Abstract
Dietary intake/status of the trace mineral Se may affect the risk of developing hypertensive conditions of pregnancy, i.e. pre-eclampsia and pregnancy-induced hypertension (PE/PIH). In the present study, we evaluated Se status in U.K. pregnant women to establish whether pre-pregnant Se status or Se supplementation affected the risk of developing PE/PIH. The samples originated from the SPRINT (Selenium in PRegnancy INTervention) study that randomised 230 U.K. primiparous women to treatment with Se (60 μg/d) or placebo from 12 weeks of gestation. Whole-blood Se concentration was measured at 12 and 35 weeks, toenail Se concentration at 16 weeks, plasma selenoprotein P (SEPP1) concentration at 35 weeks and plasma glutathione peroxidase (GPx3) activity at 12, 20 and 35 weeks. Demographic data were collected at baseline. Participants completed a FFQ. U.K. pregnant women had whole-blood Se concentration lower than the mid-range of other populations, toenail Se concentration considerably lower than U.S. women, GPx3 activity considerably lower than U.S. and Australian pregnant women, and low baseline SEPP1 concentration (median 3.00, range 0.90-5.80 mg/l). Maternal age, education and social class were positively associated with Se status. After adjustment, whole-blood Se concentration was higher in women consuming Brazil nuts (P= 0.040) and in those consuming more than two seafood portions per week (P= 0.054). A stepwise logistic regression model revealed that among the Se-related risk factors, only toenail Se (OR 0.38, 95% CI 0.17, 0.87, P= 0.021) significantly affected the OR for PE/PIH. On excluding non-compliers with Se treatment, Se supplementation also significantly reduced the OR for PE/PIH (OR 0.30, 95% CI 0.09, 1.00, P= 0.049). In conclusion, U.K. women have low Se status that increases their risk of developing PE/PIH. Therefore, U.K. women of childbearing age need to improve their Se status.
Highlights
Dietary intake/status of the trace mineral Se may affect the risk of developing hypertensive conditions of pregnancy, i.e. pre-eclampsia and pregnancy-induced hypertension (PE/PIH)
Baseline whole-blood Se concentration (12 weeks) was significantly correlated with the concentration of Se in toenails clipped at 16 weeks (Spearman’s r 1⁄4 0·447, P, 0·001), as shown in Fig. 1, but not with plasma glutathione peroxidase (GPx3) activity measured at 12 weeks (Spearman’s r 1⁄4 0·042, P1⁄40·533)
We validated our second hypothesis that Se status/Se supplementation affects the risk of developing hypertensive conditions of pregnancy; the odds of PE/PIH were significantly reduced in women with higher pre-pregnancy Se status and in those supplemented with Se from 12 weeks of gestation
Summary
Dietary intake/status of the trace mineral Se may affect the risk of developing hypertensive conditions of pregnancy, i.e. pre-eclampsia and pregnancy-induced hypertension (PE/PIH). As many as 10 % of women are affected by high blood pressure in pregnancy and some 2 – 5 % will go on to develop proteinuria, triggering a diagnosis of the more serious hypertensive condition, i.e. pre-eclampsia (PE)(1,2). Is PE associated with high maternal and fetal morbidity and mortality[1,2], women who have had PE, or pregnancy-induced hypertension (PIH), have a greater risk of developing hypertension, stroke and IHD in later life(3 – 5). Genetic evidence suggests that the Abbreviations: DBP, diastolic blood pressure; GPx, glutathione peroxidase; GPx3, plasma glutathione peroxidase; PE, pre-eclampsia; PIH, pregnancyinduced hypertension; SEPP1, selenoprotein P; Treg cells, regulatory T cells
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