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Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population.

ABSTRACT: (1) Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on the perinatal outcome. Aim: to assess the changes occurring in dietary iodine intake, potassium iodide supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). (2) Methods: Between 2009-2011, an observational study included a cohort of women whose pregnancies were monitored in the public health system in the Central and North Metropolitan areas of Catalonia. Women received individual educational counseling, a dietary questionnaire was completed, and a urine sample was collected for iodine determination at each trimester visit. (3) Results: 633 (67.9%) women answered the questionnaire at all 3 visits. The percentage of women with a desirable UIC (?150 ?g/L) increased from the first to the second trimester and remained stable in the third (57.3%, 68.9%, 68%; p < 0.001). Analysis of the relationship between UIC?150 ?g/L and the women's dietary habits showed that the percentage with UIC ?150 ?g/L increased with greater consumption of milk in the first trimester, and the same was true for iodized salt use in all three trimesters and iodine supplementation in all three. (4) Conclusion: During pregnancy, increased intake of milk, iodized salt, and iodine supplements were associated with an increase in the UIC.

SUBMITTER: Torres MT

PROVIDER: S-EPMC7551663 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population.

Torres Maria-Teresa MT Vila Lluis L Manresa Josep-María JM Casamitjana Roser R Prieto Gemma G Toran Pere P Falguera Gemma G Francés Lidia L The Iodegest Study Group

Nutrients 20200831 9

(1) Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on the perinatal outcome. Aim: to assess the changes occurring in dietary iodine intake, potassium iodide supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). (2) Methods: Between 2009-2011, an observational study included a cohort of women whose pr ...[more]

PMID: 32878172

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Project description:ObjectiveMild to moderate iodine deficiency during pregnancy has been associated with adverse neurodevelopmental outcomes in offspring. Few research studies to date combine assessment of urinary iodine (UIC and/or ICr), biomarkers that best reflect dietary intake, with reported dietary intake of iodine rich foods in their assessment of iodine deficiency. Thus, a systematic review was conducted to incorporate both these important measures.DesignUsing PRISMA guidelines, a comprehensive search was conducted in three electronic databases (EMBASE®, MedLine® and Web of Science®) from January 1970-March 2021. Quality assessment was undertaken using the Newcastle Ottawa Scale. Eligible studies included reported assessment of iodine status through urinary iodine (UIC and/or ICr) and/or dietary intake measures in pregnancy alongside neurodevelopmental outcomes measured in the children. Data extracted included study author, design, sample size, country, gestational age, child age at testing, cognitive tests, urinary iodine assessment (UIC in μg/L and/or ICr in μg/g), dietary iodine intake assessment and results of associations for the assessed cognitive outcomes.ResultsTwelve studies were included with nine reporting women as mild-moderately iodine deficient based on World Health Organization (WHO) cut-offs for urinary iodine measurements < 150 μg/l, as the median UIC value in pregnant women. Only four of the nine studies reported a negative association with child cognitive outcomes based on deficient urinary iodine measurements. Five studies reported urinary iodine measurements and dietary intakes with four of these studies reporting a negative association of lower urinary iodine measurements and dietary iodine intakes with adverse offspring neurodevelopment. Milk was identified as the main dietary source of iodine in these studies.ConclusionThe majority of studies classified pregnant women to be mild-moderately iodine deficient based on urinary iodine assessment (UIC and/or ICr) and/or dietary intakes, with subsequent offspring neurodevelopment implications identified. Although a considerable number of studies did not report an adverse association with neurodevelopmental outcomes, these findings are still supportive of ensuring adequate dietary iodine intakes and urinary iodine monitoring throughout pregnancy due to the important role iodine plays within foetal neurodevelopment. This review suggests that dietary intake data may indicate a stronger association with cognitive outcomes than urinary iodine measurements alone. The strength of this review distinguishes results based on cognitive outcome per urinary iodine assessment strategy (UIC and/or ICr) with dietary data. Future work is needed respecting the usefulness of urinary iodine assessment (UIC and/or ICr) as an indicator of deficiency whilst also taking account of dietary intakes.

