Provision of Small-Quantity Lipid-Based Nutrient Supplements Increases Plasma Selenium Concentration in Pregnant Women in Malawi: A Secondary Outcome of a Randomized Controlled Trial

Marjorie J. Haskell, Kenneth Maleta, Charles D. Arnold, Josh M. Jorgensen, Yue Mei Fan, Ulla Ashorn, Andrew Matchado, Nagendra K. Monangi, Ge Zhang, Huan Xu, Elizabeth Belling, Julio Landero, Joanne Chappell, Louis J. Muglia, Mikko Hallman, Per Ashorn, Kathryn G. Dewey

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    Abstract

    Background: Pregnant women in Malawi are at risk of selenium deficiency, which can have adverse effects on pregnancy outcomes. Interventions for improving selenium status are needed. Objectives: To assess the effect of provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) to Malawian women during pregnancy on their plasma selenium concentrations at 36 wk of gestation. Methods: Pregnant women (≤20 wk of gestation) were randomly assigned to receive daily either: 1) iron and folic acid (IFA); 2) multiple micronutrients (MMN; 130 μg selenium per capsule); or 3) SQ-LNS (130 μg selenium/20 g). Plasma selenium concentrations were measured by inductively coupled plasma mass spectrometry at baseline and after ≥16 wk of intervention (at 36 wk of gestation) and compared by intervention group. Results: At 36 wk of gestation, median (quartile 1, quartile 3) plasma selenium concentrations (micromoles per liter) were 0.96 (0.73, 1.23), 0.94 (0.78, 1.18), and 1.01 (0.85, 1.28) in the IFA, MMN, and SQ-LNS groups, respectively. Geometric mean (GM) plasma selenium concentration was 5.4% (95% CI: 1.8%, 9.0%) higher in the SQ-LNS group than in the MMN group and tended to be higher than in the IFA group (+4.2%; 95% CI: 1.0%, 7.8%). The prevalence of adjusted plasma selenium concentrations <1 μmol/L was 55.1%, 57.8%, and 47.3% in the IFA, MMN, and SQ-LNS groups, respectively; it was lower in the SQ-LNS group than in the MMN group, OR = 0.44 (95% CI: 0.24, 0.83), and tended to be lower than in the IFA group, OR = 0.54 (95% CI: 0.29, 1.03). There was a significant interaction between baseline plasma selenium concentration and intervention group (P = 0.003). In the lowest tertile of baseline selenium concentrations, GM plasma selenium concentration was higher, and the prevalence of low values was lower in the SQ-LNS group compared with the MMN and IFA groups at 36 wk of gestation (P ≤ 0.007). Conclusions: Provision of SQ-LNS containing selenium to pregnant women can be an effective strategy for improving their selenium status. This trial was registered at clinicaltrials.gov (identifier: NCT01239693).

    Original languageEnglish
    Article numbernzac013
    JournalCurrent Developments in Nutrition
    Volume6
    Issue number3
    DOIs
    Publication statusPublished - Mar 2022
    Publication typeA1 Journal article-refereed

    Keywords

    • lipid-based nutrient supplements
    • Malawi
    • plasma
    • pregnancy
    • selenium status

    Publication forum classification

    • Publication forum level 1

    ASJC Scopus subject areas

    • Medicine (miscellaneous)
    • Food Science
    • Nutrition and Dietetics

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