Phototherapy Effects on Zinc Level of Neonates With Hyperbilirubinemia: A Systematic Review and Meta-analysis

Abstract

Background: Phototherapy is the most common treatment of neonatal jaundice that affects the zinc level as well as the bilirubin level. Objectives: The purpose of this study is to investigate the effect of phototherapy on the zinc level of infants with jaundice by a systematic review and meta-analysis. Methods: In this systematic review and meta-analysis a comprehensive literature search of the databases, including Cochrane Library, Web of Science, PubMed, Scopus, and Google Scholar web browser was conducted using standard keywords. Data analysis of this meta-analysis was performed using STATA software, version 14 and P<0.05 was considered a significant level for tests. Results: In the five studies reviewed in this article with a sample size of 398 individuals, phototherapy increased the level of zinc [Standardized mean difference (SMD): 0.88 (95% CI: 0.38, 1.38), P<0.001] and decreased bilirubin level [SMD: -7.67 (95% CI: -9.11, -6.23), P<0.001] in infants with jaundice. The effect of phototherapy was on the zinc level of these groups: infants with a birth weight of 3000 to 3300 grams (gr) [SMD: 1.07 (95% CI: 0.42, 1.71), P<0.001] and 3301 to 3600 gr [SMD: 0.40 (95% CI: -0.32, 1.12), P=0.028], three-day-old infants [SMD: 1.05 (95% CI: 0.35, 1.74), P<0.001], four-day-old [SMD: 0.76 (95% CI: 0.26, 1.32)], and 5-day-old ones [SMD: 0.23 (95% CI: -0.01, 0.48)]. In addition, phototherapy affected on zinc level of those whose gestational age (GA) was 37 [SMD: 1.12 (95% CI: 0.06, 2.17), P<0.001] and 38 [SMD: 0.61 (95% CI: 0.15, 1.06), P=0.001] weeks. Conclusions: Phototherapy by reducing the level of bilirubin increases the level of zinc in infants with jaundice. So, the standardized mean difference of “phototherapy effects on the zinc level of infants with jaundice” decreases with increasing infants’ weight, increasing infants’ age, and increasing gestational age.