British Journal of Nutrition

Full Papers

Dietary Surveys and Nutritional Epidemiology

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

Margaret P. Raymana1 c1, Elizabeth Searlea2, Lynne Kellya3, Sigurd Johnsena4, Katherine Bodman-Smitha1, Sarah C. Batha1, Jinyuan Maoa1 and Christopher W. G. Redmana2

a1 Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK

a2 Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford OX3 9DU, UK

a3 Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork, Republic of Ireland

a4 Surrey Clinical Research Centre (CRC), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XP, UK

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 that a small increase in the Se intake of UK pregnant women of inadequate Se status would protect against the risk of pre-eclampsia, as assessed by biomarkers of pre-eclampsia. In a double-blind, placebo-controlled, pilot trial, we randomised 230 primiparous pregnant women to Se (60 μg/d, as Se-enriched yeast) or placebo treatment from 12 to 14 weeks of gestation until delivery. Whole-blood Se concentration was measured at baseline and 35 weeks, and plasma selenoprotein P (SEPP1) concentration at 35 weeks. The primary outcome measure of the present study was serum soluble vascular endothelial growth factor receptor-1 (sFlt-1), an anti-angiogenic factor linked with the risk of pre-eclampsia. Other serum/plasma components related to the risk of pre-eclampsia were also measured. Between 12 and 35 weeks, whole-blood Se concentration increased significantly in the Se-treated group but decreased significantly in the placebo group. At 35 weeks, significantly higher concentrations of whole-blood Se and plasma SEPP1 were observed in the Se-treated group than in the placebo group. In line with our hypothesis, the concentration of sFlt-1 was significantly lower at 35 weeks in the Se-treated group than in the placebo group in participants in the lowest quartile of Se status at baseline (P= 0·039). None of the secondary outcome measures was significantly affected by treatment. The present finding that Se supplementation has the potential to reduce the risk of pre-eclampsia in pregnant women of low Se status needs to be validated in an adequately powered trial.

(Received August 15 2013)

(Revised January 28 2014)

(Accepted January 31 2014)

(Online publication April 08 2014)

Key Words:

  • Selenium;
  • Pre-eclampsia;
  • Soluble vascular endothelial growth factor receptor-1;
  • Pregnancy;
  • Selenoprotein P

Correspondence

c1 Corresponding author: Professor M. P. Rayman, fax +44 1483 686401, email m.rayman@surrey.ac.uk

Footnotes

  Abbreviations: CRP, C-reactive protein; GPx, glutathione peroxidase; PIH, pregnancy-induced hypertension; PlGF, placental growth factor; SEPP1, selenoprotein P; sFlt-1, soluble vascular endothelial growth factor receptor-1

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