title: Selenium and Preeclampsia: a Systematic Review and Meta-analysis.
abstract: Conflicting results exist between selenium concentration and preeclampsia. The role of selenium in the development of preeclampsia is unclear. We conducted a meta-analysis to compare the blood selenium level in patients with preeclampsia and healthy pregnant women, and to determine the effectiveness of selenium supplementation in preventing preeclampsia. We searched PubMed, ScienceDirect, the Cochrane Library, and relevant references for English language literature up to November 25, 2014. Mean difference from observational studies and relative risk from randomized controlled trials were meta-analyzed by a random-effect model. Thirteen observational studies with 1515 participants and 3 randomized controlled trials with 439 participants were included in the meta-analysis. Using a random-effect model, a statistically significant difference in blood selenium concentration of -6.47 μg/l (95 % confidence interval (CI) -11.24 to -1.7, p = 0.008) was seen after comparing the mean difference of observational studies. In randomized controlled trials, using a random-effect model, the relative risk for preeclampsia was 0.28 (0.09 to 0.84) for selenium supplementation (p = 0.02). Evidence from observational studies indicates an inverse association of blood selenium level and the risk of preeclampsia. Supplementation with selenium significantly reduces the incidence of preeclampsia. However, more prospective clinical trials are required to assess the association between selenium supplementation and preeclampsia and to determine the dose, beginning time, and duration of selenium supplementation.
authors.affiliation: Department of Obstetrics, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
authors.forename: Min
authors.identifier: http://orcid.org/0000-0003-3226-8223
authors.initials: M
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China.|Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China.|Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Gu
authors.affiliation: Department of Obstetrics, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China. sysky803@aliyun.com.
authors.forename: Shuyan
authors.initials: S
authors.lastname: Lv
mesh_terms: D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D012643:Selenium / Q000097:blood*
chemical_list: D012643:Selenium
keywords: Preeclampsia; Selenium; Systematic review and meta-analysis