Role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia: a systematic review of current evidence.
BACKGROUND
Neonatal hyperbilirubinemia is frequently seen condition in the NICU. Oral zinc has been tried for the prevention of hyperbilirubinemia.


OBJECTIVE
To evaluate the role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia in term and preterm infants.


METHODS
The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS) and other data base.


RESULTS
This review included six RCT that fulfilled inclusion criteria. One study evaluated the role of zinc in very low birth weight (VLBW) infants and remaining enrolled neonates  ≥35 weeks of gestation. The dose of zinc varied from 5 to 20 mg/day and duration from 5-7 days. All the studies used zinc sulfate, only one study used zinc gluconate. The total neonates enrolled in these different RCT are 749.


CONCLUSIONS
Role of zinc in the prevention of neonatal hyperbilirubinemia is not supported by the current evidence. Only one study was able to show reduction in the mean TSB level and requirement of phototherapy with zinc, and the remaining studies did not report any positive effect. None of the studies showed any effect on the duration of phototherapy, incidence of phototherapy, age of starting of phototherapy and any serious adverse effect.
a Department of Pediatrics , Pt B.D Sharma, PGIMS , Rohtak , Haryana , India.
Deepak
D
Sharma
b Department of Pediatrics , Shiraz University of Medical Sciences , Shiraz , Iran.
Nazanin
N
Farahbakhsh
c Department of Medicine , Mahatma Gandhi Medical College and Hospital , Jaipur , Rajasthan , India , and.
Pradeep
P
Sharma
d Department of Pathology , N.K.P Salve Medical College , Nagpur, Maharashtra , India.
Sweta
S
Shastri
D000284:Administration, Oral; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000517:prevention & control*; D007231:Infant, Newborn; D016032:Randomized Controlled Trials as Topic; D014131:Trace Elements / Q000627:therapeutic use*; D015032:Zinc / Q000627:therapeutic use*
D014131:Trace Elements; D015032:Zinc
Neonatal hyperbilirubinemia; term neonates; very low birth weight; zinc gluconate; zinc sulfate