DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20162163

Study of changes in the blood levels of copper and zinc following the blood exchange transfusion in neonates with hyperbilirubinemia

Mehrdad Mirzarahimi, Afsaneh Enteshari-Moghaddam, Raheleh Asghari Moghaddam, Abbas Naghizade, Mohammad Mazani

Abstract


Background: Blood exchange transfusion (EXT) is an essential treatment method in some icteric newborns and causes some changes in trace elements in them. The effects of blood exchange transfusion on zinc (Zn) and copper (Cu) in newborn infants is unknown. This study was conducted to determine the possible effects of EXT on Zn and Cu by comparing the levels of Zn and Cu in jaundiced neonates.

Methods: In this study, 30 jaundiced term neonates undergoing EXT for the first time, because of idiopathic unconjugated hyperbilirubinemia, were selected. The Zn and Cu levels of 30 blood bank donors’ samples used for EXT were measured and 30 pairs of umbilical cord blood samples were examined for Zn and Cu before and one hour and five days after exchange transfusion. The serum bilirubin concentration was measured before and after EXT. The collected data in laboratory were analysed by statistical methods using SPSS.19.

Results: In this study 43% were girls and 56.7% were boys and the average age of the infants was 4.56 days at the time of admission. Before EXT, the average of serum bilirubin was 27.74±2.03 mg/dl, and the average of serum Zn was 48.53±4.94 μg/dl that was lower than serum Zn concentration one hour after EXT (55.98±7.60 μg/dl) and five days after EXT (56.63±10.92 μg/dl). This difference was statistically significant (P=0.001). Furthermore, the average of serum Cu concentration was 59.56±10.92 μg/dl before EXT, 60.48±10.05 μg/dl after EXT and 58.64±8.06 μg/dl five days after EXT that didn't vary significantly from each other.

Conclusions: The results showed that after EXT, the serum Zn concentration was higher than before EXT but the changes in serum Cu concentration was little and negligible. 


Keywords


Trace elements, Exchange transfusion, Icteric newborn, Zinc, Copper, Hyperbilirubinemia

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References


Wong R, Desander G, Sibley E. Neonatal jaundice and liver disease. Fanaroff and Martin's Neonatal prenatal Medicine: Disease of the fetus and infant, 8th ed. St Louis: Mosby; 2006: 1446-1450.

Behrman RE, Kliegman RM. Nelson essential of pediatrics. 6th ed. Philadelphia: W.B. Saunders; 2011: 334-337.

Behrman RE, Kliegman RM, Jenson HB. Nelson textbook of pediatrics. 19th ed. Philadelphia: W.B. Saunders; 2011: 603-612.

Steiner LA, Bizzarro MJ, Ehrenkranz RA, Gallagher PG. A decline in the frequency of neonatal exchange transfusions and its effect on exchange-related morbidity and mortality. Am J Dis Child. 2007;120(1):127-32.

Roohani N, Hurrell R, Kelishadi R, Schulin R. Zinc and its importance for human health. J Res Med Sci. 2013;18(2):144–57.

Walravens PA. Nutritional Importance of Copper and Zinc in Neonates and Infants. Clin Chem J. 1980;26(2):185-9.

Robinson C, Weigley E, Mueller D. Robinson's Basic Nutrition and Diet Therapy. 8th Edition, New Jersey, Prentice-Hall Inc; 1997: 201-230.

Keen CL, Uriu-Hare J, Hawk S, Jankowski M, Daston G, Kwik-Uribe C. Effect of Copper Deficiency on Prenatal Development and Pregnancy Outcome. Am J Clin Nutr. 1998;67(5):1003-11.

Sakha K, Ostad Rahimi R, Jafari Rohi A, Abasalizadeh SH. Comparison of serum zinc and copper levels between term and preterm neonates cord blood and their mothers’ blood. Iran J Pediatr. 2005;15:255-60.

Lockitch G, William J Godolphin WJ, Pendray MR, Quigley G. The effect of red cell and plasma transfusion on serum zinc and copper levels in the neonate. Am J Clin Nutr. 1983;38:701-5.

khoshdel A, danesh A. Changes of blood sugar and total calcium in hyperbilirubinemic neonates after exchange transfusion. J Shahrekord Univ Med Sci. 2003;5(3):35-40.

Gillian L, William J, Margaret R, Gayle T. The effect of red cell and plasma transfusion on serum zinc and copper levels in the neonate. Am J Clin Nutr. 1993;62:701-5.

Wilson DC, Tubman RJ, Bell N, Halliday HL, McMaster D. Effect of Blood Transfusion on Plasma Selenium, Glutathione Peroxidase and Manganese Levels in Very Low Birth Weight Infants. J Clin Biochem Nutr. 1999;60:126-32.

Lindeman JH, Lentjes EG, Houd kamp E, Van zoeren-Groben D, Schrijver J, Berger HM, Effect of exchange transfusion on plasma antioxidants in the newborn. N Engl J Med. 1992;90:200-3.

Khatami SF, Parvaresh P, Shakerian-Ardekani Th, Gharib M. Comparing micronutrients concentration before and after blood exchange transfusion in newborns. Iran J Pediatr. 2007;17:118-25.

Khatami F, Parvaresh P, Parvaresh P, Gharib M. The Investigation of Effects of Blood Exchange Transfusion on Selenium in Newborn Infants. Iran J Pediatr. 2013;23(2):131-7.

Hasant EJ. Evaluation of Copper, Zinc, Manganese, and Magnesium Levels in Newborn Jaundice. India J Pediatr. 2011;58:163-9.

Boskabadi H, Maamouroi Gh, Mohsen Zade H, Shakeri MT, Ghayour M. Comparison of Zinc Level between Neonates with Jaundice and Healthy Neonates. Int J Pediatr. 2014;2:34.

Rihab M, Hamdan Z, Elhassan M, Sumia. Zinc and copper levels in low birth weight deliveries in Medani Hospital, Sudan. J Trop Pediatr Nutr. 2014;7:386-9.