Obican Sarah G, Jahnke Gloria D, Soldin Offie P, Scialli Anthony R
Department of Obstetrics and Gynecology, George Washington University, Washington, DC, USA.
Birth Defects Res A Clin Mol Teratol. 2012 Sep;94(9):677-82. doi: 10.1002/bdra.23051. Epub 2012 Aug 18.
Iodine deficiency is an important nutritional deficiency, with more than 2 billion people worldwide estimated to be at risk. The developing fetus and young children are particularly at risk. During pregnancy and lactation, iodine requirements increase, whether in iodine-poor or iodine-sufficient countries, making the mother and the developing fetus vulnerable. The American Thyroid Association (ATA) recommends 250 micrograms per day of iodine intake for pregnant and lactating women. The thyroid gland is able to adapt to the changes associated with pregnancy as long as sufficient iodine is present. Dietary intake is the sole source of iodine, which is essential to the synthesis of thyroid hormones. Iodine is found in multiple dietary sources including iodized salt, dairy products, seaweed, and fish. Prenatal vitamins containing iodine are a good source of iodine, but iodine content in multivitamin supplements is highly variable. Congenital hypothyroidism is associated with cretinism. Clinical hypothyroidism has been associated with increased risk of poor perinatal outcome including prematurity, low birth weight, miscarriage, preeclampsia, fetal death, and impaired fetal neurocognitive development. Subclinical hypothyroidism is also associated with poor pregnancy outcomes and potential fetal neurocognitive deficits, but the data are more variable than those for clinical hypothyroidism. We concur with the ATA recommendation that all pregnant and lactating women should ingest (through diet and supplements) 250 micrograms of iodine daily. To achieve this goal, we recommend that all pregnant and lactating women take daily iodine supplementation of 150 micrograms.
碘缺乏是一种重要的营养缺乏症，据估计全球有超过20亿人面临风险。发育中的胎儿和幼儿尤其危险。在怀孕和哺乳期间，无论在缺碘国家还是碘充足的国家，碘的需求量都会增加，这使得母亲和发育中的胎儿容易受到影响。美国甲状腺协会（ATA）建议孕妇和哺乳期妇女每天摄入250微克碘。只要有足够的碘，甲状腺就能适应与怀孕相关的变化。饮食摄入是碘的唯一来源，碘对甲状腺激素的合成至关重要。碘存在于多种饮食来源中，包括加碘盐、乳制品、海藻和鱼类。含碘的产前维生素是碘的良好来源，但多种维生素补充剂中的碘含量差异很大。先天性甲状腺功能减退与呆小症有关。临床甲状腺功能减退与围产期不良结局风险增加有关，包括早产、低出生体重、流产、先兆子痫、胎儿死亡和胎儿神经认知发育受损。亚临床甲状腺功能减退也与不良妊娠结局和潜在的胎儿神经认知缺陷有关，但相关数据的变异性比临床甲状腺功能减退的数据更大。我们赞同ATA的建议，即所有孕妇和哺乳期妇女应（通过饮食和补充剂）每天摄入250微克碘。为实现这一目标，我们建议所有孕妇和哺乳期妇女每天补充150微克碘。
