Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort

被引：19

作者：

Snart, Charles Jonathan Peter ^{[1
]}

Threapleton, Diane Erin ^{[1
]}

Keeble, Claire ^{[2
]}

Taylor, Elizabeth ^{[1
]}

Waiblinger, Dagmar ^{[3
]}

Reid, Stephen ^{[4
]}

Alwan, Nisreen A. ^{[5
,6
,7
]}

Mason, Dan ^{[3
]}

Azad, Rafaq ^{[3
]}

Cade, Janet Elizabeth ^{[8
]}

Simpson, Nigel A. B. ^{[9
]}

Meadows, Sarah ^{[10
,11
]}

McKillion, Amanda ^{[10
,11
]}

Santorelli, Gillian ^{[3
]}

Waterman, Amanda H. ^{[12
]}

Zimmermann, Michael ^{[13
]}

Stewart, Paul M. ^{[14
]}

Wright, John ^{[3
]}

Mon-Williams, Mark ^{[12
]}

Greenwood, Darren Charles ^{[1
,2
]}

Hardie, Laura J. ^{[1
]}

机构：

[1] Univ Leeds, Sch Med, Leeds Inst Cardiovasc & Metab Med, LIGHT Labs, Leeds LS2 9JT, W Yorkshire, England

[2] Univ Leeds, Leeds Inst Data Analyt, Leeds LS2 9JT, W Yorkshire, England

[3] Bradford Teaching Hosp NHS Fdn Trust, Bradford Inst Hlth Res, Bradford BD9 6RJ, W Yorkshire, England

[4] Univ Leeds, Sch Earth & Environm, Earth Surface Sci Inst, Leeds LS2 9JT, W Yorkshire, England

[5] Univ Southampton, Southampton Gen Hosp, Fac Med, Sch Primary Care & Populat Sci, Southampton SO16 6YD, Hants, England

[6] Univ Southampton, NIHR Southampton Biomed Res Ctr, Southampton, Hants, England

[7] Univ Hosp Southampton NHS Fdn Trust, Southampton, Hants, England

[8] Univ Leeds, Sch Food Sci & Nutr, Nutr Epidemiol Grp, Leeds LS2 9JT, W Yorkshire, England

[9] Univ Leeds, Sch Med, Div Womens & Childrens Hlth, Leeds LS2 9JT, W Yorkshire, England

[10] Univ Cambridge, Elsie Widdowson Lab, Cambridge CB1 9NL, England

[11] Univ Cambridge, MRC Epidemiol Unit, NIHR Nutr Biomarker Lab, Clifford Allbutt Bldg,Hills Rd, Cambridge CB2 0AH, England

[12] Univ Leeds, Sch Psychol, Leeds LS2 9JT, W Yorkshire, England

[13] Swiss Fed Inst Technol, Lab Human Nutr, Inst Food Nutr & Hlth, CH-8092 Zurich, Switzerland

[14] Univ Leeds, Fac Med & Hlth, Leeds LS2 9JT, W Yorkshire, England

来源：

BMC MEDICINE | 2020年 / 18卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Birthweight; Iodine; Pregnancy; Insufficiency; SGA; PREGNANT-WOMEN; WEIGHT; BORN; DEFICIENCY; NUTRITION; EXCRETION; AREA; RISK; AGE;

D O I：

10.1186/s12916-020-01602-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outcomes, finding inconsistent evidence for specific outcomes. Methods Maternal iodine status was estimated from spot urine samples collected at 26-28 weeks' gestation from 6971 mothers in the Born in Bradford birth cohort. Associations with outcomes were examined for both urinary iodine concentration (UIC) and iodine-to-creatinine ratio (I:Cr). Outcomes assessed included customised birthweight (primary outcome), birthweight, small for gestational age (SGA), low birthweight, head circumference and APGAR score. Results There was a small positive association between I:Cr and birthweight in adjusted analyses. For a typical participant, the predicted birthweight centile at the 25th percentile of I:Cr (59 mu g/g) was 2.7 percentage points lower than that at the 75th percentile of I:Cr (121 mu g/g) (99% confidence interval (CI) 0.8 to 4.6), birthweight was predicted to be 41 g lower (99% CI 13 to 69) and the predicted probability of SGA was 1.9 percentage points higher (99% CI 0.0 to 3.7). There was no evidence of associations using UIC or other birth outcomes, including stillbirth, preterm birth, ultrasound growth measures or congenital anomalies. Conclusion Lower maternal iodine status was associated with lower birthweight and greater probability of SGA. Whilst small, the effect size for lower iodine on birthweight is comparable to environmental tobacco smoke exposure. Iodine insufficiency is avoidable, and strategies to avoid deficiency in women of reproductive age should be considered.

引用

页数：11