Diana Sarokhani - Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Amir Adibi - Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
Mohsen Abdan - Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Moloud Fakhri - Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

Background: Phototherapy is the most common treatment of neonatal jaundice that affects the zinc level as well as the bilirubin level. Objectives: The purpose of this study is to investigate the effect of phototherapy on the zinc level of infants with jaundice by a systematic review and meta-analysis. Methods: In this systematic review and meta-analysis a comprehensive literature search of the databases, including Cochrane Library, Web of Science, PubMed, Scopus, and Google Scholar web browser was conducted using standard keywords. Data analysis of this meta-analysis was performed using STATA software, version ۱۴ and P<۰.۰۵ was considered a significant level for tests.  Results: In the five studies reviewed in this article with a sample size of ۳۹۸ individuals, phototherapy increased the level of zinc [Standardized mean difference (SMD): ۰.۸۸ (۹۵% CI: ۰.۳۸, ۱.۳۸), P<۰.۰۰۱] and decreased bilirubin level [SMD: -۷.۶۷ (۹۵% CI: -۹.۱۱, -۶.۲۳), P<۰.۰۰۱] in infants with jaundice. The effect of phototherapy was on the zinc level of these groups: infants with a birth weight of ۳۰۰۰ to ۳۳۰۰ grams (gr) [SMD: ۱.۰۷ (۹۵% CI: ۰.۴۲, ۱.۷۱), P<۰.۰۰۱] and ۳۳۰۱ to ۳۶۰۰ gr [SMD: ۰.۴۰ (۹۵% CI: -۰.۳۲, ۱.۱۲), P=۰.۰۲۸], three-day-old infants [SMD: ۱.۰۵ (۹۵% CI: ۰.۳۵, ۱.۷۴), P<۰.۰۰۱], four-day-old [SMD: ۰.۷۶ (۹۵% CI: ۰.۲۶, ۱.۳۲)], and ۵-day-old ones [SMD: ۰.۲۳ (۹۵% CI: -۰.۰۱, ۰.۴۸)]. In addition, phototherapy affected on zinc level of those whose gestational age (GA) was ۳۷ [SMD: ۱.۱۲ (۹۵% CI: ۰.۰۶, ۲.۱۷), P<۰.۰۰۱] and ۳۸ [SMD: ۰.۶۱ (۹۵% CI: ۰.۱۵, ۱.۰۶), P=۰.۰۰۱] weeks. Conclusions: Phototherapy by reducing the level of bilirubin increases the level of zinc in infants with jaundice. So, the standardized mean difference of “phototherapy effects on the zinc level of infants with jaundice” decreases with increasing infants’ weight, increasing infants’ age, and increasing gestational age.

Zinc, Hyperbilirubinemia, Neonatal jaundice, Jaundice, Neonatal, Phototherapy, Light therapy