title: Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1.
abstract: BACKGROUND
  Among HIV-infected pregnant women, low selenium status may increase risk of mother-to-child transmission (MTCT) of HIV and poor pregnancy outcomes (low birthweight, small for gestational age, preterm birth, and fetal death) through several mechanisms, such as by promoting maternal HIV disease progression, viral shedding in the genital tract, and development of mastitis. However, there is no direct epidemiologic evidence on these relations among HIV-infected pregnant women.
  
  
  OBJECTIVE
  To investigate the association between selenium status during pregnancy and pregnancy outcomes, MTCT of HIV, and child mortality.
  
  
  METHODS
  Baseline plasma selenium measurements from HIV-positive pregnant women (n = 670) were obtained between 12-27 weeks of gestation and mother-child pairs were followed prospectively until 24 months after delivery.
  
  
  RESULTS
  Low plasma selenium levels were associated with increased risks of fetal death, child death, and HIV transmission through the intrapartum route. Low selenium status was not associated with risks of low birthweight or preterm birth but was associated with an apparently lower risk of small for gestational age.
  
  
  CONCLUSIONS
  Adequate selenium status may be beneficial for some but not all pregnancy outcomes. Further studies are needed to better understand the role of selenium status in pregnancy outcomes, HIV transmission, and child health.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. rkupka@hsph.harvard.edu
authors.forename: Roland
authors.initials: R
authors.lastname: Kupka
authors.forename: Miriam
authors.initials: M
authors.lastname: Garland
authors.forename: Gernard
authors.initials: G
authors.lastname: Msamanga
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: David
authors.initials: D
authors.lastname: Hunter
authors.forename: Wafaie
authors.initials: W
authors.lastname: Fawzi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005313:Fetal Death; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000821:virology*; D011256:Pregnancy Outcome; D012643:Selenium / Q000097:blood*; D014801:Vitamin A / Q000097:blood
chemical_list: D015415:Biomarkers; D014801:Vitamin A; D012643:Selenium