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. Design: 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 statu, was not associated with risks of low birthweight or preterm birth but was associated with an apparently lower risk of small for gestational age. Conclusion: Adequate selenium status may be beneficial for some but not all pregnancy outcomes. Ford er studies are needed to better understand the role of selenium status in pregnancy outcomes, HIV transmission, and child health.