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


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. 


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

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