Faculty of Education, University of Tasmania, Launceston 7250, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart 7001, Australia.
Nutrients. 2019 Aug 22;11(9):1974. doi: 10.3390/nu11091974.
This synopsis paper aims to identify if a common pattern of learning and social difficulties can be conceptualized across recent longitudinal studies investigating the influence of mild-to-moderate gestational iodine deficiency (GID) on offspring's optimal cognitive and psycho-social development. The main studies investigated are: The Southampton Women's Study (SWS)-United Kingdom; the Avon Longitudinal Study of Parents and Children (ALSPAC)-United Kingdom; the Gestational Iodine Cohort Longitudinal Study-Tasmania, Australia, and the Danish National Birth Cohort Case-Control Study-Denmark. In contrast to severe GID where there is a global negative impact on neurodevelopment, mild-to-moderate intrauterine iodine deficiency has subtler, but nonetheless important, permanent cognitive and psycho-social consequences on the offspring. This paper links the results from each study and maintains that mild-to-moderate GID is associated with a disorder that is characterized by speed of neural transmitting difficulties that are typically associated with working memory capacity difficulties and attention and response inhibition. The authors maintain that this disorder is better identified as Gestational Iodine Deficiency Processing Disorder (GIDPD), rather than, what to date has often been identified as 'suboptimal development'. The Autistic Spectrum Disorder (ASD), Attention Deficit, Hyperactivity Disorder (ADHD), language and literacy disorders (learning disabilities and dyslexia) are the main manifestations associated with GIDPD. GIDPD is identified on IQ measures, but selectively and mainly on verbal reasoning IQ subtests, with individuals with GIDPD still operating within the 'normal' full-scale IQ range. Greater consideration needs to be given by public health professionals, policy makers and educators about the important and preventable consequences of GID. Specifically, more emphasis should be placed on adequate iodine intake in women prior to pregnancy, as well as during pregnancy and when lactating. Secondly, researchers and others need to further extend, refine and clarify whether GIDPD, as a nosological (medical classification) entity, is a valid disorder and concept for consideration.
本文旨在探讨轻度至中度妊娠期碘缺乏(GID)对后代最佳认知和心理社会发展的影响,通过对近期调查这一影响的纵向研究进行综合分析,明确是否存在共同的学习和社会困难模式。主要研究包括:英国南安普顿女性研究(SWS)、英国阿冯纵向父母与子女研究(ALSPAC)、澳大利亚塔斯马尼亚妊娠期碘队列纵向研究和丹麦国家出生队列病例对照研究。与严重 GID 对神经发育产生全面负面影响不同,轻度至中度宫内碘缺乏对后代的认知和心理社会发展具有更微妙但同样重要的永久性影响。本文将各个研究的结果联系起来,并认为轻度至中度 GID 与一种障碍有关,这种障碍的特征是神经传递速度困难,通常与工作记忆容量困难、注意力和反应抑制有关。作者认为,这种障碍最好被确定为妊娠期碘缺乏处理障碍(GIDPD),而不是迄今为止通常被确定为“发育不良”的障碍。自闭症谱系障碍(ASD)、注意力缺陷多动障碍(ADHD)、语言和读写障碍(学习障碍和阅读障碍)是与 GIDPD 相关的主要表现。GIDPD 在智商测试中被识别出来,但在言语推理智商测试中选择性地且主要地被识别出来,具有 GIDPD 的个体仍然在“正常”的全量表智商范围内运作。公共卫生专业人员、政策制定者和教育工作者需要更加重视 GID 的重要和可预防后果。具体来说,需要更加重视女性在怀孕前、怀孕期间和哺乳期的适当碘摄入。其次,研究人员和其他人员需要进一步扩展、改进和澄清 GIDPD 是否作为一种分类(医学分类)实体,是否是一个有效的障碍和概念。