Abstract

Severe iodine deficiency during pregnancy has been associated with pregnancy/neonatal loss, and adverse pregnancy outcomes; however, the impact of mild–to–moderate iodine insufficiency, though prevalent in pregnancy, is not well-documented. We assessed whether mild iodine deficiency during pregnancy was associated with pregnancy/infant loss, or with other adverse pregnancy outcomes. We used samples and data from the Avon Longitudinal Study of Parents and Children (ALSPAC), from 3140 singleton pregnancies and from a further 42 women with pregnancy/infant loss. The group was classified as mildly-to-moderately iodine deficient with a median urinary iodine concentration of 95.3 µg/L (IQR 57.0–153.0; median urinary iodine-to-creatinine ratio (UI/Creat) 124 µg/g, IQR 82–198). The likelihood of pregnancy/infant loss was not different across four UI/Creat groups (<50, 50–149, 150–250, >250 µg/g). The incidence of pre-eclampsia, non-proteinuric gestational hypertension, gestational diabetes, glycosuria, anaemia, post-partum haemorrhage, preterm delivery, mode of delivery, being small for gestational age, and large for gestational age did not differ significantly among UI/Creat groups, nor were there any significant differences in the median UI/Creat. We conclude that maternal iodine status was not associated with adverse pregnancy outcomes in a mildly-to-moderately iodine-deficient pregnant population. However, in view of the low number of women with pregnancy/infant loss in our study, further research is required.

Highlights

  • Iodine is essential for the production of thyroid hormones and is important during pregnancy and early life owing to its role in brain development

  • We investigated whether insufficient and excess iodine status during pregnancy was associated with adverse obstetric outcomes defined as: (i) pregnancy loss or infant loss by the age of 1 year; (ii) common obstetric complications including hypertensive disorders of pregnancy, glucose derangements, anaemia, preterm delivery, caesarean delivery, post-partum haemorrhage and babies born small or large for gestational age

  • Women were selected on the basis of a singleton pregnancy and if they had at least one existing measure of urinary iodine-to-creatinine (UI/Creat) during pregnancy; these existing measures were from previous and ongoing studies examining the relationship between maternal iodine status and child IQ at age 8 years and the measures were already available in the Avon Longitudinal Study of Parents and Children (ALSPAC) resource (n = 3524)

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Summary

Introduction

Iodine is essential for the production of thyroid hormones and is important during pregnancy and early life owing to its role in brain development. Nutrients 2018, 10, 291 progress in the eradication of iodine deficiency in many countries worldwide (through the use of iodised salt), iodine deficiency remains a problem in pregnant women in many countries, including the UK [1]. The World Health Organization (WHO) categorises iodine adequacy in a pregnant population if the median urinary iodine concentration (UIC) is 150–249 μg/L; a median UIC in pregnancy of 500 μg/L as excessive [2]. Significant neurodevelopmental impairment occurs with severe maternal iodine deficiency during pregnancy, including the development of cretinism [3]. Correction of severe iodine deficiency in the population decreases the rates of cretinism [4] and increases offspring IQ [5]. Observational studies have found associations between mild-to-moderate iodine deficiency during pregnancy and poorer offspring cognition, IQ, and school performance [6,7,8,9,10]

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