Effects of different birth seasons on screening thresholds for neonatal glucose-6-phosphate dehydrogenase deficiency in Shanghai and its distribution characteristics
10.3760/cma.j.cn101070-20240425-00256
- VernacularTitle:不同出生季节对上海市新生儿葡萄糖-6-磷酸脱氢酶缺乏症筛查临界值的影响及其分布特征
- Author:
Jing GUO
1
;
Guoli TIAN
;
Zhixing ZHU
;
Zhuo ZHOU
;
Wei JI
;
Xiaofen ZHANG
;
Yanmin WANG
Author Information
1. 上海市儿童医院，上海交通大学医学院附属儿童医院新生儿筛查中心，上海 200040
- Publication Type:Journal Article
- Keywords:
Glucose-6-phosphate dehydrogenase deficiency;
Indirect method;
Cut-off value;
Neonatal screening;
Birth season
- From:
Chinese Journal of Applied Clinical Pediatrics
2025;40(1):39-43
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the differences in screening neonatal glucose-6-phosphate dehydrogenase (G6PD) deficiency in different birth seasons, establish screening thresholds for G6PD concentration in each season using indirect methods, and verify the reliability of the results.Methods:This was a cross-sectional study.A total of 140 823 newborns were collected from the Neonatal Screening Center of Shanghai Children′s Hospital from January 2020 to December 2023, including 41 029 cases, 35 796 cases, 33 969 cases and 30 029 cases in spring, summer, autumn and winter groups, respectively.The concentration of G6PD on the dried blood filter paper was determined using an automatic fluorescence analyzer.The distribution and statistical index of concentration values in four seasons were analyzed.The Kolmogorov-Smirnov test was used for normal distribution.The skewed distribution data was converted into approximately normal distribution using Box-Cox.Outliers were eliminated using the interquartile range (Turkey) method.The cumulative frequency distribution map was drawn through R language programming.The linear regression equation Y=B X+ A was fitted.The 0.5th percentile ( P0.5) was used as the screening threshold, which was compared with the reference value given by the manufacturer or laboratory and with the reference change value (RCV). Results:In the spring group, the positive rate was 4.02‰, 91 cases were confirmed, and the incidence was 1∶451.In the summer group, the positive rate was 7.18‰, 90 cases were confirmed, and the incidence was 1∶398.In the autumn group, the positive rate was 3.21‰, 86 cases were confirmed, and the incidence was 1∶395.In the winter group, the positive rate was 2.26‰, 61 cases were confirmed, and the incidence was 1∶492.The incidence rate did not change significantly in the four seasons ( P>0.05).The G6PD concentrations in the four seasons were compared in pairs, and the result was winter>autumn>spring>summer.The thresholds for G6PD screening were established indirectly: 25.08 U/dL, 22.83 U/dL, 26.63 U/dL and 38.01 U/dL in spring, summer, autumn and winter groups, respectively.The relative deviation in the threshold between the summer group and the laboratory was lower than RCV, while that between the other groups was higher than RCV.According to the screening threshold, the negative and positive conformity rates of 12 batches of 120 samples in the inter-laboratory evaluation program of Chinese Taiwan Preventive Medicine Foundation of China reached 100%. Conclusions:There is no difference in the incidence of G6PD deficiency between birth seasons.It is feasible to establish the screening threshold in each season using indirect methods, which is conducive to improving the efficiency of screening.
