Gogia Siddhartha, Sachdev Harshpal S
Department of Pediatrics and Neonatology, Max Hospital, Gurgaon, Haryana, India.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD007991. doi: 10.1002/14651858.CD007991.pub2.
Zinc deficiency is a significant public health problem in low- and middle-income countries. Zinc is essential for the formation and migration of neurons along with the formation of neuronal synapses. Its deficiency could interfere with the formation of neural pathways and with neurotransmission, thus affecting behavior (for example, attention, activity, engagement, temperament) and development (for example, gross and fine motor skills, social skills). Zinc supplementation provided to infants and children is a possible strategy to improve the mental and motor development of infants and children at high risk of zinc deficiency.
To assess the effects of zinc supplementation compared to placebo on measures of psychomotor development or cognitive function in children.
We searched MEDLINE, PsycINFO, CINAHL and Latin American Database (LILACS) on 1 December 2011. We searched EMBASE and CENTRAL 2011 Issue 12 on 19 January 2012. We searched Dissertation Abstracts International and the metaRegister of Controlled Trials on 30 November 2011.
Randomized or quasi-randomized placebo-controlled trials involving synthetic zinc supplementation provided to infants or children (less than five years of age) were eligible.
Two review authors screened search results, selected studies, assessed the studies for their risk of bias and extracted data.
We included 13 trials in this review.Eight studies reported data on the Bayley Scales of Infant Development (BSID) in 2134 participants. We combined the data in a meta-analysis to assess the effect on development as measured by the Mental Development Index (MDI) and Psychomotor Development Index (PDI). There was no significant effect of zinc supplementation: the mean difference between the zinc supplementation and placebo groups on the MDI was -0.50 (95% confidence interval (CI) -2.06 to 1.06; P = 0.53; I(2) = 70%) and the mean difference between the groups for the PDI was 1.54 (95% CI -2.26 to 5.34; P = 0.43; I(2) = 93%). Most studies had low or unclear risk of bias but there was significant heterogeneity, which was not adequately explained by our subgroup analyses. The overall quality of evidence was considered 'moderate'.Two trials provided data on motor milestone attainment. There was no significant difference in the time to attainment of milestones between the placebo group and the zinc supplementation group in either of the studies.No study provided data on cognition score or intelligence quotient (IQ) or on adverse effects of zinc supplementation.
AUTHORS' CONCLUSIONS: There is no convincing evidence that zinc supplementation to infants or children results in improved motor or mental development.
锌缺乏是低收入和中等收入国家的一个重大公共卫生问题。锌对于神经元的形成和迁移以及神经元突触的形成至关重要。其缺乏可能会干扰神经通路的形成和神经传递，从而影响行为（如注意力、活动、参与度、气质）和发育（如大肌肉和小肌肉运动技能、社交技能）。给婴幼儿补充锌是一种可能改善锌缺乏高危婴幼儿心理和运动发育的策略。
评估与安慰剂相比，补充锌对儿童心理运动发育或认知功能指标的影响。
我们于2011年12月1日检索了MEDLINE、PsycINFO、CINAHL和拉丁美洲数据库（LILACS）。于2012年1月19日检索了EMBASE和CENTRAL 2011年第12期。于2011年11月30日检索了国际学位论文摘要和对照试验元注册库。
涉及给婴幼儿（小于5岁）补充合成锌的随机或半随机安慰剂对照试验符合要求。
两位综述作者筛选检索结果、选择研究、评估研究的偏倚风险并提取数据。
本综述纳入了13项试验。八项研究报告了2134名参与者的贝利婴幼儿发育量表（BSID）数据。我们将数据合并进行荟萃分析，以评估对用心理发育指数（MDI）和心理运动发育指数（PDI）衡量的发育的影响。补充锌没有显著效果：补充锌组和安慰剂组在MDI上的平均差异为-0.50（95%置信区间（CI）-2.06至1.06；P = 0.53；I² = 70%），两组在PDI上的平均差异为1.54（95%CI -2.26至5.34；P = 0.43；I² = 93%）。大多数研究的偏倚风险较低或不明确，但存在显著异质性，我们的亚组分析未能充分解释。证据的总体质量被认为是“中等”。两项试验提供了运动里程碑达成情况的数据。在任何一项研究中，安慰剂组和补充锌组在达到里程碑的时间上均无显著差异。没有研究提供关于认知分数或智商（IQ）或补充锌的不良反应的数据。
没有令人信服的证据表明给婴幼儿补充锌能改善运动或心理发育。
