Effect of oral zinc supplementation on serum bilirubin levels in term neonates undergoing phototherapy for hyperbilirubinemia

Enterohepatic bilirubin circulation helps determine neonatal jaundice. The present study evaluated the role of oral zinc in reducing serum bilirubin in term neonates with hyperbilirubinemia. It enrolled 106 term neonates with jaundice within the phototherapy range admitted to a level III neonatal intensive care unit and randomized them to receive either oral zinc sulfate (5 mg/day) or a matching placebo for five days. Both groups received conventional phototherapy as per American Academy of Pediatrics (AAP) guidelines and were evaluated for total serum bilirubin levels at 24, 48, 72, and 96 hr after intervention. 

The study observed-

• The mean (SD) total serum bilirubin levels in zinc and placebo groups were 15.3 (2.85) vs. 17.1 (2.21) mg/dL at 24 h; 11.7 (4.46) vs. 14.62 (3.83) mg/dL at 48 h; 6.7 (4.77) vs 9.5 (3.70) mg/dL at 72 h; and 5.1 (3.95) vs 6.5 (3.70) mg/dL after 72 hr, respectively. 
• Significantly lower mean (SD) duration of phototherapy in the zinc group than the placebo group. 
• No significant difference in hospital stay between the two groups.

This study shows that oral zinc sulfate supplementation at a dose of 5 mg once a day along with phototherapy is effective in reducing total and indirect serum bilirubin levels and the total duration of phototherapy required in the term neonatal hyperbilirubinemia, with minimal or no adverse effects.

Mandkecha TH, et al. Effect of Oral Zinc Supplementation on Serum Bilirubin Levels in Term Neonates With Hyperbilirubinemia Undergoing Phototherapy: A Double-blind Randomized Controlled Trial. INDIAN PEDIATRICS. 2023.