A STUDY OF ZINC SUPPLEMENTATION FOR NEONATAL HYPERBILIRUBINEMIAAT PEDIATRICS DEPARTMENT OF NMCH, PATNA, BIHAR
Abstract
Objectives: To determine the efficacy of oral zinc for treatment ofidiopathic neonatal hyperbilirubinemia in near-term and term (35-41 weeks) neonates.
Design: Randomized placebo-controlled trial.
Setting: Pediatrics Department of NMCH
Participants: Eighty newborns with idiopathic neonatalhyperbilirubinemia.
Intervention: Neonates were randomized to receive either oralzinc sulfate (10 mg/d) or placebo for 7 days.
Main outcome measures: Primary: total serum bilirubin levels at48 (±12) h, 96 (±12) h and 144 (±12) h after intervention.
Secondary: duration of phototherapy, and serum zinc and copperlevels.
Results: Baseline mean (SD) total serum bilirubin levels were14.8 (3.8) and 14.4 (3.5) mg/dL in zinc and placebo groups, respectively. No significant differences were observed in totalbilirubin levels between the two groups after the intervention.
Mean (SD) total serum bilirubin levels in zinc and placebo groupswere 13.9 (2.5) vs. 13.4 (1.9) mg/dL (mean difference 0.566; 95%CI -0.535, 1.668, P=0.038) at 48 h, 13.1 (2.7) vs. 12.8 (2.3) mg/dL(mean difference 0.234; 95% CI -1.011, 1.479, P =0.708) at 96 hand 8.0 (2.0) vs. 8.6 (1.2) mg/dL (mean difference -0.569, 95% CI-1.382, 0.242, P=0.166) at 144 h. Although the mean duration ofphototherapy in the zinc group was less by 21.3 h (95% CI 11.6,30.9, P=0.052), the difference was not significant. Postintervention,serum zinc levels were significantly higher in thezinc-supplemented group while serum copper levels werecomparable between the two groups.
Conclusions: Oral zinc sulfate, in a dose of 10 mg/day, isnot effective in the management of idiopathic neonatalhyperbilirubinemia.Keywords
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Xiong T, Qu Y, Cambier S, Mu D. The side effects of phototherapy for neonatal jaundice: what do we know? What should we do? Eur J Pediatr. 2017;170:1247-55.
Smits-Wintjens VE, Rath ME, van Zwet EW, Oepkes D, Brand A, Walther FJ, et al. Neonatal morbidity after exchange transfusion for red cell alloimmune hemolytic disease. Neonatology. 2013;103:141-7.
Vitek L, Zelenka J, Zadinova M, Malina J. The impact of intestinal microflora on serum bilirubin levels. J Hepatol 2005;42:2338-43.
Vitek L, Muchova L, Zelenka J, Zadinova M, Malina J. The effect of zinc salts on serum bilirubin levels in hyperbilirubinemic rats. J Pediatr Gastroenterol Nutr. 2005;40:135-40.
Rana N, Mishra S, Bhatnagar S, Paul V, Deorari AK, Agarwal R. Efficacy of zinc in reducing hyperbilirubinemia among at-risk neonates: a randomized, double-blind, placebo-controlled trial. Indian J Pediatr. 2011;78:1073-8.
Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999;103:6-14.
American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114:297-316.
Mendez-Sanchez N, Roldan-Valadez E, Gonzalez V, Roldan-Valadez E, Flores MA, Uribe M. Zinc sulfate inhibits the enterohepatic cycling of unconjugated bilirubin in subjects with Gilbert’s syndrome. Ann Hepatol. 2002;1:40-43.
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