Abstract

Background: Identifying women at risk for small-for-gestational-age newborns (SGA) is an important challenge in obstetrics. Several different risk factors have been suggested to contribute to the development of SGA. Previous research is inconclusive on the role selenium (Se) plays in the development of SGA. The aim of the study was therefore to explore the role of Se concentrations in amniotic fluid in order to understand its possible role in the development of SGA. Study Design: This prospective, single center study investigated the relationships between Se concentrations in amniotic fluid and pregnancy outcomes. Amniotic fluid was collected from pregnant women during amniocentesis at 16/17 weeks of pregnancy. Se values were determined using the electrothermal atomic absorption spectrometry and expressed in µg/L. Characteristics of mothers and newborns were obtained from women and delivery records. Results: 327 samples of amniotic fluid were evaluated. Patients with SGA newborns had significantly lower mean values of amniotic fluid concentrations of Se compared to appropriate-for-gestational-age (AGA) newborns (4.8 ± 1.9 µg/L versus 5.6 ± 2.5 µg/L (p = 0.017)). Adjusting for different risk factors, Se remained the only significant factor impacting the outcome of a newborn (b = −0.152, s.e. = 0.077; p < 0.048). Se levels in amniotic fluid did not correlate with pre-eclampsia or preterm delivery. Conclusion: Amniotic fluid Se levels represent a viable root of further investigation and assessment in order to identify women with low birth weight newborns early. Women with decreased Se levels had a statistically significant chance of developing SGA. Further research is needed to elucidate the link between Se, other trace elements, and other risk factors and their impact on the development of SGA newborns.

Highlights

  • Small-for-gestational-age (SGA) newborns are defined as babies below the 10th percentile of an individualized birth-weight ratio

  • Our study aimed to investigate the impact of Se concentration in amniotic fluid (AF) of pregnant women referred to amniocentesis due to an increased risk of adverse pregnancy outcomes

  • Through evaluating our primary aim, we examined the possibility to use amniotic fluid levels of microelements such as Se in order to improve our risk assessment for women at risk of their fetuses developing towards small-for-gestational-age newborns (SGA)

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Summary

Introduction

Small-for-gestational-age (SGA) newborns are defined as babies below the 10th percentile of an individualized birth-weight ratio. It is difficult to identify women who are early in pregnancy in which fetuses with SGA will develop [5]. An important risk factor for SGA as well as pre-eclampsia and pre-term birth, adjusted for other confounding factors, is advanced maternal age [6]. Especially in this group of pregnant women improved indicators for identifying fetuses at risk for SGA are needed. Identifying women at risk for small-for-gestational-age newborns (SGA) is an important challenge in obstetrics. The aim of the study was to explore the role of Se concentrations in amniotic fluid in order to understand its possible role in the development of SGA.

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