Noncompliance to iodine supplementation recommendation is a risk factor for iodine insufficiency in Portuguese pregnant women: results from the IoMum cohort

Matta-Coelho, Cláudia; Guimarães, Juliana; Bracchi, Isabella; Moreira, Nara Xavier; Pinheiro, Ana Catarina; Pestana, Diogo; Mota, Inês Barreiros; Cortez, Alane Pereira; Prucha, Carmo; Martins, Carla; Pinto, Edgar; Delerue–Matos, Cristina; Dias, Cláudia Camila; Moreira-Rosário, André; Azevedo, Luís Filipe; Fernandes, Virgínia Cruz; Ramalho, Carla; Calhau, Conceição; Brantsæter, Anne Lise; Leite, João Costa; Keating, Elisa

doi:10.1007/s40618-022-01813-7

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…In other European countries, where salt iodization had been introduced, the optimal ioduria was achieved in school-aged children, although not in pregnant women (29,30). Similar results were obtained in Portuguese pregnant women in the 1st trimester, where median UIC was 104 mg/liter, 19% had UIC < 50 mg/liter, and the supplementation rate was 57%, despite a decade long official recommendations regarding iodine supplementation during pregnancy, thus, showing poor adherence to the guidelines (31). The low iodine status was associated with poorer knowledge in terms of iodine significance and its sources (32).…”

Section: Discussionsupporting

confidence: 64%

Iodine deficiency and real-life supplementation ineffectiveness in Polish pregnant women and its impact on thyroid metabolism

et al. 2023

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IntroductionIodine is a pivotal component of thyroid hormones, and its deficiency leads to negative pregnancy outcomes. Therefore, during gestation, additional iodine supplementation is recommended.ObjectivesBy evaluating a group of women from western Poland, the study updated on iodine status during pregnancy and the effectiveness of iodine supplementation in relation to the maternal and neonatal thyroid function.Patients and methodsA total of 91 women were recruited before the delivery between 2019 and 2021. During the medical interview, the patients declared their dietary supplements intake. Thyroid parameters (TSH, ft3, ft4, a-TPO, a-Tg, and TRAb) were measured in the serum of mothers and in the cord blood of newborns after birth. Urinary iodine concentration (UIC) and urine/creatinine (UIC/crea) ratio were assessed in single urine samples using a validated high-performance liquid chromatography with ultraviolet detection (HPLC-UV). Neonatal TSH screening from dried blood spot was analyzed.ResultsPregnant women showed a median (interquartile range) UIC of 106 (69–156) µg/liter and UIC/crea ratio of 104 (62–221) µg/g, whereas approximately 20% had UIC/crea below 50 µg/g, indicating iodine deficiency. The iodine supplementation ratio was 68%. No significant differences in UIC, UIC/crea and thyroid parameters were found between iodine supplemented and non-supplemented groups; however, the highest ioduria was detected when iodine was supplemented in addition to levothyroxine in comparison with both substances administered separately. Patients with UIC/crea within 150–249 µg/g demonstrated the lowest TSH and a-TPO levels. Screening TSH was above 5 mIU/liter in 6% of children.ConclusionsDespite the national salt iodization and the recommendation to supplement iodine during gestation, the status of the abovementioned microelement and real-life intake revealed the ineffectiveness of the current iodine-deficiency prophylaxis model in pregnancy.

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Section: Discussionsupporting

confidence: 64%

Iodine deficiency and real-life supplementation ineffectiveness in Polish pregnant women and its impact on thyroid metabolism

et al. 2023

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“…With regard to the associations between sociodemographic characteristics and ETEs levels, education was positively associated with urinary Mo concentrations. Despite the lack of literature data on Mo levels in pregnancy, a similar positive association between educational level and other ETEs such as iodine has been observed [50,51].…”

Section: Discussionmentioning

confidence: 79%

Essential Trace Elements Status in Portuguese Pregnant Women and Their Association with Maternal and Neonatal Outcomes: A Prospective Study from the IoMum Cohort

