Assessment of Trace Elements on Newborns with Neonatal Jaundice Attending Federal Teaching Hospital, Owerri

Abstract

Neonatal jaundice is a very prevalent problem in newborn babies and continues to be a major cause of morbidity and hospital admission of neonates especially in low- and middle-income nations. Although the importance of bilirubin metabolism in the pathophysiology is well known, there is accumulating evidence that abnormalities in trace elements homeostasis may influence oxidative stress, integrity of erythrocytes and bilirubin metabolism. This study determined the serum bilirubin concentrations and other selected trace elements in neonates with neonatal jaundice attending Federal Teaching Hospital, Owerri. This comparison investigation was done on 120 babies (60 neonates with neonatal jaundice and 60 seemingly healthy newborns of the same age as controls). Venous blood (5 ml) was aseptically obtained from each participant using sterile disposable syringes and needles by a competent laboratory scientist or qualified health care provider. Samples were placed in plain specimen tubes, allowed to clot and retract, and centrifuged at 3000 rpm for 5 minutes to collect serum. Serum total, direct and indirect bilirubin, zinc, copper, iron, selenium and magnesium concentrations were tested by the proper laboratory methods. The data were analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Mean values between the groups were compared by using Student’s t-test. The link between bilirubin and trace elements concentrations was determined by using Pearson’s correlation analysis. Results are reported as mean ± standard deviation, and p<0.05 was considered statistically significant. The mean levels of total bilirubin (18.36 ± 5.40 mg/dL), direct bilirubin (2.87 ± 1.09 mg/dL), and indirect bilirubin (15.50 ± 4.32 mg/dL) were significantly higher in neonates with neonatal jaundice compared to controls (7.13 ± 2.93, 0.72 ± 0.26, and 6.41 ± 2.68 mg/dL, respectively; p=0.000 for all). Newborns with neonatal jaundice had significantly lower serum concentrations of zinc, selenium, and magnesium compared to controls (54.66 ± 7.96 µg/dL vs 87.95 ± 9.10 µg/dL; 37.18 ± 7.68 µg/L vs 67.22 ± 6.88 µg/L; and 1.60 ± 0.20 mg/dL vs 2.16 ± 0.13 mg/dL, respectively; p=0.000 for all). In contrast, babies with neonatal jaundice had significantly higher levels of copper and iron (153.31 ± 17.87 µg/dL and 146.63 ± 16.02 µg/dL, respectively) compared to controls (118.72 ± 10.75 µg/dL and 98.37 ± 8.81 µg/dL, respectively; p=0.000 for both). Total bilirubin in neonates with neonatal jaundice was significantly negatively correlated with zinc (r = −0.896, p=0.000), selenium (r = −0.766, p=0.000), and magnesium (r = −0.910, p=0.000) but significantly positively correlated with copper (r = 0.958, p=0.000) and iron (r = 0.797, p=0.000). Neonatal jaundice in newborns showed considerable perturbation in serum trace element levels with decreased zinc, selenium and magnesium and elevated copper and iron concentrations. The substantial relationships between bilirubin and certain trace elements suggest that altered trace element homeostasis may be connected with the metabolic pathways involved in newborn jaundice. Additional research is needed to explain the mechanisms behind these changes and to assess the possible therapeutic significance of these changes in the therapy of newborn jaundice