BMJ Global Health (Sep 2021)
Association of maternal prenatal selenium concentration and preterm birth: a multicountry meta-analysis
- ,
- Anisur Rahman,
- Fyezah Jehan,
- Ana Alfirevic,
- Kenneth Maleta,
- Ulla Ashorn,
- Per Ashorn,
- Kelli K Ryckman,
- Tahmeed Ahmed,
- Usha Dhingra,
- Arup Dutta,
- Saikat Deb,
- Sunil Sazawal,
- Rajiv Bahl,
- Salahuddin Ahmed,
- Stephen H Kennedy,
- Monjur Rahman,
- Jesmin Pervin,
- Cathrine Hoyo,
- Rasheda Khanam,
- Sayedur Rahman,
- James A Litch,
- Aneeta Hotwani,
- Daniel E Roth,
- Ge Zhang,
- Abdullah Al Mahmud,
- Mikko Hallman,
- Huan Xu,
- Usma Mehmood,
- Zarko Alfirevic,
- Jeffrey C Murray,
- Bellington Vwalika,
- Susan Murphy,
- Patrick Musonda,
- Nagendra Monangi,
- Angharad Care,
- Fahad Aftab,
- Waqasuddin Khan,
- Joan T Price,
- Yuemei Fan,
- Thanh Q Le,
- Julio A Landero,
- Gerald F Combs,
- Elizabeth Belling,
- Joanne Chappell,
- Fansheng Kong,
- Criag Lacher,
- Nabidul Haque Chowdhury,
- Furqan Kabir,
- Imran Nisar,
- Ambreen Nizar,
- Javairia Khalid,
- Said Ali,
- Mohammed Hamad Juma,
- Md Munirul Islam,
- Laura Goodfellow,
- Juhi K Gupta,
- Larry Rand,
- Courtney Baruch-Gravett,
- Abdullah Baqui,
- Jane Hirst,
- Laura L Jelliffe-Pawlowski,
- Jeffrey Stringer,
- Louis Muglia
Affiliations
- Anisur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
- Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Ana Alfirevic
- Department of Women`s and Children`s Health, University of Liverpool, Liverpool, Merseyside, UK
- Kenneth Maleta
- School of Public Health, University of Malawi College of Medicine, Blantyre, Malawi
- Ulla Ashorn
- University of Tampere, Tampere, Pirkanmaa, Finland
- Per Ashorn
- Center for Child Health Research, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Pirkanmaa, Finland
- Kelli K Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
- Tahmeed Ahmed
- Cardiology, ICDDR,B, Dhaka, Bangladesh
- Usha Dhingra
- Center for Public Health Kinetics, New Delhi, India
- Arup Dutta
- Center for Public Health Kinetics, New Delhi, India
- Saikat Deb
- Research Division, Public Health Laboratory, Center for Public Health Kinetics, Chake Chake, Tanzania
- Sunil Sazawal
- Center for Public Health Kinetics, New Delhi, India
- Rajiv Bahl
- Department of Medicine, World Health Organization, Geneva, Switzerland
- Salahuddin Ahmed
- Projahnmo Research Foundation, Dhaka, Bangladesh
- Stephen H Kennedy
- INTERBIO-21st Study Consortium, Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK
- Monjur Rahman
- Nutritional and Clinical Services Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
- Jesmin Pervin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
- Cathrine Hoyo
- Department of Biological Sciences and Center for Human Health and the Enivironment, North Carolina State University, Raleigh, North Carolina, USA
- Rasheda Khanam
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sayedur Rahman
- Projahnmo Research Foundation, Dhaka, Bangladesh
- James A Litch
- Global Alliance to Prevent Prematurity and Stillbirth, Lynnwood, Washington, USA
- Aneeta Hotwani
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Daniel E Roth
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Ge Zhang
- Division of Human Genetics, Cincinnati Children`s Hospital Medical Center, Cincinnati, Ohio, USA
- Abdullah Al Mahmud
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
- Mikko Hallman
- Medical Research Centre Oulu, PEDEGO Research Unit, University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
- Huan Xu
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, Ohio, USA
- Usma Mehmood
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Zarko Alfirevic
- Department of Women’s and Children’s Health, Faculty of Health & Life Sciences, Harris Wellbeing of Women Research Centre, University of Liverpool, Liverpool, UK
- Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA
- Bellington Vwalika
- School of Medicine, University of Zambia, Lusaka, Zambia
- Susan Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
- Patrick Musonda
- School of Public Health, University of Zambia, Lusaka, Zambia
- Nagendra Monangi
- Division of Neonatology, Cincinnati Children`s Hospital Medical Center, Cincinnati, Ohio, USA
- Angharad Care
- Department of Women`s and Children`s Health, University of Liverpool, Liverpool, UK
- Fahad Aftab
- Research Division, Public Health Laboratory, Center for Public Health Kinetics, Chake Chake, Tanzania
- Waqasuddin Khan
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Joan T Price
- Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Yuemei Fan
- Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Pirkanmaa, Finland
- Thanh Q Le
- Benh Vien Tu Du, Ho Chi Minh City, Viet Nam
- Julio A Landero
- Department of Chemistry, University of Cincinnati, Cincinnati, Ohio, USA
- Gerald F Combs
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Medford, Massachusetts, USA
- Elizabeth Belling
- Division of Human Genetics, Cincinnati Children`s Hospital Medical Center, Cincinnati, Ohio, USA
- Joanne Chappell
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, Ohio, USA
- Fansheng Kong
- Division of Human Genetics, Cincinnati Children`s Hospital Medical Center, Cincinnati, Ohio, USA
- Criag Lacher
- Grand Forks Human Nutrition Research Center, USDA ARS, Grand Forks, North Dakota, USA
- Nabidul Haque Chowdhury
- Projahnmo Research Foundation, Dhaka, Bangladesh
- Furqan Kabir
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Imran Nisar
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Ambreen Nizar
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Javairia Khalid
- Biorepository and Omics Research Group, Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Sindh, Pakistan
- Said Ali
- Research Division, Public Health Laboratory, Center for Public Health Kinetics, Chake Chake, Tanzania
- Mohammed Hamad Juma
- Research Division, Public Health Laboratory, Center for Public Health Kinetics, Chake Chake, Tanzania
- Md Munirul Islam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
- Laura Goodfellow
- Department of Women`s and Children`s Health, University of Liverpool, Liverpool, Merseyside, UK
- Juhi K Gupta
- Department of Women`s and Children`s Health, University of Liverpool, Liverpool, Merseyside, UK
- Larry Rand
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA
- Courtney Baruch-Gravett
- Global Alliance to Prevent Prematurity and Stillbirth, Lynnwood, Washington, USA
- Abdullah Baqui
- International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Jane Hirst
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
- Laura L Jelliffe-Pawlowski
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Jeffrey Stringer
- Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Louis Muglia
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, Ohio, USA
- DOI
- https://doi.org/10.1136/bmjgh-2021-005856
- Journal volume & issue
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Vol. 6,
no. 9
Abstract
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.
