@article{45688b760e164a159b69899dfdeed69f,
title = "Association of maternal prenatal selenium concentration and preterm birth: A multicountry meta-analysis",
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.",
keywords = "child health, environmental health, epidemiology, maternal health, nutrition",
author = "Nagendra Monangi and Huan Xu and Rasheda Khanam and Waqasuddin Khan and Saikat Deb and Jesmin Pervin and Price, {Joan T.} and {INTERBIO-21st Study Consortium} and Kennedy, {Stephen H.} and {Al Mahmud}, Abdullah and Yuemei Fan and Le, {Thanh Q.} and Angharad Care and Landero, {Julio A.} and Combs, {Gerald F.} and Elizabeth Belling and Joanne Chappell and Fansheng Kong and Criag Lacher and Salahuddin Ahmed and Chowdhury, {Nabidul Haque} and Sayedur Rahman and Furqan Kabir and Imran Nisar and Aneeta Hotwani and Usma Mehmood and Ambreen Nizar and Javairia Khalid and Usha Dhingra and Arup Dutta and Said Ali and Fahad Aftab and Juma, {Mohammed Hamad} and Monjur Rahman and Bellington Vwalika and Patrick Musonda and Tahmeed Ahmed and Islam, {Md Munirul} and Ulla Ashorn and Kenneth Maleta and Mikko Hallman and Laura Goodfellow and Gupta, {Juhi K.} and Ana Alfirevic and Susan Murphy and Larry Rand and Ryckman, {Kelli K.} and Murray, {Jeffrey C.} and Rajiv Bahl and Litch, {James A.} and Per Ashorn",
note = "Funding Information: Funding This work was supported by the Bill & Melinda Gates Foundation. The funders did not have any role in study design, data analysis, data interpretation, writing of the report or submission for publication. The findings and conclusions of this article are solely the responsibility of the authors. Bill & Melinda Gates Foundation (OPP1175128, OPP1152451). Funders: GZ is supported by the March of Dimes Prematurity Research Center Ohio Collaborative and by the Burroughs Wellcome Fund (Grant 10172896). Cohort Investigations. California Prediction of Poor Outcomes of Pregnancy (CPPOP): UCSF California Preterm Birth Initiative. NEST: National Institute of Environmental Health Sciences (R21ES014947, R01ES016772, P30ES025128 and P01ES022831), the US Environmental Protection Agency (RD-83543701), the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085173) and the Duke Cancer Institute. iLiNS-DYAD-M trial is funded by a grant to the University of California, Davis from the Bill & Melinda Gates Foundation (OPP49817). A grant to the University of California, Davis from the Office of Health, Infectious Diseases and Nutrition, Bureau for Global Health, US Agency for International Development (USAID) under terms of Cooperative Agreement No. AID-OAA-A-12–00005 through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360. The Global Alliance to Prevention of Prematurity and Stillbirth (GAPPS) Biorepository Programme funded by the Preventing Preterm Birth Initiative grant from the Bill & Melinda Gates Foundation (OPP1033514). MDIG trial funded by The Bill & Melinda Gates Foundation (OPP1066764). Funding Information: Acknowledgements We are grateful to all participating families and study personnel from 17 international pregnancy cohorts, who took part in this study. Payment for access to data and article-processing charges for this publication was covered by The Bill & Melinda Gates Foundation (Grant no: OPP1175128, OPP1152451). The authors would like to acknowledge the March of Dimes Prematurity Research Centre Ohio Collaborative for their support to the original GWAS study that identified the EEFSEC gene and led to this study. The Aga Khan University would like to acknowledge Dr Yoshida Sachiyo and Dr Alexander Manu from the WHO, community health workers, pregnant women and their families. This study used biospecimen processing and storage services from the Discover Together Biobank at Cincinnati Children{\textquoteright}s Hospital Research Foundation. We thank the Discover Together Biobank for support of this work. The NEST study acknowledges the support from National Institute of Environmental Health Sciences, the US Environmental Protection Agency, the National Institute of Diabetes and Digestive and Kidney Diseases and the Duke Cancer Institute. Th CPPOP study acknowledge support from the UCSF California Preterm Birth Initiative. The iLiNS-DYAD-M trial acknowledge the support by a grant to the University of California, Davis from The Bill & Melinda Gates Foundation (OPP49817) and a grant to the University of California, Davis from the Office of Health, Infectious Diseases and Nutrition, Bureau for Global Health, US Agency for International Development (USAID) through the Food and Nutrition Technical Assistance III Project (FANTA). MDIG, AMANHI, GAPPS and INTERBIO cohorts acknowledge the support by The Bill & Melinda Gates Foundation. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = sep,
day = "13",
doi = "10.1136/bmjgh-2021-005856",
language = "English",
volume = "6",
number = "9",
}
