A review of experimental studies of iodine deficiency during fetal development.

Iodine deficiency is now recognized as a major international public health problem. It is estimated that 800 million people may be at risk of the effects of iodine deficiency. In humans, the effects occur at all stages of development: the fetus, the neonate, the child and adult. The effects are now denoted by the term iodine deficiency disorders (IDD). They include miscarriages, stillbirths, congenital anomalies, as well as the more familiar goiter, cretinism, impaired brain function, and hypothyroidism in children and adults. In domestic animals, reproductive failure has been reported with the production of aborted, stillborn and weak calves. Experimental studies in animal models have been reviewed to provide evidence of the mechanisms involved, particularly in relation to brain development. The findings in three different species (rat, sheep, monkey) indicate that the effects are mediated by a combination of maternal and fetal hypothyroidism, the effect of maternal hypothyroidism being earlier than the onset of fetal thyroid secretion. The findings suggest that iodine deficiency has an early effect on neuroblast multiplication and, if so, this could be important in the pathogenesis of the neurological form of endemic cretinism. The assessment of the full effects of iodine deficiency on the brain requires further studies in the postnatal period to determine the duration of these effects.