Effect of selenium on markers of risk of pre-eclampsia in UK pregnant women: a randomised, controlled pilot trial
What this study found
Selenium supplementation improved selenium status and showed a signal of benefit in the subgroup with the lowest baseline selenium. In that bottom quartile, selenium lowered sFlt-1 at 35 weeks versus placebo (5.22 ng/ml vs 7.49 ng/ml; ratio 0.70, 95% CI 0.49, 0.98; P 0.039), while across all participants there was no significant effect on sFlt-1 (ratio 0.95, 95% CI 0.80, 1.12; P 0.511). SEPP1 was higher with selenium than placebo at 35 weeks (5.30 mg/ml vs 3.00 mg/ml; P 0.0001), and whole-blood selenium increased in the selenium group but fell in placebo (baseline 1.31 mmol/l to 1.87 mmol/l…
- Study & population
- Randomized, double-blind, placebo-controlled pilot trial in primiparous pregnant women in Oxford, United Kingdom, recruited at about 12.3 weeks' gestation and followed until delivery.
- Intervention
- Participants received oral selenium as Se-enriched yeast (SelenoPrecise) 60 mg/d daily from randomization at 12 to 14 weeks of gestation until delivery.
- Key limitation
- This was a small pilot trial and the authors note it was underpowered to detect definitive clinical effects.
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Open PDFOriginal abstract
Pre-eclampsia is a serious hypertensive condition of pregnancy associated with high maternal and fetal morbidity and mortality. Se intake or status has been linked to the occurrence of pre-eclampsia by our own work and that of others. We hypothesised that a small increase in the Se intake of UK pregnant women of inadequate Se status would protect against the risk of pre-eclampsia, as assessed by biomarkers of pre-eclampsia. In a double-blind, placebo-controlled, pilot trial, we randomised 230 primiparous pregnant women to Se (60 μg/d, as Se-enriched yeast) or placebo treatment from 12 to 14 weeks of gestation until delivery. Whole-blood Se concentration was measured at baseline and 35 weeks, and plasma selenoprotein P (SEPP1) concentration at 35 weeks. The primary outcome measure of the present study was serum soluble vascular endothelial growth factor receptor-1 (sFlt-1), an anti-angiogenic factor linked with the risk of pre-eclampsia. Other serum/plasma components related to the risk of pre-eclampsia were also measured. Between 12 and 35 weeks, whole-blood Se concentration increased significantly in the Se-treated group but decreased significantly in the placebo group. At 35 weeks, significantly higher concentrations of whole-blood Se and plasma SEPP1 were observed in the Se-treated group than in the placebo group. In line with our hypothesis, the concentration of sFlt-1 was significantly lower at 35 weeks in the Se-treated group than in the placebo group in participants in the lowest quartile of Se status at baseline (P= 0·039). None of the secondary outcome measures was significantly affected by treatment. The present finding that Se supplementation has the potential to reduce the risk of pre-eclampsia in pregnant women of low Se status needs to be validated in an adequately powered trial.