Abstract
BackgroundHyperbilirubinemia is a common neonatal problem. Studies conducted on the effectiveness of zinc salts on serum indirect bilirubin levels in newborns have yielded different results, all calling for further research. This study aimed to determine the effect of oral zinc sulfate on indirect hyperbilirubinemia in preterm infants admitted to the neonatal intensive care unit.MethodsA randomized double-blind clinical trial was performed in the neonatal intensive care unit of Vali-e-Asr Hospital in Birjand, Iran. The study population comprised neonates aged between 31 and 36 gestational weeks, who required phototherapy in the neonatal intensive care unit. A total of 60 neonates were selected by census and allocated into an experimental group and a control group. In addition to phototherapy, the experimental group received 1 cc/Kg zinc sulfate syrup (containing 5 mg/5 cc zinc sulfate; Merck Company, Germany), and the control group received a placebo syrup (containing 1 cc/kg sucrose). Data were analyzed in SPSS-21 software using the independent t-test, repeated-measures ANOVA, Bonferroni post-hoc test, and Mann-Whitney test. P-values smaller than 0.05 were considered significant.ResultsBilirubin level changes in the experimental and control groups six hours after intervention were − 1.45 ± 3.23 and − 0.49 ± 0.37 (p = 0.024), respectively. The changes 24 and 48 h after intervention were-3.26 ± 2.78 and − 1.89 ± 1.20 (p = 0.017) in the experimental group and − 4.89 ± 2.76 and − 3.98 ± 2.32 (p = 0.23) in the control group, respectively. There was no significant difference in the phototherapy duration between the two groups (p = 0.24).ConclusionsThe results of this study showed that the use of zinc sulfate syrup in preterm infants with indirect hyperbilirubinemia significantly reduced bilirubin levels within 48 h of treatment.Trial registrationTrial registration: IRCT, IRCT2015120825439N1. Registered 21 February 2016, http://irct.ir/trial/21277
Highlights
The results revealed a significant difference between the mean changes in bilirubin levels from baseline to six hours after the intervention from baseline to 24 h after the intervention in the two groups, with the average change being more considerable in the experimental group
No infants received additional treatment due to the effects of zinc sulfate consumption or exacerbation of jaundice. This clinical trial was conducted to evaluate the effect of zinc sulfate on serum indirect bilirubinemia in preterm infants admitted to the neonatal intensive care unit
The results of this study showed that the mean changes in bilirubin levels during the first six to 24 h of treatment in the experimental group was significantly greater than in the control group
Summary
Studies conducted on the effectiveness of zinc salts on serum indirect bilirubin levels in newborns have yielded different results, all calling for further research. This study aimed to determine the effect of oral zinc sulfate on indirect hyperbilirubinemia in preterm infants admitted to the neonatal intensive care unit. Hyperbilirubinemia occurs in infants due to its increased production after the destruction of red blood cells. This is the primary mechanism of bilirubin excretion, whereby bilirubin is excreted in bile along with the stool [2,3,4]. Other treatments include the use of high-dose intravenous immunoglobulin [7], metalloporphyrins [8], and phenobarbital [9]
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