Correlation between Prolonged Hyperbilirubinemia and Serum Zinc Level in Term Neonates

Document Type : Original Article

Authors

1 Non-Communicable Pediatric Diseases Research Center, Department of Pediatrics, Babol University of Medical Sciences, Babol, Iran.

2 Non-Communicable Pediatric Diseases Research Center, Department of Pediatrics, Babol University of Medical Sciences, Babol, Iran

3 Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran

4 Department of Pediatrics, Amirkola Children’s Hospital, Babol University of Medical Sciences, Babol, Iran

5 Student Research Committee, Babol University of Medical Sciences, Babol, Iran

Abstract

Background: Prolonged hyperbilirubinemia is defined as jaundice persisting more than two and three weeks of life in term and preterm neonates, respectively. In total, 15-40% of jaundiced neonates became prolonged. The most common causes of prolonged hyperbilirubinemia are breastfeeding, infection, hypothyroidism, and continued hemolysis. Given the fact that no study was conducted on the association between the serums zinc level and prolonged hyperbilirubinemia, this study aimed to compare the healthy neonates with newborns suffering from prolonged hyperbilirubinemia in terms of serum zinc level.
Methods: This cross-sectional analytical descriptive study with a control group included all neonates who had a history of hospital admission and phototherapy due to hyperbilirubinemia at Amirkola Children’s Hospital, Babol, Iran. After discharge, on the 14th day of birth, all neonates followed up at the outpatient clinic. The serum bilirubin was checked and the neonates were assigned into the case (with prolonged hyperbilirubinemia) and control (without prolonged hyperbilirubinemia) groups. Both groups were matched regarding confounding factors. Serum zinc level was measured using the colorimetric method and the two groups were compared in this regard.
Results: In total, 60 neonates in the case (n=30) and control (n=30) groups were investigated in this study. The serum zinc levels in the case and control groups were 83.7±35.35 and 92.73±38.13 μg/dl, respectively. There was no significant difference between the two groups in terms of the serum zinc level (P=0.34).
Conclusion: There is no statistically significant correlation between the serum zinc level and prolonged hyperbilirubinemia in term neonates who had been treated with phototherapy.

Keywords

References

1. Beiranvand S, Hosseinadadi R, Firuuzi M, Almasian M, Anbari K. Impact of combined oral zinc sulfate and phototherapy on serum bilirubin levels in the term neonates with jaundice. Iran J Neonatal. 2018; 9(3):20-5.
2. Terrin G, Berni Canani R, Di Chiara M, Pietravalle A, Aleandri V, Conte F, et al. Zinc in early life: a key element in the fetus and preterm neonate. Nutrients. 2015; 7(12):10427-46.
3. King JC. Zinc: an essential but elusive nutrient. Am J Clin Nutr. 2011; 94(2):679S-84S.
4. Mendez-Sanchez N, Roldan-Vaadez E, Flores MA, Cardenas-Vazquez R, Uribe M. Zinc salts precipitate unconjugated bilirubin in vitro and inhibit enterohepatic cycling of bilirubin in hamsters. Eur J Clin Invest. 2001; 31(9):773-80.
5. Hashemian S, Mohammadzadeh A, AtaeeNakhaei A. Efficacy of zinc sulfate in reducing unconjugated hyperbilirubinemia in neonates. Rev Clin Med. 2014; 1(4):229-32.
6. Mendez-Sanchez N, Martinez M, 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(1):40-3.
7. Rana N, Mishra S, Bhatnagar S, Paul V, Deorari K, Agarwal R. Efficacy of zinc in reducing hyperbilirubinemia among at-risk neonates: a randomized, double-blind, placebo-controlled trial. Indian J Pediatr. 2011; 78(9):1073-8.
8. Vitec L, Munchova L, Zelenka J, Zadinova M, Malina J. The effect of zinc sulfate on serum bilirubin levels in hyperbilirubinemic rats. J Pediatr Gastroenterol Nutr. 2005; 40(2):135-40.
9. Hasan EJ. Evaluation of copper, zinc, manganese and magnesium levels in newborn jaundice in Baghdad. IBN Al-Haitham J Pure Appl Sci. 2011; 24(3):800.
10. Becker PJ, Carney LN, Corkins MR, Monczka J, Smith E, Smith SE, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (under-nutrition). J Acad Nutr Dietetics. 2014; 114(12): 1988-2000.
11. El-Mazary AA, Abdel Aziz R, Sayed M, Mahmoud R, Saedii A. Effect of intensive phototherapy and exchange transfusion on copper, zinc and magnesium serum levels in neonates with indirect hyperbilirubinemia. Int J Pediatr. 2017; 5(2): 4371-83.
12. Boskabadi H, Maamouri G, Zadeh HM, Shakeri MT, Ghayour-Mobarhan M, Mohammadi S, et al. Comparison of serum zinc level between neonates with jaundice and healthy neonates. Shiraz E Med J. 2015; 16(11-12):e27392.
13. Mosayebi Z, Rahmani M, Ardakani SB, Sheikh M, Shariat M, Rezaeizadeh G. Evaluation of serum zinc levels in hyperbilirubinemic neonates before and after phototherapy. Iran J Pediatr. 2016; 26(3):41-6.
Iranian Journal of Neonatology
Volume 10, Issue 4
November 2019
Pages 1-5

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