Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and child outcomes2
Identifieur interne : 000F72 ( Pmc/Corpus ); précédent : 000F71; suivant : 000F73Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and child outcomes2
Auteurs : Roland Kupka ; Ferdinand Mugusi ; Said Aboud ; Gernard I. Msamanga ; Julia L. Finkelstein ; Donna Spiegelman ; Wafaie W. FawziSource :
- The American journal of clinical nutrition [ 0002-9165 ] ; 2008.
Abstract
In observational studies, adequate selenium status has been associated with better pregnancy outcomes and slowed HIV disease progression.
We investigated the effects of daily selenium supplements on CD4 cell counts, viral load, pregnancy outcomes, and maternal and infant mortality among 913 HIV-infected pregnant women.
In this randomized, double-blind, placebo-controlled trial, eligible women between 12 and 27 wk of gestation were given daily selenium (200 μg as selenomethionine) or placebo as supplements from recruitment until 6 mo after delivery. All women received prenatal iron, folic acid, and multivitamin supplements irrespective of experimental assignment.
The selenium regimen had no significant effect on maternal CD4 cell counts or viral load. Selenium was marginally associated with a reduced risk of low birth weight [relative risk (RR) = 0.71; 95% CI: 0.49, 1.05;
Among HIV-infected women from Dar es Salaam, Tanzania, selenium supplements given during and after pregnancy did not improve HIV disease progression or pregnancy outcomes, but may improve child survival. This trial was registered at clinical-trials.gov as NCT00197561.
Url:
PubMed: 18541571
PubMed Central: 2474659
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PMC:2474659Le document en format XML
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<author><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name>
</author>
<author><name sortKey="Mugusi, Ferdinand" sort="Mugusi, Ferdinand" uniqKey="Mugusi F" first="Ferdinand" last="Mugusi">Ferdinand Mugusi</name>
</author>
<author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name>
</author>
<author><name sortKey="Msamanga, Gernard I" sort="Msamanga, Gernard I" uniqKey="Msamanga G" first="Gernard I" last="Msamanga">Gernard I. Msamanga</name>
</author>
<author><name sortKey="Finkelstein, Julia L" sort="Finkelstein, Julia L" uniqKey="Finkelstein J" first="Julia L" last="Finkelstein">Julia L. Finkelstein</name>
</author>
<author><name sortKey="Spiegelman, Donna" sort="Spiegelman, Donna" uniqKey="Spiegelman D" first="Donna" last="Spiegelman">Donna Spiegelman</name>
</author>
<author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and child outcomes<xref rid="FN2" ref-type="fn">2</xref>
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<author><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name>
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<author><name sortKey="Mugusi, Ferdinand" sort="Mugusi, Ferdinand" uniqKey="Mugusi F" first="Ferdinand" last="Mugusi">Ferdinand Mugusi</name>
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<author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name>
</author>
<author><name sortKey="Msamanga, Gernard I" sort="Msamanga, Gernard I" uniqKey="Msamanga G" first="Gernard I" last="Msamanga">Gernard I. Msamanga</name>
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<author><name sortKey="Finkelstein, Julia L" sort="Finkelstein, Julia L" uniqKey="Finkelstein J" first="Julia L" last="Finkelstein">Julia L. Finkelstein</name>
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<author><name sortKey="Spiegelman, Donna" sort="Spiegelman, Donna" uniqKey="Spiegelman D" first="Donna" last="Spiegelman">Donna Spiegelman</name>
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<author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name>
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<series><title level="j">The American journal of clinical nutrition</title>
<idno type="ISSN">0002-9165</idno>
<imprint><date when="2008">2008</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">In observational studies, adequate selenium status has been associated with better pregnancy outcomes and slowed HIV disease progression.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">We investigated the effects of daily selenium supplements on CD4 cell counts, viral load, pregnancy outcomes, and maternal and infant mortality among 913 HIV-infected pregnant women.</p>
</sec>
<sec id="S3"><title>Design</title>
<p id="P3">In this randomized, double-blind, placebo-controlled trial, eligible women between 12 and 27 wk of gestation were given daily selenium (200 μg as selenomethionine) or placebo as supplements from recruitment until 6 mo after delivery. All women received prenatal iron, folic acid, and multivitamin supplements irrespective of experimental assignment.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">The selenium regimen had no significant effect on maternal CD4 cell counts or viral load. Selenium was marginally associated with a reduced risk of low birth weight [relative risk (RR) = 0.71; 95% CI: 0.49, 1.05; <italic>P</italic>
