Effect of selenium on markers of risk of pre-eclampsia in UK pregnant women: a randomised, controlled pilot trial

The British Journal of Nutrition
Q1
Apr 2014
Citations:106
Influential Citations:6
Interventional (Human) Studies
90
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Methods
Double-blind, placebo-controlled randomized pilot trial in primiparous pregnant women. 230 participants recruited at the John Radcliffe Hospital, Oxford, UK; eligibility included first pregnancy and 12–14 weeks' gestation; generally healthy.
Intervention
60 mg/d selenium, as Se-enriched yeast (SelenoPreciseTM); taken daily from 12–14 weeks' gestation until delivery.
Results
Se supplementation increased selenium status by 35 weeks (whole-blood Se: 1.31 μmol/L at baseline to 1.87 μmol/L; placebo: 1.16 μmol/L; P<0.0001). Plasma SEPP1 increased in the Se group to 5.30 mg/mL vs 3.00 mg/mL in placebo (P<0.0001). In participants in the lowest baseline Se quartile, Se lowered sFlt-1 to 5.22 ng/mL vs 7.49 ng/mL in placebo (Se:placebo ratio 0.70; P=0.039). sFlt-1:PlGF ratio decreased by 49% but not significant (P=0.066). No significant effects on secondary outcomes. When combining pre-eclampsia or PIH, Se reduced odds in all participants (OR 0.35; 95% CI 0.13–0.97; P=0.044) and showed a trend in the bottom third. Authors conclude selenium may reduce pre-eclampsia risk in women with low Se status, but validation in a properly powered trial is needed; consider higher dose or earlier start.
Limitations
Underpowered to detect differences in the primary endpoint (sFlt-1) due to an error in the initial power calculation; actual power for subgroups ~35–55%; small number of PE/PIH events; some missing 35-week data; initiation at 12 weeks may miss periconception effects; adherence issues and generalizability limited to similar populations with low selenium status.

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...