An Increase in Consuming Adequately Iodized Salt May Not Be Enough to Rectify Iodine Deficiency in Pregnancy in an Iodine-Sufficient Area of China

Wang, Zhifang; Zhu, Wei; Mo, Zhe; Wang, Yuanyang; Mao, Guangming; Lou, Xiaoming

doi:10.3390/ijerph14020206

Cited by 32 publications

(42 citation statements)

References 26 publications

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“…This study also shows that the pregnant population remain iodine-deficient when consuming 25 ppm iodized salt. This finding is in line with our previous IDD surveillance results from pregnant women in Zhejiang Province [14,15]. Nevertheless, the finding in this study is not consistent with the results from the three other provinces (Shandong, Shanxi and Jiangsu), where pregnant women were iodine-sufficient when they consumed 25 ppm iodized salt [11]..…”

Section: Discussionsupporting

confidence: 63%

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Geographical influences on the iodine status in pregnant women, neonates, and school-age children in China

Lou

Mao

Zhu

et al. 2020

Nutr J

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Background: Pregnant women, neonates, and school-age children are vulnerable to iodine deficiency. The iodine contents in the environment (drinking water and household salt for cooking) vary by geographical location in China. The aim of this study was to assess the iodine status in vulnerable groups from different geographical zones and analyze the iodine content in household salt and drinking water from these zones. Methods: In coastal and inland regions of Zhejiang Province, China, samples of spot urine, drinking water, and household salt for cooking from both pregnant women and school-age children were determined for iodine concentration between 2017 and 2018. Thyroid-stimulating hormone (TSH) levels from neonates born between 2014 and 2015 were acquired from the Newborns Screening Information System. The iodine status of the vulnerable populations was assessed according to the criteria recommended by the World Health Organization. Results: The median UIC of pregnant women was significantly lower in the coastal region (113.0 μg/L) than the inland region (134.9 μg/L; p < 0.001). The median UICs of pregnant women from these two regions were below the lower optimal iodine cutoff level of 150 μg/L. The percentage of neonates with elevated TSH (> 5 mIU/L) was significantly higher in the coastal region (15.8%) than the inland region (10.5%; p < 0.001). The percentage of neonates with elevated TSH from each region decreased within the range of mild iodine deficiency of 3-19.9%. The median UIC of the coastal school-age children was 156.0 μg/L, and the median UIC of inland children was 181.5 μg/ L. Both medians fell within the recommended optimal iodine range of 100-299 μg/L. The iodine concentrations in drinking water varied from 1.0 μg/L in the inland region to 2.0 μg/L in the coastal region. The proportion of households that consumed iodized salt was lower in the coastal region (nearly 65%) than the inland region (approximately 95%). Conclusions: In these two regions with low iodine contents in drinking water, both pregnant women and neonates were iodine-deficient, although school-age children were iodine-sufficient. Urgent efforts are needed to improve the iodine status of pregnant women and neonates.

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Section: Discussionsupporting

confidence: 63%

“…For pregnant women and school-age children, stratified random sampling was performed. The sampling followed the WHO's and Chinese IDD surveillance guidelines [6,13], and the details have been provided in our previous studies [14,15]. Briefly, a total of eighteen counties from these two regions were selected.…”

Section: Methodsmentioning

confidence: 99%

Geographical influences on the iodine status in pregnant women, neonates, and school-age children in China

Lou

Mao

Zhu

et al. 2020

Nutr J

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“…Additionally, this study further supports the notion that SAC median UIC could be an imprecise approach for estimating iodine status in pregnant women [7][8][9][10][11]. In consolidation, The IGN has revealed that 29 countries reported iodine deficiency in pregnant women, whereas their SAC populations were sufficient [46].…”

Section: Discussionsupporting

confidence: 79%

“…Accordingly, many researchers have emphasised the need for alternative means (e.g. iodine supplements) to ensure adequate iodine intake during pregnancy [7][8][9][10][11], and the World Health Organisation (WHO) has recommended increasing iodine intake from 150 to 250 μg/day [12].…”

Section: Introductionmentioning

confidence: 99%

Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia

Azzeh

Refaat

2020

Preprint

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Background: Despite the serious maternal and foetal complications associated with iodine deficiency during pregnancy, surveys related to pregnant women in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, measured urine iodine concentrations (UIC) alongside the potential socioeconomic factors contributing towards iodine inadequacy in reproductive age and pregnant Saudi women from the Western province of KSA. Methods: Spot urine samples were collected from 1222 pregnant and 400 age-matched non-pregnant/non-lactating reproductive age women. The socioeconomic characteristics were obtained through a structured questionnaire. The WHO criteria for iodine sufficiency in non-pregnant (100–199 μg/L) and pregnant (150–249 μg/L) women were applied. Results: The median UIC in the non-pregnant women (101.64 μg/L; IQR: 69.83 – 143.55) was at the lowermost WHO recommended cut-off, whereas the pregnant group were iodine deficient (112.99 μg/L; IQR: 81.01 – 185.57). Moreover, the median UIC was below adequacy across the different trimesters. Multiparity (OR = 3.091; 95%CI: 1.707–5.598) and earning below the minimum wage (2.520; 95%CI: 1.038–6.119) significantly increased the risk of iodine deficiency only in the non-pregnant women. Passive smoking, however, was an independent risk factor for iodine deficiency in the non-pregnant (OR = 1.818; 95%CI: 1.097–3.014) and pregnant (OR = 1.653; 95%CI: 1.043–2.618) groups. The use of non-iodised salt also significantly increased the risk of iodine deficiency in the non-pregnant (OR = 2.052; 95%CI: 1.118–3.766) and pregnant women (OR = 3.813; 95%CI: 1.992–7.297), whereas iodine supplements significantly lowered the risk in both groups (OR = 0.364; 95%CI: 0.172–0.771 and OR = 0.002; 95%CI: 0.001–0.005, respectively). Moreover, BMI correlated independently and significantly with median UIC in the non-pregnant in both study populations. Conclusions: This study is the first to show borderline iodine sufficiency in reproductive age Saudi women from the Western province, whereas mild iodine deficiency was observed in the pregnant population and could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous maternal-foetal health consequences of iodine deficiency.

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“…28 Nonetheless dietary iodine intake remains insufficient among pregnant women in Shanghai, Zhejiang, and other coastal cities where iodine is considered sufficient for the general population. 29,30 A national survey from the Mainland reported that the median UIC levels of pregnant and lactating women were 123-224 μg/L and 109-224 μg/L, respectively; median UIC was higher among those in inland cities, because of a higher iodine level in the salt and greater household coverage. 31 In contrast, the progress in tackling iodine insufficiency in Hong Kong has been far from satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Moderate iodine deficiency among pregnant women in Hong Kong: revisit the problem after two decades

Tam

Chan

et al. 2017

Hong Kong Med J

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An Increase in Consuming Adequately Iodized Salt May Not Be Enough to Rectify Iodine Deficiency in Pregnancy in an Iodine-Sufficient Area of China

Cited by 32 publications

References 26 publications

Geographical influences on the iodine status in pregnant women, neonates, and school-age children in China

Geographical influences on the iodine status in pregnant women, neonates, and school-age children in China

Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia

Moderate iodine deficiency among pregnant women in Hong Kong: revisit the problem after two decades

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