Bracchi,

Guimarães,

Rodrigues

et al. 2023

Biology

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Cobalt (Co), copper (Cu), manganese (Mn), molybdenum (Mo), and zinc (Zn) are essential trace elements (ETEs) and important cofactors for intermediary metabolism or redox balance. These ETEs are crucial during pregnancy, their role on specific pregnancy outcomes is largely unknown. This prospective study (#NCT04010708) aimed to assess urinary levels of these ETEs in pregnancy and to evaluate their association with pregnancy outcomes. First trimester pregnant women of Porto and Lisbon provided a random spot urine sample, and sociodemographic and lifestyle data. Clinical data were obtained from clinical records. Urinary ETEs were quantified by inductively coupled plasma mass spectrometry (ICP-MS). A total of 635 mother:child pairs were included. Having urinary Zn levels above the 50th percentile (P50) was an independent risk factor for pre-eclampsia (PE) (aOR [95% CI]: 5.350 [1.044–27.423], p = 0.044). Urinary Zn levels above the P50 decreased the risk of small for gestational age (SGA) birth head circumference (aOR [95% CI]: 0.315 [0.113–0.883], p = 0.028), but it increased the risk SGA length (aOR [95% CI]: 2.531 [1.057–6.062], p = 0.037). This study may provide valuable information for public health policies related to prenatal nutrition, while informing future efforts to de-fine urinary reference intervals for ETEs in pregnant women.

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“…A prospective observational study was carried out from the IoMum cohort (Monitoring iodine status in Portuguese pregnant women and the impact of supplementation—trial registration number NCT04010708) according to the guidelines laid down in the Declaration of Helsinki. Pregnant women attending their first trimester routine ultrasound scan at Centro Hospitalar Universitário de São João (CHUSJ), Porto, between April 2018 and April 2019 were invited to participate as described previously [ 37 , 38 , 39 ]. All women who had a routine ultrasound scan between 10 and 13 weeks of gestation with confirmed fetal vitality, who signed the informed consent form, and who provided a urine sample at recruitment in summer or in the winter were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Association of 3-Phenoxybenzoic Acid Exposure during Pregnancy with Maternal Outcomes and Newborn Anthropometric Measures: Results from the IoMum Cohort Study

Guimarães

Bracchi

Pinheiro

et al. 2023

Toxics

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The aims of this study were to characterize the exposure of pregnant women living in Portugal to 3-phenoxybenzoic acid (3-PBA) and to evaluate the association of this exposure with maternal outcomes and newborn anthropometric measures. We also aimed to compare exposure in summer with exposure in winter. Pregnant women attending ultrasound scans from April 2018 to April 2019 at a central hospital in Porto, Portugal, were invited to participate. Inclusion criteria were: gestational week between 10 and 13, confirmed fetal vitality, and a signature of informed consent. 3-PBA was measured in spot urine samples by gas chromatography with mass spectrometry (GC-MS). The median 3-PBA concentration was 0.263 (0.167; 0.458) µg/g creatinine (n = 145). 3-PBA excretion was negatively associated with maternal pre-pregnancy body mass index (BMI) (p = 0.049), and it was higher during the summer when compared to winter (p < 0.001). The frequency of fish or yogurt consumption was associated positively with 3-PBA excretion, particularly during the winter (p = 0.002 and p = 0.015, respectively), when environmental exposure is low. Moreover, 3-PBA was associated with levothyroxine use (p = 0.01), a proxy for hypothyroidism, which could be due to a putative 3-PBA—thyroid hormone antagonistic effect. 3-PBA levels were not associated with the anthropometric measures of the newborn. In conclusion, pregnant women living in Portugal are exposed to 3-PBA, particularly during summer, and this exposure may be associated with maternal clinical features.

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Noncompliance to iodine supplementation recommendation is a risk factor for iodine insufficiency in Portuguese pregnant women: results from the IoMum cohort

Cited by 5 publications

References 29 publications

Iodine deficiency and real-life supplementation ineffectiveness in Polish pregnant women and its impact on thyroid metabolism

Iodine deficiency and real-life supplementation ineffectiveness in Polish pregnant women and its impact on thyroid metabolism

Essential Trace Elements Status in Portuguese Pregnant Women and Their Association with Maternal and Neonatal Outcomes: A Prospective Study from the IoMum Cohort

Association of 3-Phenoxybenzoic Acid Exposure during Pregnancy with Maternal Outcomes and Newborn Anthropometric Measures: Results from the IoMum Cohort Study

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