Prenatal Maternal Zinc Supplements Reduce Infant Diarrhea

Abstract

Research Article| October 01 2010 Prenatal Maternal Zinc Supplements Reduce Infant Diarrhea AAP Grand Rounds (2010) 24 (4): 43. https://doi.org/10.1542/gr.24-4-43 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Prenatal Maternal Zinc Supplements Reduce Infant Diarrhea. AAP Grand Rounds October 2010; 24 (4): 43. https://doi.org/10.1542/gr.24-4-43 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: infantile diarrhea, prenatal care, zinc supplement, diarrhea Source: Iannotti L, Zavaleta N, Leon Z, et al. Maternal zinc supplementation reduces infectious disease morbidity in Peruvian infants. J Pediatr. 2010; 156(6): 960– 964; doi: https://doi.org/10.1016/j. jpeds.2009.12.023Google Scholar Investigators from the US and Peru performed this double-blind randomized controlled trial in a peri-urban slum of Lima, Peru between 1995 and 1997 to assess the effect of zinc supplementation during pregnancy on subsequent infectious diseases through infancy. Researchers enrolled 1,295 women between 10 and 24 weeks gestation who were carrying a low-risk singleton pregnancy. These women were stratified by gestational age (less than or more than 17 weeks) and parity (nulliparous or multiparous) and then randomized to take a daily supplement of 60 mg of iron and 250 μg of folic acid either with or without 15 mg of zinc. The two tablets were otherwise indistinguishable, and were taken from 10 to 24 weeks gestation until one month postpartum. Socioeconomic and household characteristics and maternal anthropometric measurements were recorded. Infant weights were recorded at birth and then monthly for 12 months. Morbidity surveillance was done by field workers through weekly home visits. Of the 421 infants who completed the 12-month study, 214 received zinc supplementation. There were no differences between the zinc-supplemented and control groups with regard to socioeconomic or household characteristics, gestational age at birth, or birth weight. Adjusting for the age of the infant, breastfeeding, season, and sanitation and hygiene covariates, prenatal zinc supplementation reduced the risk of a diarrheal episodes lasting more than seven days by 34% (OR 0.66; 95% CI, 0.43–0.99; P=.04) and decreased the presence of mucus in the stool (OR 0.65; 95% CI, 0.46–0.92; P=.01) as compared to controls. The mean observed days with diarrhea among infants prenatally treated with zinc (5.8%) was less than infants in the control group (7.7%; P=.01). There was a trend toward fewer diarrheal episodes (≥3 liquid or loose stools in 24-hour period) in the prenatal zinc-supplemented group. No effect was detected for respiratory illnesses, fever, scabies, or impetigo. The authors conclude that prenatal zinc supplementation decreased diarrhea-associated morbidity in offspring during the first 12 months of life. In 2009, the World Health Organization recommended that zinc be added to oral rehydration therapy in the treatment of acute diarrhea. 1 The authors of this article propose an immunological basis to explain the beneficial effect from prenatal zinc supplementation. Zinc deficiency in humans decreases the activity of serum thymulin (a thymic hormone), which is required for maturation of T-helper cells and plays an important role in cell-mediated immune function and also functions as an anti-inflammatory and antioxidant agent.2 Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide.3 Zinc deficiency places children at increased risk of illness and death from diarrhea.4 Zinc deficiency is prevalent in low-income countries, as this micronutrient is mainly found in expensive red meat. Pooled analysis of studies that have assessed the effect of... You do not currently have access to this content.