Efficacy of High-Dose vs. Standard-Dose Enteral Zinc Supplementation on Growth and Zinc Status in Very Preterm Infants: A Randomized Controlled Trial
Abstract
Objective: Preterm infants are at a heightened risk of zinc deficiency. Supplemental zinc may reduce mortality rates and enhance immunomodulatory functions. However, enteral zinc administration may negatively influence copper and iron absorption in the gastrointestinal tract. Therefore, we investigated the efficacy of high and standard doses of enteral zinc supplementation in this population.
Material and Methods: We included very preterm neonates (gestational age <32 weeks; birth weight <1,800 g) and randomly administered high- (10 mg/day) or standard-dose (1 mg/day) zinc supplements. Intergroup differences in growth parameters and serum zinc levels were compared with baseline within-participant changes.
Results: Forty participants were enrolled (n=20 per group), with mean gestational age and birth weight of 29.0 weeks and 1,173.8 g, respectively. No significant disparities in baseline characteristics or intervention variables, including the duration of supplementation (47 vs. 35 days) and average daily caloric intake (132.75 vs. 133.33 kcal/kg/day), were observed. The mean increments in weight, weight-for-age Z-score, and serum zinc levels were 14.92 vs. 15.57 g/kg/day, -0.04 vs. 0.10, and -0.7 vs. 4.2 μg/dL for the high- and standard-dose groups, respectively. No significant differences in growth velocity, Z-scores, serum copper and ferritin levels, or clinical outcomes were observed between the groups.
Conclusion: There were no significant differences in the mean changes in growth parameters and serum zinc levels from baseline to post-intervention between neonates receiving high-dose and those receiving standard-dose zinc supplements.
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