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Association of Selenium Levels with Preeclampsia: A Systematic Review and Meta-analysis

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Abstract

Several observational studies have shown inconclusive findings on the association between selenium levels and preeclampsia. This systematic review and meta-analysis was conducted to clarify the association between selenium levels and preeclampsia. The databases PubMed, Google Scholar, ScienceDirect, and the Cochrane Library were searched for studies which investigated selenium levels with preeclampsia and which were published up to April 2022. The overall standardized mean differences (SMD) of selenium levels between cases and controls were measured. Sensitivity analysis, reporting bias, subgroup analysis, and meta-regression were performed for the estimate. The meta-analysis was calculated using the “meta” package in the open-source software R. A total of 26 studies with 1855 preeclampsia cases compared with 3728 healthy pregnant controls were included. The level of selenium was significantly lower in cases of preeclampsia compared with the controls [SMD =  − 0.85; 95% confidence interval (CI): (− 1.46, − 0.25); P =  < 0.01). As there was significant heterogeneity [I2 = 96%, Cochran’s Q = 620.47; P =  < 0.01], the random effects model was used. A stratified meta-analysis revealed that selenium levels were significantly lower in the cases compared with the controls among pregnant women from the African continent [SMD =  − 1.15 (− 1.65, − 0.65); P =  < 0.01]. Likewise, the same pattern was observed among women from middle- and low-income countries [SMD =  − 1.32 (− 2.22, − 0.42); P =  < 0.01]. None of the investigated factors (Modified Newcastle–Ottawa Scale quality score, year of publication, and sample size) showed significant association with the selenium SMD. The level of certainty of this evidence is “low certainty,” as calculated by the GRADEpro GDT online tool. This meta-analysis with low level of evidence certainty revealed that low selenium level is associated significantly with preeclampsia. This pattern is also observed in women from the African continent and women from low- or middle-income countries. Further studies with different prospective designs and detailed patient characteristics are needed to consolidate this evidence.

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Data Availability

Data used to generate the result in this manuscript is available as a supplementary material in this manuscript.

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Authors and Affiliations

  1. Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, P.O. BOX. 991, Unaizah, Kingdom of Saudi Arabia

    Hamdan Z. Hamdan

  2. Faculty of Medicine, Al-Neelain University, Khartoum, Sudan

    Hamdan Z. Hamdan & Sumaia Z. Hamdan

  3. Department of Obstetrics and Gynecology, Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia

    Ishag Adam

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Contributions

HZH, SZH, and IA conceptualized and designed the study. HZH and SZH conducted the search. IA performed as a judge for dispute. HZH and IA performed the statistical analyses. HZH, SZH, and IA drafted the paper. All authors reviewed the draft and approved this version of the paper.

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Correspondence to Hamdan Z. Hamdan.

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(Prisma checklist; Databases searching strategies; Characteristics of all studies of this systematic review and meta-analysis of selenium levels in preeclampsia).

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Hamdan, H.Z., Hamdan, S.Z. & Adam, I. Association of Selenium Levels with Preeclampsia: A Systematic Review and Meta-analysis. Biol Trace Elem Res 201, 2105–2122 (2023). https://doi.org/10.1007/s12011-022-03316-1

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