Project description:Background:Iodine deficiency is a public health problem. The universal salt iodization (USI) program is the main, simple, and cost-effective intervention strategy to control iodine deficiency. The study examined the iodine status in school-aged children in Ashanti region, Ghana, using thyroid volumes along with urinary iodine concentrations, the methods recommended by the WHO/ICCIDD for monitoring the sustained impact of USI programs. Methods:This cross-sectional study was conducted among school-aged children (6-12 years) from randomly selected schools in the central and northern part of the Ashanti region, Kumasi Metropolis, and Ejura-Sekyedumase Municipality, respectively. A total of 852 children were enrolled in the study. Thyroid volume and urinary iodine concentrations of the children were determined using the standardized methods recommended by WHO/ICCIDD. Anthropometric measurements were also evaluated. Results:The mean values of thyroid volume in female and male school-aged children were 3.53?±?0.09 and 3.32?±?0.07, respectively. The thyroid size was significantly associated with age (P < 0.0001), weight (P < 0.0001), height (P < 0.0001), BMI (P < 0.05), and BSA (P < 0.0001) by Pearson's correlation in both males and females. The P50 (median) thyroid volumes of school children investigated in this study were generally larger compared to the WHO/ICCIDD reference data by age and body surface area. The median value of urinary iodine concentration was 201.85??g/L, which showed significant sex difference (P value <0.0001). Excessive iodine nutrition (?300??g/L) was observed among 34.4% of male children and 27.6% of female children. Also, 12.8% of the male and 19.5% of the female children had UIC below requirement (<100??g/L). The criteria of thyroid volume per age yielded a goitre prevalence of 2.2%. In contrast, the criteria of thyroid volume by body surface area yielded a goitre prevalence of 0.9%. Conclusion:The study clearly indicated that adequate iodine nutrition exists generally among the school children. However, insufficient and excessive iodine intakes still persist among some of the children. The establishment of local reference values for thyroid volume that might be applicable to precisely define goitre prevalence in the Ghanaian context is highly recommended.

Project description:PurposePregnant women in Sweden are mildly iodine deficient. We investigated the effect of daily iodine supplementation on the iodine and thyroid status of pregnant women.MethodsIn this pilot, randomized, double-blind trial, 200 thyroid-healthy pregnant women were recruited at mean (standard deviation) pregnancy week 8.85 (1.62) and assigned (1:1) to daily intake of a multivitamin tablet with or without 150 μg of iodine. Urine and serum samples were collected at baseline and once during the second and third trimesters. Urinary iodine concentration (UIC), serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibodies (TPOabs) were analyzed. Neonatal TSH data were collected. UIC and Tg were also analyzed in a group of 89 thyroid-healthy non-pregnant women of reproductive age (WRA).ResultsAt baseline, the intervention and the control groups had similar median UIC (interquartile range (IQR)): 110 μg/L (74-119) and 111 μg/L (66-168), respectively. The intervention group reached iodine sufficiency with median UIC (IQR) 139 μg/L (89-234) and 136 μg/L (91-211) in the second and third trimester, respectively, without significant difference from the lower limit of the recommended range, i.e. 150-250 μg/L (p = 0.42 and p = 0.87, respectively). The intervention group had higher median UIC and lower median Tg compared to the control group during the second (p < 0.001 and p = 0.019, respectively) and third trimester (p < 0.001 and p = 0.003, respectively), whereas thyroid hormones, serum TPOabs, and neonatal TSH were similar. The WRA group presented median UIC (IQR) 65 μg/L (30-98) and median Tg (IQR) 18 μg/L (13-27).ConclusionA daily supplement containing 150 μg of iodine to a group of pregnant women with mild iodine deficiency improved the iodine status from mild ID to iodine sufficiency. This improvement seems to have had a positive impact on maternal thyroglobulin. This study is now under extension to investigate the children's neuropsychological development.Trial registrationClinicalTrials.gov Identifier NCT02378246, May 3, 2015, retrospectively registered.

Project description:BACKGROUND:Iodine deficiency is the most common cause of preventable brain harm and cognitive impairment in children. Portuguese women of childbearing age, pregnant women and their progeny were shown to have inadequate iodine intake. Consequently, the Portuguese Health Authorities have recommended a daily supplementation with 150-200 µg iodine in preconception, pregnancy, and lactation. The IodineMinho study intends to evaluate whether (i) this recommendation impacted on the prevalence of iodine deficiency in pregnant women from the Minho region of Portugal, (ii) the time of initiation of iodine supplementation (if any) influences the serum levels of thyroid hormones at several intervals during pregnancy and (iii) there are serum thyroid-hormone parameters in the 1st trimester of pregnancy that predict psychomotor development of the child at 18 months of age. METHODS:Most Portuguese women are followed throughout pregnancy in community Family Health Units, where family physicians may choose to follow the National recommendation or other, concerning iodine sufficiency. This study will recruit women (N?=?304) who intend to become pregnant or are already pregnant from 10 representative Units. Physician's approach and prescriptions, sociodemographic, nutrition and clinical information will be obtained at baseline and throughout pregnancy. To evaluate endocrine function, blood and urine samples will be collected at recruitment, once in each trimester of pregnancy, at delivery and 3 months after delivery. Breastmilk samples will be collected for iodine and energy content analysis. Children will be evaluated for psychomotor development at 18 months. Maternal thyroid volume will be evaluated by ultrasound scan at baseline, in the 3rd trimester and at 3 months after delivery. DISCUSSION:Iodine deficiency early during development precludes children from achieving full intellectual capabilities. This protocol describes a study that is innovative and unique in its detailed and comprehensive evaluation of maternal and child endocrine and psychomotor parameters. By evaluating the effectiveness of the iodine supplementation recommendation, it will contribute to the public health systems' efforts to provide excellence in maternal and infant care. TRIAL REGISTRATION:ClinicalTrials.gov, NCT04288531 . Registered 28 February 2020-Retrospectively registered.

Dataset Information

Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population.

Publications

Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population.

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