Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
International Center for Diarrheal Disease Research, GPO Box 128, Dhaka, 1000, Bangladesh.
Clin Nutr. 2015 Oct;34(5):923-30. doi: 10.1016/j.clnu.2014.09.020. Epub 2014 Oct 5.
BACKGROUND & AIMS: Selenium deficiency has been shown to affect the neurological development in animals, but human research in this area is scarce. We aimed to assess the impact of selenium status during pregnancy on child development at 1.5 years of age.
This prospective cohort study was nested into a food and micronutrient supplementation trial (MINIMat) conducted in rural Bangladesh. Using inductively coupled plasma mass spectrometry, we measured selenium concentrations in erythrocyte fraction of blood collected from 750 mothers at gestational week 30, and calculated μg per g hemoglobin. A revised version of Bayley Scales of Infant Development was used to assess children's mental and psychomotor development. A Bangladeshi version of MacArthur's Communicative Development Inventory was used to assess language comprehension and expression. Linear regression analyses adjusted for multiple covariates were used to assess the associations.
Maternal erythrocyte selenium concentrations varied considerably, from 0.19 to 0.87 μg/g hemoglobin (median 0.46 μg/g hemoglobin), and were associated with developmental measures. An increase in erythrocyte selenium by 0.50 μg/g hemoglobin was associated with an increase in children's language comprehension by 3.7 points (0.5 standard deviations; 95% confidence interval: 0.40, 7.1; p = 0.028). The same increase in erythrocyte selenium corresponded to an increase in the girls' psychomotor development by 12 points (0.9 standard deviation; 95% confidence interval: 4.3, 19; p = 0.002), but much less in boys.
Low prenatal selenium status seems to be disadvantageous for children's psychomotor and language development. Further studies are needed to elucidate the underlying mechanisms of these effects.
已有研究表明，硒缺乏会影响动物的神经发育，但该领域的人体研究较少。本研究旨在评估妊娠期间硒状况对 1.5 岁儿童发育的影响。
本前瞻性队列研究嵌套于孟加拉国农村地区开展的一项食物和微量营养素补充试验（MINIMat）。采用电感耦合等离子体质谱法，检测了 750 名母亲妊娠 30 周时采集的血红细胞中硒浓度，并计算每克血红蛋白中的微克数。采用贝利婴幼儿发展量表第三版评估儿童的精神和运动发育，采用麦克阿瑟语言发展量表孟加拉语版评估语言理解和表达能力。采用多元调整线性回归分析评估相关性。
母亲红细胞硒浓度差异较大，范围为 0.19 至 0.87 μg/g 血红蛋白（中位数 0.46 μg/g 血红蛋白），并与发育指标相关。红细胞硒增加 0.50 μg/g 血红蛋白，儿童语言理解能力增加 3.7 分（0.5 个标准差；95%置信区间：0.40，7.1；p = 0.028）。同样的红细胞硒增加对应女孩运动发育增加 12 分（0.9 个标准差；95%置信区间：4.3，19；p = 0.002），但男孩的增幅较小。
低产前硒状态似乎不利于儿童的运动和语言发育。需要进一步研究阐明这些影响的潜在机制。
