Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynaecology, Gothenburg, Sweden.
Division of Infection Control, Environment and Health, Norwegian Institute of Public Health, Oslo, Norway.
Sci Total Environ. 2021 Dec 1;798:149271. doi: 10.1016/j.scitotenv.2021.149271. Epub 2021 Jul 27.
Pregnancy-induced hypertensive disorders (PIHD), including preeclampsia, cause maternal and perinatal morbidity and mortality worldwide. Several studies have linked selenium supplementation and selenium status to the risk of preeclampsia, but there are no published prospective population-based studies examining associations between dietary selenium intake and preeclampsia.
To examine associations between selenium intake from diet and supplements and selenium blood status and PIHD incidence, with sub-analyses for pregnancy-induced hypertension (PIH) and preeclampsia, in a large pregnancy cohort.
The study is based on 69,972 singleton pregnancies from the Norwegian Mother, Father and Child Cohort Study. Maternal dietary selenium intake was assessed with a validated, semi-quantitative food frequency questionnaire at about gestational week 22. Maternal selenium concentrations were measured in whole blood collected around gestational week 18 in a subset of 2572 women. Preeclampsia and PIH diagnosges were obtained from the Medical Birth Registry of Norway.
Participants had a median dietary selenium intake of 53 μg/day (IQR 44-62). Dietary selenium intake was not significantly associated with PIHD (adjusted (a) OR 1.03, 95% CI 0.98, 1.08 per SD of selenium intake), preeclampsia or PIH. Threshold analyses for deciles of dietary selenium intake did not show any significant associations. Neither inorganic (aOR 1.01, 95% CI 0.98, 1.05) or organic selenium supplement intake (aOR 0.98, 95% CI 0.95, 1.02) or selenium blood status was significantly associated with PIHD (aOR 1.03, 95% CI 0.86, 1.22) or PIHD subgroups.
No significant associations were found between reported selenium intake from diet, or dietary supplements or whole-blood selenium status and PIHD in general or preeclampsia specifically. Hence, the results of this large population-based study, with selenium intake close to the recommended daily intake, do not support previous findings indicating a possible protective effect of selenium supplementation or selenium status with regard to preeclampsia incidence.
妊娠高血压疾病(PIHD),包括子痫前期,在全球范围内导致母婴发病率和死亡率。一些研究将硒补充剂和硒状态与子痫前期的风险联系起来,但没有发表过基于人群的前瞻性研究来检查饮食中硒摄入与子痫前期之间的关系。
在一个大型妊娠队列中,检查饮食和补充剂中的硒摄入与硒血液状况与 PIHD 发生率之间的关联,并对子痫前期和妊娠高血压(PIH)进行亚分析。
本研究基于挪威母婴儿童队列研究中的 69972 例单胎妊娠。在大约妊娠 22 周时,使用经过验证的半定量食物频率问卷评估了母体的饮食硒摄入量。在 2572 名妇女中,大约妊娠 18 周时采集全血测量了母体硒浓度。从挪威医学出生登记处获得子痫前期和 PIH 诊断。
参与者的中位饮食硒摄入量为 53μg/天(IQR 44-62)。饮食硒摄入量与 PIHD(调整(a)OR 1.03,95%CI 0.98,1.08 每 SD 的硒摄入量)、子痫前期或 PIH 无显著相关性。饮食硒摄入量的十分位数的阈值分析也没有显示出任何显著的相关性。无机硒(aOR 1.01,95%CI 0.98,1.05)或有机硒补充剂摄入(aOR 0.98,95%CI 0.95,1.02)或全血硒状态与 PIHD(aOR 1.03,95%CI 0.86,1.22)或 PIHD 亚组也无显著相关性。
一般来说,报告的饮食硒摄入或饮食补充剂或全血硒状态与 PIHD 或子痫前期之间没有显著相关性。因此,这项基于人群的大型研究结果,硒摄入量接近推荐的每日摄入量,不支持以前的研究结果,表明硒补充剂或硒状态可能对子痫前期的发生有保护作用。