The effect of the delivery mode on the total antioxidant activity, oxidative stress, and serum bilirubin level in G6PD-deficient male newborn infants

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common condition worldwide that significantly increases the risk of neonatal hyperbilirubinemia and bilirubin encephalopathy. While some G6PD-deficient neonates exhibit hemolysis triggered by known oxidative exposures, such triggers are absent in the majority of cases. Labor is associated with pain, fear, anxiety, and fetal hypoxia, all of which induce the production of free radicals. This study aimed to evaluate the effects of delivery mode on oxidative stress and antioxidant capacity, as well as its presumptive impact on serum bilirubin levels in G6PD-deficient newborns. This study evaluated the impact of delivery mode on total antioxidant capacity (TAC), oxidative stress, and serum bilirubin levels in G6PD-deficient male newborn infants. All male G6PD-deficient newborns with APGAR scores of 8 or greater at 1 and 5 min post-birth were enrolled. Transcutaneous bilirubin levels were monitored daily using a BiliChek device up to the sixth day of life. Umbilical cord blood samples were analyzed for malondialdehyde (MDA) and TAC using commercial ZellBio GmbH kits (Germany). Among 923 screened male neonates, 66 (7.15%) were G6PD-deficient. Cord blood MDA and TAC levels did not differ significantly between the vaginal delivery (VD) and cesarean delivery (CD) groups ( P = 0.545 and P = 0.591, respectively). Serial bilirubin measurements also revealed no significant difference between the two groups ( P = 0.254), although bilirubin levels increased significantly over time in both groups ( P < 0.001). Phototherapy was required in 45.45% of the neonates, with no significant difference between the delivery modes ( P = 0.138). This study demonstrates that the delivery mode does not significantly influence oxidative stress, total antioxidant capacity, hemoglobin levels, or serial serum bilirubin levels in G6PD-deficient neonates. Consequently, the route of delivery does not appear to modulate the risk or severity of neonatal hyperbilirubinemia in this population.