Risk factors associated with unconjugated neonatal hyperbilirubinemia in Malaysian neonates

J Trop Pediatr. 2013 Aug;59(4):280-5. doi: 10.1093/tropej/fmt023. Epub 2013 May 2.


Objective: To investigate the risk factors associated with neonatal hyperbilirubinemia in Malaysian neonates.

Methods: A prospective study was conducted to investigate the effects of glucose-6-phosphate dehydrogenase (G6PD) mutation, variant uridine diphosphate glucuronosyltransferase UGT1A1 gene and hepatic organic anion transporter protein (OATP2) gene on a group of neonates. Hyperbilirubinemia was defined as a total serum bilirubin level of ≥250 µmol/l.

Results: Of 318 neonates, 52 (16.4%) had hyperbilirubinemia. The incidence of G6PD mutation was 5.4% (15/280) among these infants. The incidence of G6PD mutation was significantly higher in the male neonates with hyperbilirubinemia (7.8%) when compared with the normal male neonates without hyperbilirubinemia (1.8%; p = 0.03). Logistic regression analysis showed that the significant risk factors for neonatal hyperbilirubinemia were Malay ethnicity [adjusted odds ratio (OR), 2.77; 95% confidence interval (CI): 1.31-5.86; p = 0.007] and G6PD mutation (adjusted OR, 3.29; 95% CI: 1.06-10.1820; p = 0.039). The gender, birth weight and gestation age of neonates, variant c.211G > A and variant of OATP2 gene were not significant.

Conclusions: Neonates with Malay ethnicity and G6PD mutation were at risk for hyperbilirubinemia.

Keywords: G6PD mutation; OATP2; UGT1A1 c.211G > A; neonatal hyperbilirubinemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian People / genetics*
  • Female
  • Genetic Variation
  • Genotype
  • Glucosephosphate Dehydrogenase / genetics*
  • Glucuronosyltransferase / genetics*
  • Humans
  • Hyperbilirubinemia, Neonatal / ethnology*
  • Hyperbilirubinemia, Neonatal / genetics
  • Incidence
  • Infant, Newborn
  • Malaysia / epidemiology
  • Male
  • Mutation
  • Organic Anion Transporters / genetics*
  • Polymorphism, Genetic
  • Prospective Studies
  • Regression Analysis
  • Risk Factors


  • Organic Anion Transporters
  • Glucosephosphate Dehydrogenase
  • UGT1A1 enzyme
  • Glucuronosyltransferase