Correlation Between Heavy Metals and Neonatal Hyperbilirubinemia Among the Patients Attended at Bangabandhu Sheikh Mujib Medical University

Abstract

Background: Neonatal hyperbilirubinemia is one of the most common clinical conditions during the early neonatal period in both term and preterm newborns. Trace elements such as magnesium (Mg), zinc (Zn), and copper (Cu) play important roles in enzymatic activity, metabolism, growth, and cellular function. Alterations in these trace elements may contribute to the development and severity of neonatal jaundice.
Objective: The present study aimed to evaluate the serum concentrations of magnesium, zinc, and copper among neonates with hyperbilirubinemia and to determine their correlation with serum bilirubin levels.
Methods: This case-control study was conducted at Bangabandhu Sheikh Mujib Medical University from January 2024 to March 2026. A total of 594 neonates were enrolled, including 319 cases with neonatal hyperbilirubinemia and 275 healthy controls. Serum bilirubin and magnesium levels were measured using an automated analyzer, while zinc and copper concentrations were determined by semi-automated colorimetric methods. Statistical analyses were performed using SPSS software, and p<0.05 was considered statistically significant.
Results: The study demonstrated statistically highly significant differences in serum Mg, Zn, and Cu levels between the case and control groups (p<0.001). The mean serum magnesium level was significantly higher in jaundiced neonates compared to controls (23.98 ± 2.11 mg/L vs. 19.19 ± 1.60 mg/L). Serum zinc levels were significantly lower in the case group (0.50 ± 0.03 mg/L) compared to controls (0.68 ± 0.10 mg/L). In contrast, serum copper levels were significantly elevated in jaundiced neonates (0.75 ± 0.08 mg/L) compared to healthy controls (0.43 ± 0.11 mg/L). Significant positive correlations were observed between serum bilirubin and both magnesium and copper levels, whereas serum zinc showed a significant negative correlation with bilirubin concentration.
Conclusion: The present study revealed significant alterations in serum magnesium, zinc, and copper levels among neonates with hyperbilirubinemia. Elevated magnesium and copper levels along with reduced zinc levels may be associated with the development and severity of neonatal jaundice. These findings suggest that trace elements may play an important role in neonatal hyperbilirubinemia and could have potential clinical significance in neonatal care.