Unit of Environment and Health, Centre for Public Health Research, Avda. Catalunya 21,Valencia, Spain.
Am J Epidemiol. 2011 Apr 1;173(7):804-12. doi: 10.1093/aje/kwq424. Epub 2011 Mar 8.
Iodine is the main constituent of thyroid hormones, which in turn are required for fetal brain development. However, the relation between iodine intake during pregnancy, thyroid function, and child neurodevelopment needs further evaluation. The authors assessed the association of maternal iodine intake from diet and supplements during pregnancy and of maternal and neonatal thyroid function with infant neurodevelopment. The Mental Development Index and Psychomotor Development Index (PDI) for 691 children were obtained between 2005 and 2007 using the Bayley Scales of Infant Development at age 1 year in a prebirth cohort in Valencia, Spain. In multivariate analyses, a maternal thyrotropin level >4 μU/mL was associated with an increased risk of a PDI <85 (odds ratio = 3.5, P = 0.02). Maternal intake of ≥150 μg/day, compared with <100 μg/day, of iodine from supplements was associated with a 5.2-point decrease in PDI (95% confidence interval: -8.1, -2.2) and a 1.8-fold increase in the odds of a PDI <85 (95% confidence interval: 1.0, 3.3). When analyses were stratified by sex, this association was intensified for girls but was not observed for boys. Further evidence on the safety and effectiveness of iodine supplementation during pregnancy is needed before it is systematically recommended in iodine-sufficient or mildly deficient areas.
碘是甲状腺激素的主要成分，而甲状腺激素又是胎儿大脑发育所必需的。然而，孕期碘摄入量、甲状腺功能与儿童神经发育之间的关系仍需进一步评估。作者评估了孕期饮食和补充剂中的碘摄入量、母亲和新生儿甲状腺功能与婴儿神经发育之间的关联。在西班牙巴伦西亚的一个产前队列中，于 2005 年至 2007 年间，使用贝利婴幼儿发育量表（Bayley Scales of Infant Development），对 691 名儿童的精神发育指数和运动发育指数（PDI）进行了评估。在多变量分析中，促甲状腺激素水平 >4 μU/mL 的母亲与 PDI <85 的风险增加相关（比值比=3.5，P=0.02）。与碘补充剂摄入量<100 μg/天相比，摄入量≥150 μg/天的母亲，其 PDI 下降 5.2 分（95%置信区间：-8.1，-2.2），PDI <85 的风险增加 1.8 倍（95%置信区间：1.0，3.3）。按性别分层分析时，这种关联在女孩中更为明显，但在男孩中并未观察到。在碘充足或轻度缺乏地区系统推荐补充碘之前，还需要进一步的证据来证明其在孕期的安全性和有效性。
