Clinical and Metabolic Response to Selenium Supplementation in Pregnant Women at Risk for Intrauterine Growth Restriction: Randomized, Double-Blind, Placebo-Controlled Trial.

Abstract

Data on the effects of selenium supplementation on clinical signs and metabolic profiles in women at risk for intrauterine growth restriction (IUGR) are scarce. This study was designed to assess the effects of selenium supplementation on clinical signs and metabolic status in pregnant women at risk for IUGR. This randomized double-blind placebo-controlled clinical trial was performed among 60 women at risk for IUGR according to abnormal uterine artery Doppler waveform. Participants were randomly assigned to intake either 100μg selenium supplements as tablet (n=30) or placebo (n=30) for 10weeks between 17 and 27weeks of gestation. After 10weeks of selenium administration, a higher percentage of women in the selenium group had pulsatility index (PI) of <1.45) (P=0.002) than of those in the placebo group. In addition, changes in plasma levels of total antioxidant capacity (TAC) (P<0.001), glutathione (GSH) (P=0.008), and high-sensitivity C-reactive protein (hs-CRP) (P=0.004) in the selenium group were significant compared with the placebo group. Additionally, selenium supplementation significantly decreased serum insulin (P=0.02), homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (P=0.02), and homeostatic model assessment for B-cell function (HOMA-B) (P=0.02) and significantly increased quantitative insulin sensitivity check index (QUICKI) (P=0.04) and HDL-C levels (P=0.02) compared with the placebo. We did not find any significant effect of selenium administration on malondialdehyde (MDA), nitric oxide (NO), fasting plasma glucose (FPG), and other lipid profiles. Overall, selenium supplementation in pregnant women at risk for IUGR resulted in improved PI, TAC, GSH, hs-CRP, and markers of insulin metabolism and HDL-C levels, but it did not affect MDA, NO, FPG, and other lipid profiles.Clinical trial registration number http://www.irct.ir : IRCT201601045623N64.