Efficacy Of Zinc Sulphate in Improving Hyperbilirubinemia in Pre-Term Neonates

Abstract

Background: Pre-term infants have a high risk of indirect hyperbilirubinemia because of immature hepatic conjugation and excessive enterohepatic circulation. The study compared oral zinc sulphate with phototherapy to enhance bilirubin reduction in pre-term infants.

Methods: A randomized, double-blind, controlled trial was conducted in the NICU at Benazir Bhutto Hospital, Rawalpindi. Neonates with hyperbilirubinemia (3036+6 weeks; 15002500 g) at pre-term were randomised to Group A (phototherapy + oral zinc sulphate 1 mg/kg every 6 hours) or Group B (phototherapy + placebo). The level of indirect bilirubin was measured at base, 6, 12, 24, and 48 hours. Phototherapy duration and adverse events were taken as secondary outcomes.

Findings: The two groups both exhibited habitual bilirubin reduction, but the zinc group exhibited a higher decline in bilirubin after 6 hours and at 48 hours, lower bilirubin levels. The duration of phototherapy in the zinc case was shorter, and adverse events were fewer and similar.

Conclusion: It seems that Zinc sulphate is a safe, cheap adjunct, which promotes bilirubin reduction in addition to phototherapy in pre-term newborns.