Association of maternal prenatal selenium concentration and preterm birth: a multicountry meta-analysis.
child health
environmental health
epidemiology
maternal health
nutrition
Journal
BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
29
03
2021
accepted:
04
08
2021
entrez:
14
9
2021
pubmed:
15
9
2021
medline:
13
10
2021
Statut:
ppublish
Résumé
Selenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations. Gestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. Maternal Se concentrations were determined by inductively coupled plasma mass spectrometry analysis. The associations between maternal Se with PTB and gestational duration were analysed using logistic and linear regressions. The results were then combined using fixed-effect and random-effect meta-analysis. In all study samples, the Se concentrations followed a normal distribution with a mean of 93.8 ng/mL (SD: 28.5 ng/mL) but varied substantially across different sites. The fixed-effect meta-analysis across the 17 cohorts showed that Se was significantly associated with PTB and gestational duration with effect size estimates of an OR=0.95 (95% CI: 0.9 to 1.00) for PTB and 0.66 days (95% CI: 0.38 to 0.94) longer gestation per 15 ng/mL increase in Se concentration. However, there was a substantial heterogeneity among study cohorts and the random-effect meta-analysis did not achieve statistical significance. The largest effect sizes were observed in UK (Liverpool) cohort, and most significant associations were observed in samples from Malawi. While our study observed statistically significant associations between maternal Se concentration and PTB at some sites, this did not generalise across the entire cohort. Whether population-specific factors explain the heterogeneity of our findings warrants further investigation. Further evidence is needed to understand the biologic pathways, clinical efficacy and safety, before changes to antenatal nutritional recommendations for Se supplementation are considered.
Sections du résumé
BACKGROUND
Selenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations.
METHODS
Gestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. Maternal Se concentrations were determined by inductively coupled plasma mass spectrometry analysis. The associations between maternal Se with PTB and gestational duration were analysed using logistic and linear regressions. The results were then combined using fixed-effect and random-effect meta-analysis.
FINDINGS
In all study samples, the Se concentrations followed a normal distribution with a mean of 93.8 ng/mL (SD: 28.5 ng/mL) but varied substantially across different sites. The fixed-effect meta-analysis across the 17 cohorts showed that Se was significantly associated with PTB and gestational duration with effect size estimates of an OR=0.95 (95% CI: 0.9 to 1.00) for PTB and 0.66 days (95% CI: 0.38 to 0.94) longer gestation per 15 ng/mL increase in Se concentration. However, there was a substantial heterogeneity among study cohorts and the random-effect meta-analysis did not achieve statistical significance. The largest effect sizes were observed in UK (Liverpool) cohort, and most significant associations were observed in samples from Malawi.
INTERPRETATION
While our study observed statistically significant associations between maternal Se concentration and PTB at some sites, this did not generalise across the entire cohort. Whether population-specific factors explain the heterogeneity of our findings warrants further investigation. Further evidence is needed to understand the biologic pathways, clinical efficacy and safety, before changes to antenatal nutritional recommendations for Se supplementation are considered.
Identifiants
pubmed: 34518202
pii: bmjgh-2021-005856
doi: 10.1136/bmjgh-2021-005856
pmc: PMC8438754
pii:
doi:
Substances chimiques
Selenium
H6241UJ22B
Types de publication
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIEHS NIH HHS
ID : P30 ES025128
Pays : United States
Organisme : NIEHS NIH HHS
ID : R21 ES014947
Pays : United States
Organisme : NIEHS NIH HHS
ID : P01 ES022831
Pays : United States
Organisme : NIEHS NIH HHS
ID : R01 ES016772
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK085173
Pays : United States
Organisme : Medical Research Council
ID : MR/T040750/1
Pays : United Kingdom
Organisme : World Health Organization
ID : 001
Pays : International
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
N Engl J Med. 2018 Aug 09;379(6):535-546
pubmed: 30089075
Environ Res. 2018 Oct;166:562-569
pubmed: 29966876
Free Radic Biol Med. 2014 Feb;67:265-77
pubmed: 24275540
Gates Open Res. 2019 Feb 5;2:49
pubmed: 31172050
J Intern Med. 2007 May;261(5):412-7
pubmed: 17444880
J Biol Chem. 2009 Feb 6;284(6):3998-4008
pubmed: 19054767
J Perinatol. 2018 Aug;38(8):963-972
pubmed: 29795450
Environ Int. 2019 Jun;127:243-252
pubmed: 30928848
Br J Nutr. 2020 Jan 28;123(2):209-219
pubmed: 31865927
Epigenetics. 2019 Apr;14(4):325-340
pubmed: 30773972
J Trace Elem Med Biol. 2018 Mar;46:103-109
pubmed: 29413099
Am J Perinatol. 2013 Aug;30(7):579-88
pubmed: 23208764
Reprod Health. 2013;10 Suppl 1:S1
pubmed: 24625113
Physiol Rev. 2014 Jul;94(3):739-77
pubmed: 24987004
Biometals. 2012 Apr;25(2):297-307
pubmed: 22045056
JAMA. 2005 Jul 20;294(3):318-25
pubmed: 16030276
Lancet. 2008 Jan 5;371(9606):75-84
pubmed: 18177778
Hypertension. 2004 Dec;44(6):838-46
pubmed: 15520301
Nutrients. 2015 Mar 31;7(4):2209-36
pubmed: 25835046
Nutr Metab Insights. 2019 Sep 29;12:1178638819879444
pubmed: 31632052
BJOG. 2006 Dec;113 Suppl 3:118-35
pubmed: 17206980
N Engl J Med. 2008 Apr 17;358(16):1700-11
pubmed: 18420502
Br J Nutr. 2001 May;85(5):517-47
pubmed: 11348568
Biol Trace Elem Res. 2019 Dec;192(2):196-205
pubmed: 30756291
Lancet Glob Health. 2018 Dec;6(12):e1297-e1308
pubmed: 30361107
CMAJ. 2011 Mar 22;183(5):549-55
pubmed: 21324870
Lancet. 2012 Jun 9;379(9832):2162-72
pubmed: 22682464
Lancet. 2017 Dec 17;388(10063):3027-3035
pubmed: 27839855
Reprod Health. 2013;10 Suppl 1:S6
pubmed: 24625252
Am J Epidemiol. 2015 Jun 1;181(11):861-73
pubmed: 25947956
N Engl J Med. 2017 Sep 21;377(12):1156-1167
pubmed: 28877031
Int J Gynaecol Obstet. 2018 Aug;142(2):207-213
pubmed: 29660833
J Nutr. 2020 Apr 1;150(4):918-928
pubmed: 31909811
Metallomics. 2020 Jun 24;12(6):935-951
pubmed: 32373896