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18 février 2012 6 18 /02 /février /2012 07:43
Journal of Exposure Science and Environmental Epidemiology (2012) 22, 191–197; doi:10.1038/jes.2011.42; published online 23 November 2011 Selenium and maternal blood pressure during childbirth Ellen M Wellsa,b, Lynn R Goldmana,c, Jeffery M Jarrettd, Benjamin J Apelberge, Julie B Herbstmanf, Kathleen L Caldwelld, Rolf U Haldena,g and Frank R Witterh aDepartment of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA bDepartment of Environmental Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA cGeorge Washington University School of Public Health and Health Services, Washington, DC, USA dInorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA eDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA fThe Columbia Center for Children's Environmental Health, Columbia University Mailman School of Public Health, New York, New York, USA gSwette Center for Environmental Biotechnology, Biodesign Institute, Arizona State University, Tempe, Arizona, USA hDepartment of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Correspondence: Dr. Lynn R. Goldman, Department of Environmental Health Sciences, Case Western Reserve University School of Medicine, 2300 Eye St., NW, Suite 106, Washington, DC 20037, USA. Tel.: +1 202 994 5179. Fax: +1 202 994 3773. E-mail: lynn.goldman@gwumc.edu Received 29 March 2011; Accepted 14 June 2011; Published online 23 November 2011. Evidence suggests selenium concentrations outside the nutritional range may worsen cardiovascular health. This paper examines the relationship between selenium and maternal blood pressure (BP) among 270 deliveries using umbilical cord serum as a proxy for maternal exposure levels. Multivariable models used linear splines for selenium and controlled for gestational age, maternal age, race, median household income, parity, smoking, and prepregnancy body mass index. Non-parametric analysis of this dataset was used to select spline knots for selenium at 70 and 90 μg/l. When selenium was <70 μg/l, increasing selenium levels were related to a non-statistically significant decrease in BP. For selenium 70–90 μg/l, a 1 μg/l increase was related to a 0.37 mm Hg (95% confidence interval (CI): 0.005, 0.73) change in systolic and a 0.35 mm Hg (0.07, 0.64) change in diastolic BP. There were very few selenium values >90 μg/l. Other studies indicate that the maternal/cord selenium ratio is 1.46 (95% CI: 1.28, 1.65). This u-shaped relationship between selenium and BP is consistent with a dual role of selenium as an essential micronutrient that is nonetheless a toxicant at higher concentrations; however, this needs to be studied further. Keywords: blood pressure; pregnancy; selenium; umbilical cord

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