital.
Results: The bilirubin level (direct and total), and hemoglobin level were found within the established normal reference interval. The observed G6PD levels in normal healthy full-term neonates against the available various reference intervals were established. In this study the cut-off value of G6PD enzyme activity was determined as 8.05 ± 1.2 U/g Hb and this in-house obtained reference interval level was significantly (*p< 0.05) lower than that of other reference intervals such as Kit insert Ref. Interval (9.55 ± 4.6 U/g Hb) and Ref. interval (12.5 ± 2.3 U/g Hb) as inferred by other studies.
Conclusions: In conclusion, we found evidence for a newly established reference interval for normal neonates between the ages of 1 to 11 days and the reference value is remarkably lower than the available reference interval. 