Antenatal zinc supplementation reduced impetigo episodes

Darmstadt GL. Pediatr Infect Dis J. 2011;doi:10.1097/INF.0b013e318243e232.

Zinc supplementation during the antenatal period demonstrated a reduction in the incidence rate of episodes of impetigo, according to a new study.

To determine the effects of maternal zinc supplementation on skin infections among infants in poor urban areas of Dhaka, Bangladesh, researchers conducted a double blind, placebo-controlled randomized trial. Five hundred fifty-nine pregnant women — between 12 and 16 weeks gestation — were enrolled in the trial, stratified by parity, and randomly assigned to receive either 30 mg of elemental zinc or a cellulose placebo tablet daily.

One hundred ninety-eight infants from mothers who received zinc supplements and the 220 infants from mothers who received the cellulose placebo were included in postnatal surveillance. After birth, six monthly home visits were conducted by trained non-medical interviewers who inquired about respiratory infections, diarrhea, fever and skin infections during the past week, using seven clinical color photographs of impetigo at varying degrees of severity and development.

Among the infants of mothers who received antenatal zinc supplementation, 10.6% had at least one episode of impetigo compared with 19.6% of the infants of mothers in the placebo group (P=.01). Infants in the treatment group demonstrated a 54% reduction in incidence rate of episodes of impetigo when compared with infants in the placebo group (P=.01).

The effect of zinc supplementation also was found to be more significant among male infants (64% reduction) and intrauterine growth restricted and low birth weight infants (73% reduction). Zinc supplementation outcomes were also more pronounced among infants of mothers with increased parity (60% reduction) or decreased socioeconomic status (71% reduction), who are more likely to be micronutrient deficient compared with high-income mothers.

Researchers highlighted cultural barriers as a potential limitation of the study, including pregnant mothers who sometimes refused to look at pictures of infection for fear that doing so might curse the infant; culturally sensitive communication and easing maternal fears could improve data quality in future studies, according to the results of the study in the January issue of The Pediatric Infectious Disease Journal.

Disclosure: The researchers report no relevant financial disclosures.

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