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Selenium and neonatal outcomes

Journal of Perinatology volume 38, page 1428 (2018)Cite this article

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I read with interest the recent state of the art on selenium (Se) [1] in extremely premature infants by Tindell and Tipple. This review is very much needed on a very much neglected area of research. The authors mentioned “less than 10 publications regarding Se deficiency and treatment in preterm and extremely preterm infants were identified in their literature review”. Our NICU and research laboratory has published three additional papers, two are very much related to the current review by Tindell. Following the Cochrane Review by Darlow mentioned by the authors (ref. 42), showing late onset sepsis was reduced by Se supplementation, we in 2012 prospectively studied maternal and cord plasma Se, by ICP-MS techniques in 256 premature infants <34 weeks gestation at high risk for bacterial sepsis [2]. A significant biochemical Se deficiency (<60 mcg/L) at birth was found in 58% infants. Se levels were half of their mothers’ levels 108 mcg/L (p < 0.003) who were 98% sufficient in Se. Se did not impact on the etiology of sepsis (R = 0.063), (p = 0.313). Se deficiency (p < 0.03), oxygen exposure (p < 0.001), and mechanical ventilation (p < 0.002) had a strong association with BPD. PPROM, chorioamnionitis, and instrumentation significantly contributed to sepsis. In this study, Se played a role in the development of BPD, but not on sepsis.

This association of Se with BPD was also found in 2003 [3] with 81 preterm infants <30 weeks gestation. We studied cord blood and third day of life Se, alpha tocopherol, total and oxidized glutathione, glutathione peroxidase, superoxide dismutase, and urinary malondialdehyde. Using subset regression analysis, yielded an equation (R2 = 0.8839) in which, RBC Se and glutathione peroxidase levels in cord and neonatal blood at 3 days of life correctly predicted infants who developed BPD 100% of the time. In this study, there was no correlation between lipid peroxidation and BPD. We were also interested in vitamin E since Se and vitamin E act synergistically in the prevention of peroxide formation and their disposal.

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References

  1. Tindell R, Tipple T. Selenium: implications for outcomes in extremely preterm infants. J Perinatol. 2018;38:197–202.

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  2. Falciglia HS, Miller JD, Hasselfeld KA, Engel AM, Falciglia GA, Walsh PM, Brady WK. Relationship between maternal and infant plasma selenium levels with sepsis and various outcome measures. Neonatal Intensive Care. 2013;26:6.

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  3. Falciglia HS, Johnson JR, Sullivan JA, Hall CF, Miller JD, Riechmann GC, Falciglia GA. Role of antoxidants nutrients and lipid peroxidation in premature infants with respiratory distress syndrome and bronchopulmonary dysplasia. Am J Perinatol. 2003;20:97–107.

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  4. Falciglia HS, Ginn-Pease ME, Falciglia GA, Lubin AH, Frank DJ, Chang W. Vitamin E and selenium levels of premature infants with severe respiratory distress syndrome and bronchopulmonary dysplasia. J Pediatr Perinat Nutr. 1988;2:35–49.

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  1. Neonatology and Pulmonary Division, Cincinnati Children’s Hospital, Cincinnati, OH, 45229, USA

    Horacio S. Falciglia

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Correspondence to Horacio S. Falciglia.

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Falciglia, H.S. Selenium and neonatal outcomes. J Perinatol 38, 1428 (2018). https://doi.org/10.1038/s41372-018-0163-2

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