Effect of zinc supplementation on morbidity and growth in hospital-born, low-birth-weight infants.
What this study found
Daily zinc supplementation did not meaningfully reduce diarrhea, acute lower respiratory infections, or improve weight and length outcomes over 12 months. The clearest effect was biochemical: 12-month plasma zinc was 100.2 6 41.9 vs 73.3 6 22.5 lg/dL, a difference of 26.9 lg/dL (95% CI 19.6 to 34.2), and zinc deficiency decreased to 12.6% vs 24.4% (difference -11.8%; 95% CI -20 to -3.4; P < 0.005). Care-seeking for illness was lower at 9 months (difference -5.7%; 95% CI -9.9 to -1.4), but deaths were similar (21 vs 19). The authors concluded that RDA-level zinc did not confer substantial…
- Study & population
- Randomized, placebo-controlled trial in hospital-born term low-birth-weight infants in urban New Delhi, India.
- Intervention
- Oral elemental zinc as zinc sulfate was given daily at 5 mg/d from enrollment (age 2-4 weeks) through 6 months, then 10 mg/d from >6 months through 12 months.
- Key limitation
- The trial was limited to mostly breastfed, hospital-born term low-birth-weight infants from one urban Indian setting, which limits generalizability.
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Open PDFOriginal abstract
BACKGROUND Low-birth-weight infants may have impaired zinc status, but little is known about the effect of zinc supplementation. OBJECTIVE The objective was to investigate the effect of daily zinc supplementation on morbidity and anthropometric status in hospital-born, low-birth-weight infants. DESIGN In a double-blind, randomized, placebo-controlled trial, 2052 hospital-born term infants with a birth weight < or =2500 g were randomly assigned to receive zinc or placebo. The zinc group received elemental zinc: 5 mg/d for those infants between ages 2 wk and 6 mo and 10 mg/d for those infants aged >6 mo. All-cause hospitalizations, prevalence of diarrhea, acute lower respiratory tract infections, visits to health care providers, weights, and lengths were ascertained at 3, 6, 9, and 12 mo of age. RESULTS The supplement was consumed for >85% of the follow-up period. Mean plasma zinc at 12 mo of age was higher in the zinc group (100.2 microg/dL) than in the control group (73.3 microg/dL) (difference in means: 26.9; 95% CI: 19.6, 34.2). The 24-h and 7-d prevalence of diarrhea and acute lower respiratory tract infections was similar at 3, 6, 9, and 12 mo. Care-seeking for illness was significantly lower in the zinc group (difference in proportions: -5.7; 95% CI: -9.9, -1.4; P < 0.05) at 9 mo. The numbers of hospitalizations, weights, and lengths were all similar at all 4 assessments. CONCLUSION Hospital-born, term, low-birth-weight infants do not seem to benefit substantially from zinc supplementation that meets the Recommended Dietary Allowance for zinc in terms of morbidity or physical growth during infancy in this setting. This trial was registered at www.clinicaltrials.gov as NCT00272142.