= 0.09] and increased risk of fetal death (RR = 1.58; 95% CI = 0.95, 2.63; <italic>P</italic>
= 0.08), but had no effect on risk of prematurity or small-for-gestational age birth. The regimen had no significant effect on maternal mortality (RR = 1.02; 95% CI = 0.51, 2.04; <italic>P</italic>
= 0.96). There was no significant effect on neonatal or overall child mortality, but selenium reduced the risk of child mortality after 6 wk (RR = 0.43; 95% CI = 0.19, 0.99; <italic>P</italic>
= 0.048).</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">Among HIV-infected women from Dar es Salaam, Tanzania, selenium supplements given during and after pregnancy did not improve HIV disease progression or pregnancy outcomes, but may improve child survival. This trial was registered at clinical-trials.gov as NCT00197561.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0376027</journal-id>
<journal-id journal-id-type="pubmed-jr-id">412</journal-id>
<journal-id journal-id-type="nlm-ta">Am J Clin Nutr</journal-id>
<journal-title>The American journal of clinical nutrition</journal-title>
<issn pub-type="ppub">0002-9165</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">18541571</article-id>
<article-id pub-id-type="pmc">2474659</article-id>
<article-id pub-id-type="manuscript">NIHMS57331</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and child outcomes<xref rid="FN2" ref-type="fn">2</xref>
</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Kupka</surname>
<given-names>Roland</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Mugusi</surname>
<given-names>Ferdinand</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Aboud</surname>
<given-names>Said</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Msamanga</surname>
<given-names>Gernard I</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Finkelstein</surname>
<given-names>Julia L</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Spiegelman</surname>
<given-names>Donna</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Fawzi</surname>
<given-names>Wafaie W</given-names>
</name>
</contrib>
<aff id="A1">From the Departments of Nutrition (RK, JLF, and WWF), Epidemiology (WWF and DS), and Biostatistics (DS), Harvard School of Public Health, Boston, MA, and the Departments of Internal Medicine (FM), Microbiology and Immunology (SA), and Community Health (GIM), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff>
</contrib-group>
<author-notes><corresp id="FN1">Address reprint requests to R Kupka, Department of Nutrition, Harvard School of Public Health, 1633 Tremont Street, Boston, MA 02120. E-mail: <email>rkupka@post.harvard.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>3</day>
<month>7</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>6</month>
<year>2009</year>
</pub-date>
<volume>87</volume>
<issue>6</issue>
<fpage>1802</fpage>
<lpage>1808</lpage>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">In observational studies, adequate selenium status has been associated with better pregnancy outcomes and slowed HIV disease progression.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">We investigated the effects of daily selenium supplements on CD4 cell counts, viral load, pregnancy outcomes, and maternal and infant mortality among 913 HIV-infected pregnant women.</p>
</sec>
<sec id="S3"><title>Design</title>
<p id="P3">In this randomized, double-blind, placebo-controlled trial, eligible women between 12 and 27 wk of gestation were given daily selenium (200 μg as selenomethionine) or placebo as supplements from recruitment until 6 mo after delivery. All women received prenatal iron, folic acid, and multivitamin supplements irrespective of experimental assignment.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">The selenium regimen had no significant effect on maternal CD4 cell counts or viral load. Selenium was marginally associated with a reduced risk of low birth weight [relative risk (RR) = 0.71; 95% CI: 0.49, 1.05; <italic>P</italic>
= 0.09] and increased risk of fetal death (RR = 1.58; 95% CI = 0.95, 2.63; <italic>P</italic>
= 0.08), but had no effect on risk of prematurity or small-for-gestational age birth. The regimen had no significant effect on maternal mortality (RR = 1.02; 95% CI = 0.51, 2.04; <italic>P</italic>
= 0.96). There was no significant effect on neonatal or overall child mortality, but selenium reduced the risk of child mortality after 6 wk (RR = 0.43; 95% CI = 0.19, 0.99; <italic>P</italic>
= 0.048).</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">Among HIV-infected women from Dar es Salaam, Tanzania, selenium supplements given during and after pregnancy did not improve HIV disease progression or pregnancy outcomes, but may improve child survival. This trial was registered at clinical-trials.gov as NCT00197561.</p>
</sec>
</abstract>
<contract-num rid="HD1">R24 HD043555-05</contract-num>
<contract-sponsor id="HD1">National Institute of Child Health & Human Development : NICHD</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>
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