Jin Ying, Coad Jane, Pond Rachael, Kim Nick, Brough Louise
R J Hill Laboratories Limited, Hamilton, New Zealand; Canterbury Health Laboratories, Christchurch, New Zealand; Nutrition Laboratory, Massey University, Palmerston North, New Zealand; School of Health Sciences, College of Health, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
R J Hill Laboratories Limited, Hamilton, New Zealand; Canterbury Health Laboratories, Christchurch, New Zealand; Nutrition Laboratory, Massey University, Palmerston North, New Zealand; Nutrition Science, School of Food and Advanced Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand.
J Trace Elem Med Biol. 2020 Sep;61:126503. doi: 10.1016/j.jtemb.2020.126503. Epub 2020 May 8.
Selenium (Se) plays an important role in selenoproteins as an antioxidant, and is involved in thyroid function, mental health and child development. Selenium is low in the local food supplies in NZ. Low selenium intake has been reported in women of childbearing age and postmenopausal women, however, there is little research relating to breastfeeding women and their infants.
The study investigates maternal and infant selenium intake and status during the first year postpartum, and possible relationships to postnatal depression and anxiety.
The Mother and Infant Nutrition Investigation (MINI) study is an observational longitudinal cohort study. In total 87 breastfeeding mother-infant pairs were recruited and followed up at 3, 6 and 12 months postpartum. Maternal selenium intake was estimated from a four-day diet diary (4DDD). Selenium concentrations were measured in maternal spot urine, breastmilk and plasma; and infant spot urine samples. Postnatal depression was screened by the Edinburgh Postnatal Depression Scale (EPDS) questionnaire.
Median maternal selenium intake was 62 (50, 84) μg/day, with 56 % below the Estimated Average Requirement (EAR) of 65 μg/day. At 3, 6, and 12 months postpartum, median maternal urinary selenium:creatinine ratios were 29.0 (22.4, 42.0), 29.5 (23.1, 28.4), and 30.9 (24.3, 35.3) μg/g; median infant urinary selenium concentrations (IUSC) were 8 (6,13), 11 (6, 15), and 24 (10, 40) μg/L; median breastmilk selenium concentrations (BMSC) were 13 (11, 14), 11 (9, 11) and 12 (11, 13) μg/L; 18 %, 11 % and 14 % of women reported probable minor depression based on the EPDS scores equal or above 10. Estimated median infant selenium intake at 3 and 6 months were 9 (8, 11) and 8 (7, 10) μg/day with 85 % and 93 % below the Adequate Intake of 12 μg/day. Median maternal plasma selenium was 105.8 μg/L at 6 months postpartum. Minor depression at three months postpartum was significantly different across tertiles of plasma selenium concentrations (p = 0.041).
Suboptimal selenium intake was observed among breastfeeding mothers and their infants in the MINI study. Potentially, some women had insufficient selenium status. Relation between selenium status and risk of postnatal depression and anxiety was inconclusive.Further research is required to explore effects on maternal thyroid function and infant neurodevelopment among women with inadequate selenium intake and status.
硒（Se）作为一种抗氧化剂在硒蛋白中发挥着重要作用，并参与甲状腺功能、心理健康和儿童发育。新西兰当地食物供应中的硒含量较低。据报道，育龄妇女和绝经后妇女的硒摄入量较低，然而，关于哺乳期妇女及其婴儿的相关研究较少。
本研究调查产后第一年母婴的硒摄入量和状况，以及与产后抑郁和焦虑的可能关系。
母婴营养调查（MINI）研究是一项观察性纵向队列研究。总共招募了87对母乳喂养的母婴对，并在产后3个月、6个月和12个月进行随访。通过为期四天的饮食日记（4DDD）估算母亲的硒摄入量。测量母亲的即时尿样、母乳和血浆以及婴儿的即时尿样中的硒浓度。通过爱丁堡产后抑郁量表（EPDS）问卷筛查产后抑郁。
母亲的硒摄入量中位数为62（50，84）μg/天，56%低于估计平均需求量（EAR）65μg/天。在产后3个月、6个月和12个月，母亲尿硒与肌酐比值的中位数分别为29.0（22.4，42.0）、29.5（23.1，28.4）和30.9（24.3，35.3）μg/g；婴儿尿硒浓度（IUSC）的中位数分别为8（6，13）、11（6，15）和24（10，40）μg/L；母乳硒浓度（BMSC）的中位数分别为13（11，14）、11（9，11）和12（11，13）μg/L；根据EPDS评分等于或高于10，分别有18%、11%和14%的女性报告可能患有轻度抑郁症。3个月和6个月时婴儿硒摄入量的估计中位数分别为9（8，11）和8（7，10）μg/天，分别有85%和93%低于适宜摄入量12μg/天。产后6个月时母亲血浆硒的中位数为105.8μg/L。产后3个月时，血浆硒浓度三分位数组之间的轻度抑郁存在显著差异（p = 0.041）。
在MINI研究中，观察到母乳喂养的母亲及其婴儿的硒摄入量未达最佳。可能有部分女性的硒状况不足。硒状况与产后抑郁和焦虑风险之间的关系尚无定论。需要进一步研究以探讨硒摄入量和状况不足的女性中对母亲甲状腺功能和婴儿神经发育的影响。
