RT Journal Article
SR Electronic
T1 Association of maternal prenatal selenium concentration and preterm birth: a multicountry meta-analysis
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e005856
DO 10.1136/bmjgh-2021-005856
VO 6
IS 9
A1 Nagendra Monangi
A1 Huan Xu
A1 Rasheda Khanam
A1 Waqasuddin Khan
A1 Saikat Deb
A1 Jesmin Pervin
A1 Joan T Price
A1 INTERBIO-21st Study Consortium
A1 Stephen H Kennedy
A1 Abdullah Al Mahmud
A1 Yuemei Fan
A1 Thanh Q Le
A1 Angharad Care
A1 Julio A Landero
A1 Gerald F Combs
A1 Elizabeth Belling
A1 Joanne Chappell
A1 Fansheng Kong
A1 Criag Lacher
A1 Salahuddin Ahmed
A1 Nabidul Haque Chowdhury
A1 Sayedur Rahman
A1 Furqan Kabir
A1 Imran Nisar
A1 Aneeta Hotwani
A1 Usma Mehmood
A1 Ambreen Nizar
A1 Javairia Khalid
A1 Usha Dhingra
A1 Arup Dutta
A1 Said Ali
A1 Fahad Aftab
A1 Mohammed Hamad Juma
A1 Monjur Rahman
A1 Bellington Vwalika
A1 Patrick Musonda
A1 Tahmeed Ahmed
A1 Md Munirul Islam
A1 Ulla Ashorn
A1 Kenneth Maleta
A1 Mikko Hallman
A1 Laura Goodfellow
A1 Juhi K Gupta
A1 Ana Alfirevic
A1 Susan Murphy
A1 Larry Rand
A1 Kelli K Ryckman
A1 Jeffrey C Murray
A1 Rajiv Bahl
A1 James A Litch
A1 Courtney Baruch-Gravett
A1 Zarko Alfirevic
A1 Per Ashorn
A1 Abdullah Baqui
A1 Jane Hirst
A1 Cathrine Hoyo
A1 Fyezah Jehan
A1 Laura L Jelliffe-Pawlowski
A1 Anisur Rahman
A1 Daniel E Roth
A1 Sunil Sazawal
A1 Jeffrey Stringer
A1 Ge Zhang
A1 Louis Muglia
YR 2021
UL http://gh.bmj.com/content/6/9/e005856.abstract
AB 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.Data are available upon reasonable request. Deidentified participant data, the statistical code, and technical processes are available from the corresponding author on reasonable request.