Background: Low birth weight (LBW) infants are at high risk of zinc deficiency, but there is a paucity of data on their zinc status. Objective: To evaluate zinc status of LBW (BW <2,500 g) and normal birth weight (NBW; BW ≥2,500 g) infants at birth and in early infancy. Methods: A total of 339 infants (LBW, n = 220; NBW, n = 119) were enrolled, and venous blood samples of mother-infant dyad were taken within 48 h of birth. Infants’ levels were repeated between 2 and 10 months of age. Serum zinc levels were estimated using an inductively coupled plasma mass spectrometer. Primary outcome was zinc deficiency, defined as serum zinc <65 µg/dl. Results: Zinc results were available for 182 LBW and 103 NBW infants at birth and for 100 LBW and 66 NBW infants at follow-up with a median postnatal age of 14 and 15.5 weeks, respectively. Median zinc levels were low and comparable at birth as well as at follow-up, with zinc deficiency being present in 51.0% of LBW and 42.4% of NBW infants at birth and in 79.0% of LBW and 66.7% of NBW infants at follow-up. Zinc levels decreased significantly in both groups from birth to follow-up, irrespective of zinc multivitamin supplementation. Zinc levels of infants with BW <2,000 g at follow-up were significantly lower compared to infants with higher BW. Conclusion: Zinc status was poor in many infants at birth irrespective of BW. Zinc status worsened significantly during early infancy, with infants with BW <2,000 g having the lowest zinc levels.

Serum retinol levels of low birth weight (LBW; birth weight < 2500 g) and normal birth weight (NBW; birth weight ≥ 2500 g) infants were evaluated at birth and 3 months using high performance liquid chromatography. At birth, levels were 13.3 ± 8.2 ug/dL in LBW (n=146) and 14.0 ± 6.2 ug/dL in NBW infants (n = 79; p = 0.51), with 41.1% of LBW and 24.1% of NBW infants having vitamin A deficiency (VAD, < 10 ug/dL; P = 0.01). At follow up, levels were 18.0 ± 9.4 ug/dL in LBW (n = 83) and 20.0 ± 7.3 ug/dL in NBW infants (n = 51; P = 0.19), with 18.1% of LBW and 3.9% of NBW infants having VAD (P = 0.02).

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Serum ferritin levels of low birth weight (LBW; BW < 2,500 g) and normal birth weight (NBW; BW ≥ 2,500 g) infants were evaluated at birth and at 3 mo using electrochemiluminescence immunoassay. At birth, levels were 318.6 (31.0-829.5) ng/mL in LBW (n = 217) and 366.2 (122.4-858.5) ng/mL in NBW infants (n = 116; p < 0.01), with 1.4 % of LBW and none of the NBW infants having levels <12 ng/mL (p = 0.20). At follow up, levels were 66.9 (4.5-567.7) ng/mL in LBW (n = 126) and 126.2 (6.8-553.7) ng/mL in NBW infants (n = 76; p = 0.27), with 11.9 % of LBW and 11.8 % of NBW infants having levels <12 ng/mL (p = 0.80).

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