Selenium: implications for outcomes in extremely preterm infants

Area of Science:

• Neonatal Medicine
• Nutritional Science
• Biochemistry

Background:

• Extremely preterm infants face high risks of bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity.
• These morbidities are potentially linked to oxidative stress from reactive oxygen and nitrogen species.
• Selenium, a trace mineral crucial for antioxidant defense via selenoenzymes, is primarily accrued in the third trimester, leading to deficiency in preterm neonates.

Purpose of the Study:

• To review the role of selenium in antioxidant systems of extremely preterm infants.
• To identify knowledge gaps concerning selenium's impact on neonatal morbidities.
• To inform prevention and treatment strategies for selenium-related complications.

Main Methods:

• Literature review focusing on selenium's role in neonatal antioxidant function.
• Analysis of existing publications on selenium deficiency and toxicity in neonates.
• Synthesis of information on selenium monitoring and dosing in preterm infants.

Main Results:

• Preterm neonates are born selenium deficient due to limited placental transfer.
• Limited data exists on selenium's specific consequences, monitoring, and optimal dosing in this population.
• Selenium is integral to antioxidant defense systems (glutathione peroxidase, thioredoxin reductase, selenoprotein P).

Conclusions:

• Selenium plays a critical role in protecting extremely preterm infants from oxidative stress-related morbidities.
• Significant gaps in knowledge hinder effective selenium management in neonates.
• Further research is essential to address selenium deficiency, toxicity, monitoring, and therapeutic strategies.