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Zinc Supplementation in Preterm Neonates and Neurological Development, A Randomized Controlled Trial
N B Mathur1, Devendra K Agarwal
1Department of Neonatology, Maulana Azad Medical College, New Delhi, India. Correspondence to: Dr NB Mathur, Director Professor and Head, Department of Neonatology, Maulana Azad Medical College, New Delhi 110 002, India. drnbmathur@gmail.com.
Insights
Zinc supplementation in preterm infants improved neurodevelopment, enhancing alertness and attention while reducing hyperexcitability. This intervention supports better growth outcomes in vulnerable newborns.
Area of Science:
- Neonatal research
- Nutritional science
- Developmental pediatrics
Background:
- Preterm neonates are at risk for neurodevelopmental and growth deficits.
- Zinc is crucial for neurological development and immune function.
Purpose of the Study:
- To evaluate the impact of zinc supplementation on the neurodevelopment and growth of preterm infants.
- To assess specific neurodevelopmental outcomes and growth parameters.
Main Methods:
- Open-labeled randomized controlled trial involving 100 preterm neonates.
- Intervention group received oral zinc; control group did not.
- Neurodevelopment assessed using Amiel-Tison neurologic assessment at 40 weeks post-conceptional age and 3 months corrected age.
Main Results:
- Zinc supplementation was associated with improved alertness and attention at 40 weeks post-conceptional age (P=0.02).
- Fewer zinc-supplemented infants exhibited hyper-excitability compared to controls at 40 weeks and 3 months corrected age.
- Significantly higher serum alkaline phosphatase levels were observed in the zinc group at 3 months corrected age.
Conclusions:
- Oral zinc supplementation until 3 months corrected age positively influences neurodevelopment in preterm breastfed infants.
- The intervention enhances alertness, attention, and reduces hyperexcitability and abnormal reflexes.
- Zinc supplementation is a potential strategy to improve outcomes in preterm neonates.
Objective:
To assess the effect of zinc supplementation on neuro-development and growth of preterm neonates.
Setting:
Referral neonatal unit of a teaching hospital.
Design:
Open-labeled Randomized controlled trial.
Participants:
100 preterm neonates.
Intervention:
Participants randomized to receive oral zinc (study group) or not (controls).
Main Outcome Measures:
Primary: Neuro-development status at 40 weeks post conceptional age and at 3 month corrected age using Amiel-Tison neurologic assessment. Secondary: anthropometry and serum alkaline phosphatase at 3 months corrected age.
Results:
At 40 weeks post-conceptional age, greater number of zinc supplemented infants demonstrated alertness and attention pattern normal for their age (P=0.02). Higher number of controls showed signs of hyper-excitability at 40 week post-conceptional age (P=0.001) and 3 months corrected age (P=0.003). At 3 month corrected age, mean serum alkaline phosphatase level was significantly higher in the study group compared to controls.
Conclusion:
Zinc supplementation till 3 month corrected age in preterm breastfed infants improves alertness and attention pattern; and decreases signs of hyperexcitability, and proportion with abnormal reflexes.
