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Zinc deficiency limiting head growth to discharge in extremely low gestational age infants with insufficient linear
Luc P Brion1, Roy Heyne2, L Steven Brown3
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA. luc.brion@utsouthwestern.edu.
Insights
Zinc deficiency affects 14% of extremely low gestational age infants (ELGANs). While zinc supplementation improved head circumference growth, it did not enhance linear growth or weight gain in these vulnerable infants.
Area of Science:
- Neonatalogy
- Nutritional Science
- Pediatric Growth
Background:
- Extremely low gestational age infants (ELGANs) often experience growth challenges.
- Optimizing nutrient intake is crucial for ELGAN development.
- The role of zinc deficiency in growth failure requires further investigation.
Purpose of the Study:
- To evaluate the link between size for age and zinc deficiency in ELGANs.
- To assess the impact of zinc supplementation on growth parameters in ELGANs.
- To analyze changes in fronto-occipital circumference (FOC), weight, and length.
Main Methods:
- Retrospective cohort study design.
- Analysis of serum zinc concentrations in ELGANs with insufficient linear growth.
- Comparison of growth outcomes before and after zinc supplementation.
Main Results:
- Zinc deficiency was diagnosed in 14% of the ELGAN cohort.
- Infants small for gestational age (SGA) showed a higher prevalence of zinc deficiency (33% vs 13%).
- Zinc supplementation (>2 weeks) improved FOC growth but not linear growth or weight gain.
Conclusions:
- Zinc deficiency is a significant concern in ELGANs, particularly those who are SGA.
- Zinc supplementation can positively impact head growth (FOC) in deficient ELGANs.
- Current supplementation protocols may not be sufficient to improve overall linear growth or weight gain in this population.
Objective:
To assess the relationship of size for age with zinc deficiency in extremely low gestational age (GA) infants (23-28 weeks, ELGANs) who had insufficient linear growth despite optimizing other nutrients and to analyze changes in fronto-occipital circumference (FOC), weight and length with zinc supplementation.
Study Design:
Retrospective cohort study.
Results:
Among 302 ELGANs, a serum zinc concentration was obtained in 52 with insufficient linear growth (17%). Zinc deficiency (serum concentration <0.74 mcg/ml) was diagnosed in 8 of 24 (33%) small for GA (SGA) compared to 35 of 278 (13%) non-SGA infants (P = 0.01). Zinc supplementation for >2 weeks improved FOC growth to discharge or 50 weeks postmenstrual age in infants with Zn deficiency. However, neither linear growth nor weight gain improved with Zn supplementation.
Conclusion:
Zinc deficiency was diagnosed in 14% ELGANs in this cohort. Zinc supplementation for >2 weeks improved FOC growth but not linear growth or weight gain.
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