Xu JX, Lin F, Wu YH, Chen ZK, Ma YB, Yang LY. Etiology analysis for term newborns with severe hyperbilirubinemia in eastern Guangdong of China. World J Clin Cases 2023; 11(11): 2443-2451 [PMID: 37123300 DOI: 10.12998/wjcc.v11.i11.2443]
Corresponding Author of This Article
Li-Ye Yang, MD, PhD, Chief Doctor, Precision Medical Lab Center, People’s Hospital of Yangjiang, No. 42 Dongshan Road, Jiangcheng District, Yangjiang 529500, Guangdong Province, China. yangleeyee@sina.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Observational Study
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Xu JX, Lin F, Wu YH, Chen ZK, Ma YB, Yang LY. Etiology analysis for term newborns with severe hyperbilirubinemia in eastern Guangdong of China. World J Clin Cases 2023; 11(11): 2443-2451 [PMID: 37123300 DOI: 10.12998/wjcc.v11.i11.2443]
Jia-Xin Xu, Fen Lin, Yong-Hao Wu, Precision Medical Center, Chaozhou Central Hospital, Chaozhou 521021, Guangdong Province, China
Zi-Kai Chen, School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou 521021, Guangdong Province, China
Yu-Bin Ma, Department of Pediatrics, Chaozhou Central Hospital, Chaozhou 521021, Guangdong Province, China
Li-Ye Yang, Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang 529500, Guangdong Province, China
Author contributions: Yang LY conceptualized and designed the study, coordinated and supervised data collection, and reviewed and revised the manuscript; Xu JX analyzed the data, drafted the initial manuscript, and revised the manuscript; Lin F collected the data, did the molecular analysis, and carried out the initial analysis; Chen ZK revised the manuscript; Wu YH and Ma YB participated in the sample and data collection and Wu YH performed the molecular analysis. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Supported bythe Natural Science Foundation of Guangdong Province, No. 2016A030307035; Special Research Plan 2019 of Chaozhou, No. 2020xg01; and High-Level Development Plan of People’s Hospital of Yangjiang, No. G2020007.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Chaozhou Central Hospital (No. 2015001).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The manuscript was prepared and revised according to the STROBE statement.
Corresponding author: Li-Ye Yang, MD, PhD, Chief Doctor, Precision Medical Lab Center, People’s Hospital of Yangjiang, No. 42 Dongshan Road, Jiangcheng District, Yangjiang 529500, Guangdong Province, China. yangleeyee@sina.com
Received: November 23, 2022 Peer-review started: November 23, 2022 First decision: February 2, 2023 Revised: February 9, 2023 Accepted: March 15, 2023 Article in press: March 15, 2023 Published online: April 16, 2023 Processing time: 134 Days and 2.3 Hours
ARTICLE HIGHLIGHTS
Research background
Neonatal hyperbilirubinemia is one of the common diseases of newborns, the pathogenic factors of neonatal hyperbilirubinemia in eastern Guangdong is not clear.
Research motivation
To understand the etiology for severe neonatal hyperbilirubinemia in Chaozhou.
Research objectives
To analyze the pathological factors contributing to severe hyperbilirubinemia in neonates.
Research methods
The clinical data were retrospectively collected and genetic variants of glucose-6-phosphate dehydrogenase (G6PD) and UGT1A1 were determined by polymerase chain reaction and sequencing.
Research results
Among the causes of severe hyperbilirubinemia, neonatal hemolysis accounted for 15.17%, breast milk jaundice accounted for 12.09%, infection accounted for 10.17%, G6PD deficiency accounted for 9.14%, and the coexistence of multiple etiologies accounted for 6.55%, unknown etiology accounted for 41.72%. ABO hemolysis and G6PD deficiency were the most common causes in the 20 cases with bilirubin encephalopathy. 94 severe hyperbilirubinemia newborns were tested for UGT1A1*6 variant (rs4148323, c.211G>A, p.Arg71Gly), 9 cases were 211 G to A homozygous variant, 37 cases were 211 G to A heterozygous variant, and 48 cases were wild genotypes.
Research conclusions
The main causes for severe hyperbilirubinemia and bilirubin encephalopathy in eastern Guangdong of China were the hemolytic disease of the newborns, G6PD deficiency and infection. UGT1A1 gene variant was also a high-risk factor for neonatal hyperbilirubinemia.
Research perspectives
Multiple genetic variants may regulate the bilirubin levels in neonate, these gene analysis may contribute to the prognosis and management for neonatal jaundice.
