Reducing Morbidity In Preterm Babies

Preterm infants are born with slightly lower selenium and glutathione peroxidase concentrations than term infants and have low hepatic stores of selenium. In very Selenium 1087

preterm infants low selenium concentrations have been associated with an increased

risk of chronic neonatal lung disease and retinopathy of prematurity (Darlow & Austin 2003). Although the full consequences of low selenium concentrations in this population are not fully known, observation from animal studies has found an association between selenium deficiency and increased susceptibility to oxidative lung injury. This has special significance for sick, very preterm infants as they are exposed to many possible sources of oxygen radical products, including high concentrations of inspired oxygen. A Cochrane review of three randomised studies that reported outcomes on 297 infants receiving selenium supplements and 290 control infants concluded that selenium supplementation in very preterm infants is associated with benefit in terms of a reduction in one or more episodes of late-onset sepsis, but is not associated with improved survival, a reduction in neonatal chronic lung disease or retinopathy of prematurity (Darlow & Austin 2003). It should be noted that most of the evidence derives from research conducted in New Zealand, a country with low soil and population selenium concentrations, and may not be readily translated to other populations.

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