Zinc Supplementation in Preterm Neonates and Neurological Development, A Randomized Controlled Trial.

OBJECTIVE To assess the effect of zinc supplementation on neuro-development and growth of preterm neonates. SETTING Referral neonatal unit of a teaching hospital. DESIGN Open-labeled Randomized controlled trial. PARTICIPANTS 100 preterm neonates. INTERVENTION Participants randomized to receive oral zinc (study group) or not (controls). MAIN OUTCOME MEASURES Primary: Neuro-development status at 40 weeks post conceptional age and at 3 month corrected age using Amiel-Tison neurologic assessment. Secondary: anthropometry and serum alkaline phosphatase at 3 months corrected age. RESULTS At 40 weeks post-conceptional age, greater number of zinc supplemented infants demonstrated alertness and attention pattern normal for their age (P=0.02). Higher number of controls showed signs of hyper-excitability at 40 week post-conceptional age (P=0.001) and 3 months corrected age (P=0.003). At 3 month corrected age, mean serum alkaline phosphatase level was significantly higher in the study group compared to controls. CONCLUSION Zinc supplementation till 3 month corrected age in preterm breastfed infants improves alertness and attention pattern; and decreases signs of hyperexcitability, and proportion with abnormal reflexes.