Background: Hyperbilirubinemia is a common neonatal problem. Studies conducted on the effectiveness of zinc salts on serum indirect bilirubin levels in newborns have yielded different results, all calling for further research. This study aimed to determine the effect of oral zinc sulfate on indirect hyperbilirubinemia in preterm infants admitted to the neonatal intensive care unit. Methods: A randomized double-blind clinical trial was performed in the neonatal intensive care unit of Vali-e-Asr Hospital in Birjand, Iran. The study population comprised neonates aged between 31 and 36 gestational weeks, who required phototherapy in the neonatal intensive care unit. A total of 60 neonates were selected by census and allocated into an experimental group and a control group. In addition to phototherapy, the experimental group received 1 cc/Kg zinc sulfate syrup (containing 5 mg/5 cc zinc sulfate; Merck Company, Germany), and the control group received a placebo syrup (containing 1 cc/kg sucrose). Data were analyzed in SPSS-21 software using the independent t-test, repeated-measures ANOVA, Bonferroni post-hoc test, and Mann-Whitney test. P-values smaller than 0.05 were considered significant. Results: Bilirubin level changes in the experimental and control groups six hours after intervention were − 1.45 ± 3.23 and − 0.49 ± 0.37 (p = 0.024), respectively. The changes 24 and 48 h after intervention were-3.26 ± 2.78 and − 1.89 ± 1.20 (p = 0.017) in the experimental group and − 4.89 ± 2.76 and − 3.98 ± 2.32 (p = 0.23) in the control group, respectively. There was no significant difference in the phototherapy duration between the two groups (p = 0.24). Conclusions: The results of this study showed that the use of zinc sulfate syrup in preterm infants with indirect hyperbilirubinemia significantly reduced bilirubin levels within 48 h of treatment.

Background and Objectives: Congenital anomalies can increase the neonatal mortality rate. Infants with anomalies suffer from long-term disabilities that impose heavy burdens on their families and healthcare systems. Understanding the prevalence of congenital anomalies helps health policy-makers develop better health-related policies. This study aimed to evaluate the prevalence of major congenital anomalies among live births in Birjand city, Iran. Methods: This cross-sectional descriptive-analytical study was conducted on 6,000 infants who were born from September 23, 2015, to March 6, 2016, in the maternity departments in Birjand. Stillbirths and infants who died immediately after birth, i.e. before the assessment for anomalies, were excluded. On the first day of birth, a neonatologist or a pediatrician performed a careful physical examination for each infant to diagnose probable congenital anomalies. Appropriate diagnostic procedures were also used to confirm the diagnosis when needed. Then, data on the characteristics of infants were collected using a researcher-made checklist. The data were reported using descriptive statistics such as absolute frequency, relative frequency, mean, and standard deviation. Moreover, the Chi-square and Fisher's exact tests were conducted using the SPSS computer program (v. 16.0) for hypothesis testing at a significance level of less than 0.05. Results: The prevalence of major congenital anomalies was 1.83 cases per 1000 live births. The prevalence rates of low birth weight and prematurity were significantly greater among infants with congenital anomalies than in their non-afflicted counterparts (45.5% vs. 15.9% and 36.4% vs. 11.1%, respectively; P < 0.05). Around 63.6% of the anomalies were among male infants and 54.5% of parents had kinship relationships. Conclusions: This study showed that the prevalence of major congenital anomalies among live births in Birjand was 1.83 cases per 1000 live births, which is less than the rates reported in other areas of Iran.

Background: Coronary heart diseases (CAD) and their risk factors are among the major causes of death in Iran. Since these risk factors begin to develop early in life, it is vital to diagnose those newborns at high risk of CAD. Objectives: The present study investigated the umbilical cord blood lipid profile of term and preterm neonates. Methods: In this cross-sectional study, the lipid profiles of 292 neonates, of which 276 were term and 16 preterm, were examined at a teaching hospital. Results: The lipid profile results of total cholesterol, triglycerides, high density lipoprotein, and low density lipoprotein were 69.8, 34.9, 23.6, and 31.5 in term neonates and 80.5, 25.5, 25.1, and 38 in preterm neonates, respectively. Conclusions: According to the current paper, the lipid profiles of eastern Iranian neonates were similar to those reported in global studies. Moreover, except for triglycerides in the female neonates, lipid profiles were significantly higher among the male neonates.

Background: Preterm neonates have a higher tendency in developing infections and their umbilical cord serves as a good environment for bacterial growth. Objective: The aim of this study was to compare the topical effects of breast milk, chlorhexidine and dry cord care methods on bacterial colonization of preterm neonates' umbilical cord in the Neonatal Intensive Care Unit (NICU) Methods: The trial was one-centered, single-blind, and in phase 2 of clinical trials from Vali-e-Asr Educational Hospital, Birjand, Iran from January to June 2017. A sample of 75 preterm infants were recruited by convenience sampling method and assigned into one of the three groups of drying, chlorhexidine, and milk by using a table of random numbers (n=25 per group). Bacterial colonization and its density were assessed in all groups during the first 12 to 24 hours of admission, and again after 72 hours. A total of 25 subjects were entered in each group and the data were analyzed by Chi-square tests (Fisher's exact test), Kruskal-Wallis analysis, Wilcoxon test, McNemar's test, and ANOVA. Results: The bacteria colonized in the newborns of groups I, II, and III before and after intervention were 64% and 36% (p=0.03), 52 and 20% (p=0.008) and 64 and 32 (p=0.02) respectively. After the intervention, colonized bacteria were significantly decreased in all three groups. Conclusion: Based on the results of this study, all three methods of drying approach, use of chlorhexidine, as well as breast milk were effective in controlling bacterial colonization in the umbilical cord of preterm neonates. Although there were no significant differences between the three groups, ultimately the use of these methods could be effective in reducing the need for antibiotics. Trial registration: Prior to the study, the protocol of study was registered at Iran's Clinical Trials Registry (http://www.irct.ir) (Registration ID: IRCT2017090517756N27). Funding: The present study was funded fully by Birjand University of Medical Sciences (grant number: 455078).