Zinc concentration in preterm newborns at term age, a prospective observational study

BMJ Paediatrics Open
Q1
Sep 2019
Citations:18
Influential Citations:1
Observational Studies (Human)
81
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Methods
Analytical, descriptive, observational, prospective study conducted in the neonatal unit of a tertiary hospital. Preterm newborns born between 1 Oct 2016 and 31 Oct 2017, gestational weeks 24–34; 83 preterm infants included (44 female, 39 male); exclusions: severe digestive symptoms and those who received enteral zinc supplementation; SZC measured at 37–41 weeks; anthropometric, clinical and nutritional data collected.
Intervention
Zinc supplementation started for preterm neonates with SZC below the normal range; initial dose 0.5 mg/kg/day for birth weight <1000 g or 1 mg/kg/day for larger infants, with progressive increases of 1 mg/kg/day up to 3 mg/kg/day; route and duration not specified.
Results
Zinc concentrations at term age were low in preterm infants (median 4.4 μmol/L; IQR 2.6–6.9). Bronchopulmonary dysplasia (BPD) was independently associated with lower SZC at term (2.7 vs 4.9 μmol/L; p=0.005; multivariate p=0.01). SZC at term age positively correlated with length at discharge and inversely correlated with weight gain. A term-control group had higher SZC (10 μmol/L). Authors emphasize maintaining adequate SZC to support growth and note ongoing randomized trials (NCT03532555) to test enteral zinc supplementation on growth and BPD; no causal inference about zinc supplementation effects can be drawn from these data.
Limitations
Observational, single-center design; small sample (n=83); potential confounding; zinc supplementation not standardized; SZC measured at a single time point (term age); not able to infer causality; 9 infants lost to follow-up.

Abstract

Objectives To determine zinc concentrations and associated factors in a population of preterm newborns at term age. Design This analytical, descriptive, observational and prospective study was conducted in the neonatal unit of a tertiary hospital. Pr...