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Short Term Oral Zinc Supplementation among Babies with Neonatal Sepsis for Reducing Mortality and Improving Outcome -
Newton Banupriya1, Ballambattu Vishnu Bhat2, Bosco Dhas Benet1
1Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, 605006, India.
Insights
Short-term zinc supplementation for newborns with sepsis significantly reduced mortality rates. This intervention also improved mental development outcomes at 12 months corrected age.
Area of Science:
- Neonatal Medicine
- Pediatric Nutrition
- Infectious Diseases
Background:
- Sepsis is a leading cause of mortality in neonates.
- Neurodevelopmental impairments are common sequelae in survivors of neonatal sepsis.
- Zinc is crucial for immune function and development.
Purpose of the Study:
- To assess the impact of short-term zinc supplementation on mortality in neonates with sepsis.
- To evaluate the neurodevelopmental outcomes at 12 months corrected age in neonates with sepsis receiving zinc supplementation.
Main Methods:
- A randomized controlled trial was conducted in a neonatal intensive care unit.
- Neonates with sepsis were randomized to receive either zinc supplementation (3 mg/kg twice daily for 10 days) or no zinc, alongside standard antibiotics.
- Neurodevelopment was assessed at 12 months corrected age using the Development Assessment Scale for Indian Infants (DASII).
Main Results:
- The mortality rate was significantly lower in the zinc supplementation group compared to the no-zinc group (P=0.04).
- While motor development quotients were similar between groups, the mental development quotient was significantly better in neonates who received zinc supplementation.
Conclusions:
- Short-term zinc supplementation is effective in reducing mortality among neonates diagnosed with sepsis.
- Zinc supplementation improves mental development in infants with a history of neonatal sepsis.
Objective:
To evaluate the efficacy of short term zinc supplementation on the mortality rate and neurodevelopment outcome in neonates with sepsis at 12 mo corrected age.
Methods:
The clinical trial was undertaken in the neonatal intensive care unit of JIPMER during the time period from September 2013 through December 2016. Neonates with clinical manifestations of sepsis who exhibited two positive screening tests (microESR, C- reactive protein, band cell count) were included and randomized into no zinc and zinc group. The intervention was zinc sulfate monohydrate given at a dose of 3 mg/kg twice a day orally for 10 d along with standard antibiotics. The no zinc group was on antibiotic treatment. Blood samples from both groups were collected at baseline and after day 10. Babies were carefully discharged from the hospital. The babies were followed up till 12 mo corrected age using DASII (Development Assessment Scale for Indian Infants).
Results:
At the time of enrolment, patient characteristics were similar in both the groups. The mortality rate was significantly higher in no zinc compared to zinc group (5 vs. 13; P = 0.04). Although motor development quotient was similar, mental development quotient was significantly better among babies who received zinc supplementation.
Conclusions:
Short term zinc supplementation of newborns with sepsis reduces mortality and improves mental development quotient at 12 mo of age.
