Abstract
Salt iodization is one of the most cost-effective strategies to eliminate iodine deficiency disorders (IDD). However, China’s dismantling of salt monopoly has reduced the availability of iodized salt in the susceptible population in pregnancy, which might cause IDD and have adverse health effects on both themselves and their offspring. The aim of our study was therefore to explore the association between IDD and women’s reproductive health. This is a population-based cross-sectional study conducted in 2018 in Zhejiang Province, China. A total of 1653 pregnant women participated in this study. Median urinary iodine concentration (UIC) in the population was used to assess iodine intake. Cox regression analyses were used to estimate the association between iodine intake and time to pregnancy, which was indicated with fecundability ratio (FR) and 95% confidence interval (CI). The percentage of participants with iodine deficiency who had been waiting longer than 13 months to get pregnant (20%; median UIC 119.6 μg/L) was significantly higher than those with iodine sufficiency (14%; median UIC 147.1 μg/L). A significant decrease in fecundity was observed in participants with iodine deficiency (FR, 0.820; 95% CI, 0.725−0.929) than those with iodine sufficiency. These findings indicate the importance of ongoing monitoring of iodine nutrition in women of reproductive age. Keeping a safe and optimal level of iodine nutrition during pregnancy should be emphasized.
Highlights
Salt iodization is one of the most cost-effective strategies to eliminate iodine deficiency disorders (IDD)
The median urinary iodine concentration (UIC) of 958 participants from the coastal regions was 119.6 μg/L, while the median UIC of 695 participants from the inland regions was 147.1 μg/L
The observed media UIC indicated that these samples were sufficiently representative to estimate iodine intake, which was consistent with the regional epidemiological surveillance results between 2015 and 2017 (Supplementary Table S2)
Summary
Salt iodization is one of the most cost-effective strategies to eliminate iodine deficiency disorders (IDD). A historically severely iodine-deficient country, introduced the universal salt iodization (USI) program in 1995, with a legislative requirement for the addition of iodine in edible salt. The requirement stated that non-iodized salt for household cooking must be sold only at designated places via a physician’s prescription. In some parts of China where increasing incidence of thyroid diseases were reported with increasing iodine intake [1,2,3,4,5], awareness was raised about the possible association between consumption of iodized salt and the escalating incidence of thyroid diseases [1,6,7]. An increasing number of medical practitioners and the public began to lose confidence about the consumption of iodized salt
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