Trofimiuk-Mudlner Malgorzata, Hubalewska-Dydejczyk Alicja
Department of Endocrinology, Jagiellonian University Medical College Ul. Kopernika 17, 31-501 Krakow. Poland.
Recent Pat Endocr Metab Immune Drug Discov. 2017;10(2):85-95. doi: 10.2174/1872214811666170309151538.
Physiological changes in pregnancy result in increased iodine demand, which may not be met in areas of mild-to-moderate iodine deficiency or borderline sufficiency. As a pregnant woman is the only source of thyroid hormones for her child during early gestation, iodine deficiencyinduced hypothyroxinemia may have deleterious effects on fetal development.
To present the current approach to iodine deficiency and its prophylaxis during pregnancy.
A review of the current literature including patents on iodine deficiency in pregnancy has been performed.
Negative influence of severe iodine deficiency on fetal development has been proved, and evidence on a deleterious impact of milder forms of iodine deficiency on cognition of the offspring is rapidly growing. Although the WHO has addressed the issues of monitoring iodine status during pregnancy, prophylactic measures and assessment of their effectiveness, there are some controversies, regarding for example the best methods for control of iodine status. New patents in urinary iodine measurement methods may make iodine nutrition monitoring easier. The main method of iodine prophylaxis, in pregnancy also, is universal salt iodization. However, particularly if there is not sufficient coverage of the households with iodized salt, additional measures, such as oral supplementation with potassium iodide tablets, are necessary in pregnant women to provide adequate iodine nutrition. Iodine supplementation improves maternal thyroid function indices; particularly, it prevents goiter formation.
Stronger evidence on beneficial effects of iodine supplementation of mild-to-moderate iodine deficient pregnant women on cognitive function of their children is still needed. It may be provided by randomized controlled trials and international initiatives. Changes in the iodine prophylaxis system should be monitored, both to prevent decreased or excessive iodine intake.
孕期的生理变化导致碘需求增加，在轻度至中度碘缺乏或临界充足的地区，这一需求可能无法得到满足。由于在妊娠早期，孕妇是其胎儿甲状腺激素的唯一来源，碘缺乏引起的低甲状腺素血症可能对胎儿发育产生有害影响。
介绍孕期碘缺乏及其预防的当前方法。
对包括孕期碘缺乏相关专利在内的当前文献进行了综述。
已证实严重碘缺乏对胎儿发育有负面影响，关于轻度碘缺乏形式对后代认知产生有害影响的证据也在迅速增加。尽管世界卫生组织已解决了孕期碘状况监测、预防措施及其有效性评估等问题，但仍存在一些争议，例如碘状况控制的最佳方法。尿碘测量方法的新专利可能会使碘营养监测更容易。孕期碘预防的主要方法也是普遍食盐碘化。然而，特别是如果碘盐对家庭的覆盖率不足，孕妇需要采取额外措施，如口服碘化钾片，以提供充足的碘营养。补充碘可改善母体甲状腺功能指标；特别是，它可预防甲状腺肿形成。
仍需要更有力的证据来证明对轻度至中度碘缺乏孕妇补充碘对其子女认知功能的有益影响。这可能由随机对照试验和国际倡议提供。应监测碘预防系统的变化，以防止碘摄入量减少或过多。
