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Brion LP, Heyne R, Steven Brown L, et al. Zinc deficiency limiting head growth to discharge in extremely low gestational age infants with insufficient linear growth: a cohort study [published online ahead of print, 2020 Aug 12]. J Perinatol. 2020;10.1038/s41372-020-00778-w. doi:10.1038/s41372-020-00778-w

Objective: To assess the relationship of size for age with zinc deficiency in extremely low gestational age (GA) infants (23-28 weeks, ELGANs) who had insufficient linear growth despite optimizing other nutrients and to analyze changes in fronto-occipital circumference (FOC), weight and length with zinc supplementation.

Study design: Retrospective cohort study.

Results: Among 302 ELGANs, a serum zinc concentration was obtained in 52 with insufficient linear growth (17%). Zinc deficiency (serum concentration <0.74 mcg/ml) was diagnosed in 8 of 24 (33%) small for GA (SGA) compared to 35 of 278 (13%) non-SGA infants (P = 0.01). Zinc supplementation for >2 weeks improved FOC growth to discharge or 50 weeks postmenstrual age in infants with Zn deficiency. However, neither linear growth nor weight gain improved with Zn supplementation.

Conclusion: Zinc deficiency was diagnosed in 14% ELGANs in this cohort. Zinc supplementation for >2 weeks improved FOC growth but not linear growth or weight gain.

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