University of Oulu

Marjorie J Haskell, Kenneth Maleta, Charles D Arnold, Josh M Jorgensen, Yue-Mei Fan, Ulla Ashorn, Andrew Matchado, Nagendra K Monangi, Ge Zhang, Huan Xu, Elizabeth Belling, Julio Landero, Joanne Chappell, Louis J Muglia, Mikko Hallman, Per Ashorn, Kathryn G Dewey, Provision of Small-Quantity Lipid-Based Nutrient Supplements Increases Plasma Selenium Concentration in Pregnant Women in Malawi: A Secondary Outcome of a Randomized Controlled Trial, Current Developments in Nutrition, Volume 6, Issue 3, March 2022, nzac013,

Provision of small-quantity lipid-based nutrient supplements increases plasma selenium concentration in pregnant women in Malawi : a secondary outcome of a randomized controlled trial

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Author: Haskell, Marjorie J.1,2; Maleta, Kenneth3; Arnold, Charles D.1,2;
Organizations: 1Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
2Department of Nutrition, University of California, Davis, Davis, CA, USA
3Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
4Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
5Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
6Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
7Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
8Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, OH, USA
9Department of Chemistry, University of Cincinnati, Cincinnati, OH, USA
10Burroughs Wellcome Fund, Research Triangle Park, NC, USA
11Medical Research Centre Oulu, PEDEGO Research Unit, University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
12Department of Paediatrics, Tampere University Hospital, Tampere, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Oxford University Press, 2022
Publish Date: 2022-05-05


Background: Pregnant women in Malawi are at risk of selenium deficiency, which can have adverse effects on pregnancy outcomes. Interventions for improving selenium status are needed.

Objectives: To assess the effect of provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) to Malawian women during pregnancy on their plasma selenium concentrations at 36 wk of gestation.

Methods: Pregnant women (≤20 wk of gestation) were randomly assigned to receive daily either: 1) iron and folic acid (IFA); 2) multiple micronutrients (MMN; 130 µg selenium per capsule); or 3) SQ-LNS (130 µg selenium/20 g). Plasma selenium concentrations were measured by inductively coupled plasma mass spectrometry at baseline and after ≥16 wk of intervention (at 36 wk of gestation) and compared by intervention group.

Results: At 36 wk of gestation, median (quartile 1, quartile 3) plasma selenium concentrations (micromoles per liter) were 0.96 (0.73, 1.23), 0.94 (0.78, 1.18), and 1.01 (0.85, 1.28) in the IFA, MMN, and SQ-LNS groups, respectively. Geometric mean (GM) plasma selenium concentration was 5.4% (95% CI: 1.8%, 9.0%) higher in the SQ-LNS group than in the MMN group and tended to be higher than in the IFA group (+4.2%; 95% CI: 1.0%, 7.8%). The prevalence of adjusted plasma selenium concentrations <1 µmol/L was 55.1%, 57.8%, and 47.3% in the IFA, MMN, and SQ-LNS groups, respectively; it was lower in the SQ-LNS group than in the MMN group, OR = 0.44 (95% CI: 0.24, 0.83), and tended to be lower than in the IFA group, OR = 0.54 (95% CI: 0.29, 1.03). There was a significant interaction between baseline plasma selenium concentration and intervention group (P = 0.003). In the lowest tertile of baseline selenium concentrations, GM plasma selenium concentration was higher, and the prevalence of low values was lower in the SQ-LNS group compared with the MMN and IFA groups at 36 wk of gestation (P ≤ 0.007).

Conclusions: Provision of SQ-LNS containing selenium to pregnant women can be an effective strategy for improving their selenium status.

This trial was registered at (identifier: NCT01239693).

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Series: Current developments in nutrition
ISSN: 2475-2991
ISSN-E: 2475-2991
ISSN-L: 2475-2991
Volume: 6
Issue: 3
Article number: nzac013
DOI: 10.1093/cdn/nzac013
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: Financial support for this work was provided by the Bill & Melinda Gates Foundation (Project Number OPP49817). The source of support had no role in the design or implementation of the study, or in data analysis or interpretation.
Copyright information: © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.