The effect of selenium supplementation on outcome in very low birth weight infants: a randomized controlled trial. The New Zealand Neonatal Study Group.

BACKGROUND: Low selenium (SE) status has been documented in preterm infants and has been suggested to be a risk factor for chronic lung disease. METHODS: A total of 534 infants with birth weight <1500 g were enrolled in 8 New Zealand centers in a double-blind placebo-controlled randomized trial of SE supplementation from week 1 of life until 36 weeks' postmenstrual age or discharge home. Supplemented infants received 7 microg/kg/d of SE when fed parenterally and 5 microg/kg/d when fed orally. Plasma SE and glutathione peroxidase concentrations were measured in mothers after delivery and in infants before randomization and at 28 days and 36 weeks' postmenstrual age. Primary outcome measures were oxygen dependency at 28 days and total days oxygen dependency. RESULTS: No significant differences were seen between the groups with respect to primary or secondary outcome measures, with the exception that fewer supplemented infants had an episode of sepsis after the first week of life (P <.038). Mean plasma SE concentrations were 0.33 micromol/L before randomization in both groups and at 28 days had risen in the supplemented group (0.56 micromol/L) but fallen in the control group (0.29 micromol/L) (P <.0001). There was no association between outcome measures and SE concentrations at 28 days or 36 weeks' postmenstrual age. However, lower maternal and infant prerandomization SE concentrations were associated with increased respiratory morbidity. CONCLUSIONS: Postnatal SE supplementation in very low birth weight infants did not improve neonatal outcome. Further investigation of SE supplementation of mothers from the second half of pregnancy is warranted.

Psychiatric disorder in the children of West Indian immigrants

The clinical characteristics of fifty-five children, born of West Indian parents, who had been referred to a Child Guidance Clinic over a period of three years, are described. The children are compared with fifty-five other children matched for age and sex. Roughly equal numbers of West Indian boys and girls were referred, although there is a considerable preponderance of boys in the rest of the clinic population. The two groups did not differ in social class or family size, nor was there a high rate of current separation amongst the parents of West Indian children. However, the West Indian children had suffered more separations from parent figures in their early years. West Indian boys showed less neurotic disorder and West Indian girls more antisocial disorder than the controls. All groups showed a severe degree of reading retardation. Caution is expressed about generalizing these findings to the population from which the children are drawn, but there is felt to be a clear cause for concern in the frequent and sometimes traumatic separations that the current migration imposes on West Indian family life (Summary)