Efficacy of Oral Zinc Therapy in Reducing Serum Bilirubin in Neonatal Jaundice in Term Neonates Undergoing Phototherapy: A Case-Control Study

Abstract

Background: Neonatal hyperbilirubinemia is among the commonest conditions requiring neonatal intensive care admission and phototherapy. Prolonged phototherapy increases hospitalization and healthcare burden, prompting interest in adjunctive therapies such as oral zinc, which reduces enterohepatic circulation of bilirubin.
Objective: To assess the efficacy of oral zinc therapy in reducing serum bilirubin in term neonates with jaundice undergoing phototherapy, and its effect on duration of phototherapy and hospital stay.
Methods: This case-control study was conducted in the Department of Pediatrics, Government Medical College, Kota, Rajasthan, over one year and one month. A hundred term neonates (37–41 weeks) with indirect hyperbilirubinemia requiring phototherapy were enrolled and divided equally into two groups: Group A (oral zinc sulfate 5 mg/day plus phototherapy) and Group B (phototherapy alone). Serial total and indirect serum bilirubin were measured at baseline, 24, 48 and 72 hours. Duration of phototherapy, hospital stay, NICU stay and adverse effects were recorded and compared using Student's t-test, chi-square test, ANOVA and Pearson correlation.
Results: Baseline demographic and clinical parameters were comparable between groups. Serum bilirubin reduction was significantly greater in the zinc group at 24, 48 and 72 hours (p<0.001). Mean duration of phototherapy was significantly shorter in the zinc group (51.0±5.22 vs 70.3±5.27 hours, p<0.001), as were hospital stay (3.10±0.76 vs 4.18±0.69 days) and NICU stay (2.94±0.71 vs 3.70±0.61 days). Fewer neonates in the zinc group required extended phototherapy (20.0% vs 68.0%, p<0.001). Adverse effects were mild and comparable between groups, and overall clinical improvement was superior in the zinc group.
Conclusion: Oral zinc supplementation, when added to standard phototherapy, significantly accelerates bilirubin clearance, shortens the duration of phototherapy and hospitalization, and is well tolerated in term neonates with indirect hyperbilirubinemia.