Incidence and Predicting Factors of Hypozincemia in Very-Low-Birth-Weight Infants at Near-Term Postmenstrual Age

Abstract

We prospectively investigated serum zinc (Zn) concentrations and clinical factors in 118 very-low-birth-weight infants with a gestational age of 29.5 ± (SD) 2.5 weeks and a birth weight of 1,194 ± 254 g at near-term postmenstrual age. The 25th percentile of the serum Zn concentration was 7.0 µmol/l. The infants whose serum Zn concentrations were less than 7.0 µmol/l (defined as hypozincemia) did not have apparent symptoms of Zn deficiency. Multivariate logistic regression analyses demonstrated that hypozincemia was associated with factors such as weight gain (1-g/kg/day increase of weight; OR 1.1762, 95% CI 1.0414–1.3286) and serum albumin concentration (1-g/dl increase of serum albumin; OR 0.0816, 95% CI 0.0152–0.4372). The types of milk feeding did not affect the serum Zn concentrations in the study subjects. This study suggests that hypozincemia in very-low-birth-weight infants at near-term postmenstrual age is associated with greater weight gain and lower serum albumin concentration. Nutritional supply of Zn by human milk fortifier and preterm formula does not appear to meet the demands of rapidly growing very-low-birth-weight infants.

Effect of oral zinc supplementation on the growth of preterm infants

“…A similar serum zinc level (62.4 ± 27.5μg/dL) was found in Bangladeshi preterm babies (12). Our findings corroborated the findings of these studies (10)(11)(12). Baseline hemoglobin levels were within normal level but gradually hemoglobin level reduced.…”

Role of trace elements in parenteral nutrition support of the surgical neonate

“…Protein accretion associated with positive energy and nitrogen balance increases the infant requirement of Zn for tissue synthesis; for the premature surgical neonate entering this phase with already decreased Zn stores, the increased demand for Zn may drive this trace element from skin stores toward other tissue to accommodate accelerated protein synthesis and DNA replication [9]. Faster growth in preterm infants is associated with lower serum Zn, and several case reports describing skin manifestations of Zn deficiencies in surgical infants reported a period of rapid weight gain immediately preceding the diagnosis [11,14,23]. In the animal model, parenteral energy provision is negatively correlated with serum Zn levels in laparotomized rats during the postoperative period [24].…”

Effect of zinc supplementation on the growth of exclusively breastfed newborn babies

“…Several workers have recorded an improved zinc status, good weight gain and better linear growth velocities in babies supplemented with zinc. Whether the effect of zinc is direct consequence of improved supply of this nutrient for growth and metabolism or is mediated through stimulation of appetite and/or less diarrheal episodes is unclear 15,16 . Zinc is essential for growth and even mild zinc deficiency leads to growth retardation.…”