Early Zinc Supplementation and Enhanced Growth of the Low-Birth Weight Neonate
Keywords:low birth weight, zinc, supplementation, catch-up growth, micronutrients
BACKGROUND: Nutritional deficits are almost universal in Low-Birth Weight babies. Zinc is essential for normal infant growth and its supplementation assists growth probably through insulin-like growth factor-1.
AIM: This double-blind randomized-controlled trial aimed at evaluating the role of zinc in catch-up growth of low-birth-weight infants and investigating its proposed mediator.
MATERIAL AND METHODS: The study was conducted in Ain Shams University Maternity Hospital. Two hundred low-birth-weight neonates were simply randomized to either oral zinc therapy or placebo. Anthropometric measurements were recorded at birth, 3, 6, and 12 months; including weight, recumbent length, head, waist, chest, and mid-upper arm circumferences, and triceps and sub-scapular skin fold thickness.
RESULTS: We found that initial and 3-months measurements, except weight, were comparable in the 2 groups. All measurements at 6- and 12-months, except sub-scapular skin-fold-thickness, were significantly higher in zinc group than placebo. Catch-up growth, at 12-months, was significant in zinc group and was significantly higher in appropriate-for-gestational-age vs. small-for-gestational-age, in preterm vs. term, and in male vs. female infants. The median 6-months insulin-like growth factor-1 levels were significantly higher in zinc group.CONCLUSION: We conclude that early start of oral zinc supplementation in low-birth-weight neonates assists catch-up growth, probably through rise of insulin-like growth factor-1.
Plum Analytics Artifact Widget Block
WHO. Maternal, Newborn, Child and Adolescent Health. WHO Library Cataloguing-in-Publication Data: Guidelines on optimal feeding of low birth-weight infants in low- and middle-income countries. Available at: http://www.who.int/maternal_child_adolescent/documents/infant_feeding_low_bw/en/ Published: 2011. Accessed: August 21, 2014.
Carlo WA. Prematurity and IUGR. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Elsevier Saunders, 2011: 555.
Kennedy TS, Oakland MJ, Shaw RD. Growth Patterns and Nutritional Factors Associated with Increased Head Circumference at 18 Months in Normally Developing, Low-birth-weight Infants. J Am Diet Assoc. 1999; 99: 1522â€“1526.
Black MM. Zinc deficiency and child development. Am J Clin Nutr. 1998; 68(suppl.): 464S-469S.
Hoque A, Ali SMK. Role of Zinc in Low Birth Weight Neonates. Bang Med J. 2009; 38(1): 24-30.
Centers for Disease Control and Prevention (CDC): Anthropometry Procedures Manual. Available at: http://www.cdc.gov/nchs/data/nhanes/nhanes_07_08/manual_an.pdf, January 2007. Accessed: October 18, 2013.
National Institutes of Health. Zinc: Fact Sheet for Health Professionals. http://ods.od.nih.gov/factsheets/ Reviewed: June, 2013. Accessed: April 26, 2013.
Drugs and Supplements: Zinc supplement (oral route, parenteral route). http://www.mayoclinic.org/ Updated: January, 2014. Accessed: May 25, 2014.
Dekker LH, Villamor E. Zinc supplementation in children is not associated with decreases in hemoglobin concentrations. Journal of Nutrition. 2010; 140(5):1035â€“1040.
Kumar A, Bagri NK, Basu S, Asthana RK. Zinc supplementation for neonatal hyperbilirubinemia: a randomized controlled trial. Indian Pediatr. 2014; 51(5):375-378.
Friel JK, Andrews WL, Matthew JD, et al. Zinc supplementation in very-low-birth-weight infants. J Pediatr Gastroenterol Nutr. 1993; 17(1): 97-104.
Castillo-DurÃ¡n C, Weisstaub G. Zinc supplementation and growth of the fetus and low birth weight infant. J Nut. 2003; 133(5 Suppl 1): 1494S-1497S.
Islam MN, Chowdhury MA, Siddika M, et al. Effect of oral zinc supplementation on the growth of preterm infants. Indian Pediatrics. 2010; 47(10): 845-849.
Aminisani N, Barak M, Shamshirgaran SM. Effect of zinc supplementation on growth of low birth weight infants aged 1-6 months in Ardabil. Iran Indian J Pediatr. 2011; 78(10): 1239-1243.
Surkan PJ, Shankar M, Katz J, et al. Beneficial effects of zinc supplementation on head circumference of Nepalese infants and toddlers: a randomized controlled trial. Eur J Clin Nutr. 2012; 66(7):836-842.
Bhutta ZA, Das JK. Interventions to address maternal and childhood undernutrition: current evidence. Nestle Nutr Inst Workshop Ser. 2014; 78:59-69.
Hershkovitz E, Printzman L, Segev Y, et al. Zinc supplementation increases the level of serum insulin-like growth factor-I but does not promote growth in infants with nonorganic failure to thrive. Horm Res. 1999; 52(4):200-204.
Ninh NX, Thissen JP, Collette L, et al. Zinc supplementation increases growth and circulating insulin-like growth factor I (IGF-I) in growth-retarded Vietnamese children. Am J Clin Nutr. 1996; 63(4):514-519.
Manish P, Gupta BD, Suman B, et al. Role of zinc supplementation in growth and neuro-development of premature and small for gestational age (SGA) babies. Natl J Community Med. 2012; 3(4): 736-739.
Bueno O, Bueno G, Moreno LA, et al. Zinc supplementation in infants with asymmetric intra uterine growth retardation; effect on growth, nutritional status and leptin secretion. Nutr Hosp. 2008; 23(3):212-9.
Castillo-DurÃ¡n C, Rodriguez A, Venegas G, et al. Zinc supplementation and growth of infants born small for gestational age. J Pediatr. 1995; 127(2): 206-211.
Strauss RS, Dietz WH. Effects of intrauterine growth retardation in premature infants on early childhood growth. J Pediatr. 1997; 130(1): 95-102.
Fong L, Tan K, Tran C, et al. Interaction of dietary zinc and intracellular binding protein metallothionein in postnatal bone growth. Bone. 2009; 44(6):1151-62.
Fukada T, Hojyo S, Furuichi T. Zinc signal: a new player in osteobiology. J Bone Miner Metab. 2013; 31(2):129-35.
Imdad A, Bhutta ZA. Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool. BMC Public Health. 2011 Apr 13; 11 Suppl 3: S22.
Ong KK, Elmlinger M, Jones R, et al. Growth hormone binding protein levels in children are associated with birth weight, postnatal weight gain, and insulin secretion. Metabolism. 2007; 56(10):1412-1417.
Alves CX, Vale SH, Dantas MM, et al. Positive effects of zinc supplementation on growth, GH, IGF1, and IGFBP3 in eutrophic children. J Pediatr Endocrinol Metab. 2012; 25(9-10): 881-887.
Hamza RT, Hamed AI, Sallam MT. Effect of zinc supplementation on growth Hormone Insulin growth factor axis in short Egyptian children with zinc deficiency. It J Pediatr. 2012; 38: 21-24.
Cossack ZT. Decline in somatomedin-C (insulin-like growth factor-1) with experimentally induced zinc deficiency in human subjects. Clin Nutr. 1991;10(5): 284-291.
Kaji H, Chihara K. Short stature by growth hormone deficiency. Nihon Rinsho. 2001; 59(Suppl 8): 30-37.
How to Cite
All rights reserved.