Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1.
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.
Kupka
Roland
R
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. rkupka@hsph.harvard.edu
Garland
Miriam
M
Msamanga
Gernard
G
Spiegelman
Donna
D
Hunter
David
D
Fawzi
Wafaie
W
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
D015415:Biomarkers; D014801:Vitamin A; D012643:Selenium