Effect of Oral Zinc Sulfate Therapy on the Management of Neonatal Non-Hemolytic Unconjugated Hyperbi-lirubinemia: A Randomized Control Trial

Background: Zinc (Zn) salts have been tried for the prevention and treatment of neonatal jaundice as they are presumed to reduce serum bilirubin through the inhibition of enterohepatic circulation with controversial results. This study aimed to evaluate the effect of Zn sulfate on both bilirubin levels and the duration of phototherapy during the management of neonatal jaundice.Methods: A double-blinded prospective study was conducted on ۶۰ healthy neonates, ≥۳۶ weeks gestation, with unconjugated non-hemolytic neonatal hyperbilirubinemia requiring phototherapy within the first week of life. They were divided into three groups of: A (n=۲۰) receiving placebo, B (n=۲۰) receiving low-dose oral Zn sulfate (۱۰mg/day), and C (n=۲۰) receiving high-dose oral Zn sulfate (۲۰ mg/day), in combination with phototherapy for seven days. Serum bilirubin levels were measured on day ۱ before starting the treatment and were reevaluated on days ۳ and ۷.Results: Day ۳ bilirubin was significantly lower in group C, compared to groups A and B (۱۲.۳۶±۲.۵۰ vs. ۱۳.۹۹±۱.۵۹ and ۱۳.۶۵±۱.۶۷ mg%; P<۰.۰۱۱ and P<۰.۰۴۳, respectively). Moreover, day-۷ bilirubin demonstrated a significant decrease in group C than in group A (۸.۰۳±۱.۷۵ vs. ۱۰.۴۷±۲.۲۴ mg%, P<۰.۰۰۱). Total phototherapy duration was significantly shorter in group C, compared to groups A and B (۲۶.۰۵±۱۱.۴۲ vs. ۳۷.۷۰±۱۸.۲۷ and ۳۶.۹۰±۱۲.۴۷ h; P<۰.۰۳۲ and P<۰.۰۲۸, respectively).Conclusion: The administration of oral Zn sulfate in a dose of ۲۰ mg/day in combination with phototherapy could be helpful and safe in reducing both bilirubin level and phototherapy duration in jaundiced neonates.  

Keywords:

Hyperbilirubinemia , Neonatal Jaundice , Phototherapy , Zinc sulfate