Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.
DBT and Wellcome India Alliance Clinical and Public health Fellow, Hyderabad, India.
Pediatrics. 2022 Aug 1;150(Suppl 1). doi: 10.1542/peds.2022-057092J.
Evidence on the effect of zinc supplementation on health outcomes in preterm or low birth weight (LBW) infants is unclear. We estimated the effect of enteral zinc versus no zinc supplementation in human milk fed preterm or LBW infants on mortality, growth, morbidities, and neurodevelopment.
Data sources include PubMed, Cochrane Central and Embase databases through March 24, 2021. Study selection was randomized or quazi-experimental trials. Two reviewers independently screened, extracted data, and assessed quality. We reported pooled relative risks (RR) for categorical outcomes, and mean differences (MD) for continuous outcomes.
Fourteen trials with 9940 preterm or LBW infants were included. Moderate to low certainty evidence showed that enteral zinc supplementation had little or no effect on mortality (risk ratio 0.73, 95% confidence interval [CI] 0.46 to 1.16), but increased weight (MD 378.57, 95% CI 275.26 to 481.88), length (MD 2.92, 95% CI 1.53 to 4.31), head growth (MD 0.56, 95% CI 0.23 to 0.90), and decreased diarrhea (RR 0.81; 95% CI 0.68 to 0.97). There was no effect on acute respiratory infections, bacterial sepsis, and psychomotor development scores. The effect of zinc supplementation on mental development scores is inconclusive. There was no evidence of serious adverse events. Eight trials had some concerns or high risk of bias, small-sized studies, and high heterogeneity between trials led to moderate to very low certainty of evidence.
Zinc supplementation in preterm or LBW infants have benefits on growth and diarrhea prevention. Further research is needed to generate better quality evidence.
关于补锌对早产儿或低出生体重（LBW）婴儿健康结局影响的证据尚不清楚。我们评估了在母乳喂养的早产儿或 LBW 婴儿中添加肠内锌与不添加锌对死亡率、生长、发病率和神经发育的影响。
数据来源包括 PubMed、Cochrane 中心和 Embase 数据库，检索时间截至 2021 年 3 月 24 日。研究选择为随机或类实验性试验。两名评审员独立筛选、提取数据并评估质量。我们报告了分类结局的汇总相对风险（RR），以及连续结局的平均差异（MD）。
纳入了 14 项涉及 9940 名早产儿或 LBW 婴儿的试验。中等至低确定性证据表明，肠内补锌对死亡率几乎没有影响（风险比 0.73，95%置信区间 [CI] 0.46 至 1.16），但增加了体重（MD 378.57，95% CI 275.26 至 481.88）、身长（MD 2.92，95% CI 1.53 至 4.31）、头围增长（MD 0.56，95% CI 0.23 至 0.90）和减少腹泻（RR 0.81；95% CI 0.68 至 0.97）。补锌对急性呼吸道感染、细菌性败血症和精神运动发育评分无影响。补锌对智力发育评分的影响尚无定论。没有证据表明有严重不良事件。8 项试验存在一些关注或高偏倚风险、小样本量以及试验间存在高度异质性，导致证据的确定性为中等至极低。
在早产儿或 LBW 婴儿中补充锌对生长和预防腹泻有益。需要进一步研究以生成更高质量的证据。
