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Importance of Maternal Selenium Status during Pregnancy

Preterm birth occurs in 5%–13% of pregnancies. It is a leading cause of perinatal mortality and morbidity and has adverse long-term consequences for the health of the child.  Selenium is a trace mineral that can interact with a number of risk factors associated with preterm birth, and has been implicated in pregnancy outcome.

Maternal risk factors for preterm birth include a previous preterm delivery, black race, low socioeconomic status, poor nutrition, infection that triggers an inflammatory response.  Endocrine conditions such as diabetes and dysfunction of the thyroid have also been associated with preterm birth.

Selenium plays a role in attenuating inflammation.  Low selenium status has been identified in women with preeclampsia.  It was hypothesized that low maternal selenium status during early gestation would increase the risk of preterm birth.

In a large cohort prospective study, 1129 women with a singleton pregnancy were followed from the 12th weeks of gestation to delivery.  Deliveries were classified as preterm or term, and preterm births.  Serum concentrations of selenium were measured during the 12th week of pregnancy.

Among the 1129 study participants, 60 women (5.3%) had a preterm birth, 21 had premature rupture of the membranes and 13 had preeclampsia. The serum selenium concentration at 12 weeks’ gestation was significantly lower among women who had a preterm birth than among those who delivered at term.  Women who have the lowest serum concentration of selenium had twice the risk of preterm birth as women who have higher serum selenium concentration, even after adjustment for the occurrence of preeclampsia.

The study shows that having low serum selenium at the end of the first trimester was related to preterm birth and was independent of the mother having preeclampsia. Low maternal selenium status during early gestation may increase the risk of preterm premature rupture of the membranes, which is a major cause of preterm birth.

Margaret P. Rayman DPhil et al; CMAJ 2011 Mar 22; 183(5):549-55.

2 Responses

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