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,
- Sunil Sazawal,
- Rajiv Bahl,
- Salahuddin Ahmed,
- Stephen H Kennedy,
- Monjur Rahman,
- Jesmin Pervin,
- Cathrine Hoyo,
- Rasheda Khanam,
- James A Litch,
- Aneeta Hotwani,
- Daniel E Roth,
- Ge Zhang,
- Abdullah Al Mahmud,
- Mikko Hallman,
- Huan Xu,
- Zarko Alfirevic,
- Jeffrey C Murray,
- Bellington Vwalika,
- Susan Murphy,
- Patrick Musonda,
- Nagendra Monangi,
- Angharad Care,
- 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
- 6 Department of Twin Research and Genetic Epidemiology, King`s College London, London, UK
- Anisur Rahman
- Centre for Rheumatology, Department of Medicine, University College London, London, UK
- Fyezah Jehan
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
- Ana Alfirevic
- Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
- Kenneth Maleta
- University of Malawi College of Medicine, Blantyre, Malawi
- Ulla Ashorn
- 1 Faculty of Medicine and Health Technology, Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
- Per Ashorn
- Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Kelli K Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
- Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Usha Dhingra
- Centre for Public Health Kinetics (CPHK), Delhi, India
- Arup Dutta
- Center for Public Health Kinetics, New Delhi, India
- Sunil Sazawal
- Centre for Public Health Kinetics (CPHK), Delhi, India
- Rajiv Bahl
- Department of Maternal, Child, and Adolescent Health and Aging, World Health Organization, Geneva, Switzerland
- Salahuddin Ahmed
- Research, Projahnmo Research Foundation, Dhaka, Bangladesh
- Stephen H Kennedy
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK
- Monjur Rahman
- Pi Research and Development Centre, Dhaka, Bangladesh
- Jesmin Pervin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, 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 Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- 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
- 2 Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Ge Zhang
- 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
- Abdullah Al Mahmud
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Victoria, Australia
- Mikko Hallman
- Medical Research Centre Oulu, PEDEGO Research Unit, University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
- Huan Xu
- Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
- Zarko Alfirevic
- Department of Women`s and Children`s Health, University of Liverpool, Liverpool, UK
- Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA
- Bellington Vwalika
- 11 Department of Obstetrics & Gynaecology, University of Zambia School of Medicine, 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
- Women`s and Children`s Health, University of Liverpool, Liverpool, UK
- Waqasuddin Khan
- Pediatrics and Child Health, 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
- Pediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
- Imran Nisar
- Pediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
- Ambreen Nizar
- Department of Paediatrics and Child Health, 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
- Women`s and Children`s Health, University of Liverpool, Liverpool, 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
-
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.
