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孕期母体碘摄入量与 18 个月龄儿童神经发育的关系。

Association Between Maternal Iodine Intake in Pregnancy and Childhood Neurodevelopment at Age 18 Months.

机构信息

School of Agriculture, Food and Wine, University of Adelaide, South Australia, Australia.

Robinson Research Institute, University of Adelaide, South Australia, Australia.

出版信息

Am J Epidemiol. 2019 Feb 1;188(2):332-338. doi: 10.1093/aje/kwy225.

Abstract

There are limited and inconsistent data suggesting that mild iodine deficiency in pregnancy might be associated with poorer developmental outcomes in children. Between 2011 and 2015, we conducted a prospective cohort study in Australia examining the relationship between maternal iodine intake in pregnancy and childhood neurodevelopment, assessed using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), in 699 children at 18 months. Maternal iodine intake and urinary iodine concentration (UIC) were assessed at study entry (<20 weeks' gestation) and at 28 weeks' gestation. Maternal iodine intake in the lowest (<220 μg/day) or highest (≥391 μg/day) quartile was associated with lower cognitive, language, and motor scores (mean differences ranged from 2.4 (95% confidence interval (CI): 0.01, 4.8) to 7.0 (95% CI: 2.8, 11.1) points lower) and higher odds (odds ratios ranged from 2.7 (95% CI: 1.3, 5.6) to 2.8 (95% CI: 1.3, 5.7)) of cognitive developmental delay (Bayley-III score <1 SD) compared with mothers with an iodine intake in the middle quartiles. There was no association between UIC in pregnancy and Bayley-III outcomes regardless of whether UIC and the outcomes were analyzed as continuous or categorical variables. Both low and high iodine intakes in pregnancy were associated with poorer childhood neurodevelopment in this iodine-sufficient population.

摘要

有一些有限且不一致的数据表明,妊娠期间轻度碘缺乏可能与儿童发育结果较差有关。在 2011 年至 2015 年期间,我们在澳大利亚进行了一项前瞻性队列研究,在 699 名 18 个月大的儿童中使用贝利婴幼儿发育量表第三版(Bayley-III)评估了母亲妊娠期间碘摄入量与儿童神经发育之间的关系。在研究开始时(<20 周妊娠)和 28 周妊娠时评估了母亲的碘摄入量和尿碘浓度(UIC)。碘摄入量最低(<220μg/天)或最高(≥391μg/天)四分位数的母亲,其认知、语言和运动评分较低(平均差异范围为 2.4(95%置信区间(CI):0.01,4.8)至 7.0(95%CI:2.8,11.1)分),认知发育迟缓(Bayley-III 评分<1 SD)的可能性更高(比值比范围为 2.7(95%CI:1.3,5.6)至 2.8(95%CI:1.3,5.7))与碘摄入量处于中间四分位的母亲相比。无论 UIC 和结果是作为连续变量还是分类变量进行分析,妊娠期间 UIC 与 Bayley-III 结局之间均无关联。在这个碘充足的人群中,妊娠期间的低碘和高碘摄入均与儿童神经发育较差有关。

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