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Abstract
ABSTRACT
Background
Pregnant women in Malawi are at risk of selenium deficiency, which can have adverse effects on pregnancy outcomes. Interventions for improving selenium status are needed.
Objectives
To assess the effect of provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) to Malawian women during pregnancy on their plasma selenium concentrations at 36 wk of gestation.
Methods
Pregnant women (≤20 wk of gestation) were randomly assigned to receive daily either: 1) iron and folic acid (IFA); 2) multiple micronutrients (MMN; 130 µg selenium per capsule); or 3) SQ-LNS (130 µg selenium/20 g). Plasma selenium concentrations were measured by inductively coupled plasma mass spectrometry at baseline and after ≥16 wk of intervention (at 36 wk of gestation) and compared by intervention group.
Results
At 36 wk of gestation, median (quartile 1, quartile 3) plasma selenium concentrations (micromoles per liter) were 0.96 (0.73, 1.23), 0.94 (0.78, 1.18), and 1.01 (0.85, 1.28) in the IFA, MMN, and SQ-LNS groups, respectively. Geometric mean (GM) plasma selenium concentration was 5.4% (95% CI: 1.8%, 9.0%) higher in the SQ-LNS group than in the MMN group and tended to be higher than in the IFA group (+4.2%; 95% CI: 1.0%, 7.8%). The prevalence of adjusted plasma selenium concentrations <1 µmol/L was 55.1%, 57.8%, and 47.3% in the IFA, MMN, and SQ-LNS groups, respectively; it was lower in the SQ-LNS group than in the MMN group, OR = 0.44 (95% CI: 0.24, 0.83), and tended to be lower than in the IFA group, OR = 0.54 (95% CI: 0.29, 1.03). There was a significant interaction between baseline plasma selenium concentration and intervention group (P = 0.003). In the lowest tertile of baseline selenium concentrations, GM plasma selenium concentration was higher, and the prevalence of low values was lower in the SQ-LNS group compared with the MMN and IFA groups at 36 wk of gestation (P ≤ 0.007).
Conclusions
Provision of SQ-LNS containing selenium to pregnant women can be an effective strategy for improving their selenium status.
This trial was registered at clinicaltrials.gov (identifier: NCT01239693).
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Details
1 Institute for Global Nutrition, University of California , Davis, Davis, CA , USA
2 Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi , Blantyre , Malawi
3 Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University , Tampere , Finland
4 Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
5 Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
6 Division of Human Genetics, Cincinnati Children's Hospital Medical Center , Cincinnati, OH , USA
7 Department of Chemistry, University of Cincinnati , Cincinnati, OH , USA
8 Medical Research Centre Oulu, PEDEGO Research Unit, University of Oulu , Oulu, Pohjois-Pohjanmaa , Finland