Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Jaén, Jaén, Spain.
Br J Nutr. 2013 Sep 14;110(5):831-9. doi: 10.1017/S0007114512005880. Epub 2013 Feb 4.
The benefits of iodine supplements during pregnancy remain controversial in areas with a mild-to-moderate iodine deficiency. The aim of the present study was to determine the effect of improving iodine intakes, with iodised salt (IS) or iodine supplements, in pregnant Spanish women. A total of 131 pregnant women in their first trimester were randomly assigned to three groups: (1) IS in cooking and at the table, (2) 200 μg potassium iodide (KI)/d or (3) 300 μg KI/d. No differences were found in thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) or thyroid volume (TV) between the three groups. Regardless of the group in which women were included, those who had been taking IS for at least 1 year before becoming pregnant had a significantly lower TV in the third trimester (P= 0.01) and a significantly higher urinary iodine in the first (173.7 (sd 81.8) v. 113.8 (sd 79.6) μg/l, P= 0.001) and third trimesters (206.3 (sd 91.2) v. 160.4 (sd 87.7) μg/l, P= 0.03). Also, no differences were seen in TSH, FT4 or FT3. Children's neurological development was not significantly associated with the consumption of IS for at least 1 year before becoming pregnant and no differences were found according to the treatment group. In conclusion, in pregnant women with insufficient iodine intake, the intake of IS before becoming pregnant was associated with a better maternal thyroid function. The form of iodide intake was not associated with maternal thyroid function or children's neurological development.
在碘缺乏轻度至中度的地区,孕妇补充碘的益处仍存在争议。本研究旨在确定通过食用碘盐(IS)或碘补充剂来改善碘摄入量对西班牙孕妇的影响。共有 131 名处于孕早期的孕妇被随机分配到三组:(1)烹饪和餐桌上使用 IS,(2)200μg 碘化钾(KI)/天或(3)300μg KI/天。三组间促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)或甲状腺体积(TV)均无差异。无论孕妇所在的组别如何,那些在怀孕前至少服用 IS 1 年的孕妇在孕晚期的 TV 明显更小(P=0.01),且在孕早期(173.7(sd 81.8)v. 113.8(sd 79.6)μg/l,P=0.001)和孕晚期(206.3(sd 91.2)v. 160.4(sd 87.7)μg/l,P=0.03)的尿碘水平更高。TSH、FT4 或 FT3 也没有差异。儿童的神经发育与怀孕前至少 1 年服用 IS 之间没有显著关联,且根据治疗组也没有发现差异。总之,在碘摄入不足的孕妇中,怀孕前摄入 IS 与更好的母体甲状腺功能相关。碘摄入的形式与母体甲状腺功能或儿童的神经发育无关。