Public Health Laboratory, Basque Government, Bilbao, Spain.
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Eur J Nutr. 2018 Aug;57(5):1807-1816. doi: 10.1007/s00394-017-1465-4. Epub 2017 Apr 29.
Median urinary iodine concentration (UIC) is used to describe the iodine status of a population. However, the link between UIC and iodine intake may vary during pregnancy. The aim of this study was to compare UIC during and after pregnancy, adjusting for factors that affect iodine intake.
Two repeated measures of UIC and data on maternal iodine intake estimated through questionnaires were collected during pregnancy and 1-4 years after pregnancy in a subsample of women (n = 598) from a mother and child cohort study in Spain. Random-effects interval regression was used to assess the changes in UIC according to pregnancy status.
Median UIC was similar during (133 μg/L) and after pregnancy (139 μg/L). After adjusting for iodised salt, iodine supplement consumption, and socio-demographic related variables, UIC was 24.0% (95% CI 11.3, 38.2) higher after than during pregnancy. This difference was maintained in a subsample of women with exhaustive information on diet (n = 291): 26.2%, 95% CI 10.3, 44.4.
In an iodine sufficient area for the general population, iodine excretion was lower during than after pregnancy when factors affecting iodine intake were controlled for. Current recommendations of median UIC during pregnancy are based on the equivalence between iodine intake and UIC estimated from studies in non-pregnant populations, which might lead to overestimation of iodine deficiency during gestation. Further studies should evaluate the equivalence between iodine intake and its urinary excretion during pregnancy.
尿碘中位数(UIC)用于描述人群的碘状况。然而,UIC 与碘摄入量之间的联系在怀孕期间可能会有所不同。本研究旨在比较怀孕期间和之后 UIC 的变化,同时调整影响碘摄入量的因素。
在西班牙的一项母婴队列研究的子样本中(n=598),在怀孕期间和产后 1-4 年内两次重复测量 UIC,并通过问卷调查收集了母体碘摄入量的数据。使用随机效应区间回归评估 UIC 根据妊娠状态的变化。
怀孕期间的 UIC 中位数(133μg/L)与产后相似(139μg/L)。在调整了碘盐、碘补充剂的消费以及社会人口相关变量后,UIC 产后比怀孕期间高 24.0%(95%CI 11.3, 38.2)。在饮食信息详尽的子样本中(n=291),这一差异仍然存在:26.2%,95%CI 10.3, 44.4。
在碘对一般人群充足的地区,当控制影响碘摄入量的因素时,UIC 在怀孕期间的排泄量低于产后。目前怀孕期间 UIC 的中位数建议是基于从非妊娠人群中研究得出的碘摄入量和 UIC 之间的等效性,这可能导致妊娠期碘缺乏的高估。应进一步研究评估怀孕期间碘摄入量与其尿排泄之间的等效性。