Jin Ying, Coad Jane, Zhou Shao J, Skeaff Sheila, Benn Cheryl, Kim Nicholas, Pond Rachael L, Brough Louise
School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand.
School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand.
JMIR Res Protoc. 2020 Aug 27;9(8):e18560. doi: 10.2196/18560.
Thyroid dysfunction is associated with cognitive impairment, mood disturbance, and postnatal depression. Sufficient thyroid hormone synthesis requires adequate intake of iodine, selenium, and iron. Iodine deficiency was historically a problem for New Zealand, and initiatives were introduced to overcome the problem: (1) mandatory fortification of all bread (except organic) with iodized salt (2009) and (2) provision of subsidized iodine supplements for pregnant and breastfeeding women (2010). Subsequent to these initiatives, most adults and children have adequate iodine status; however, status among breastfeeding women and their infants remains unclear. This paper outlines the methodology of the Mother and Infant Nutrition Investigation (MINI) study: an observational longitudinal cohort study of breastfeeding women and their infants.
This study will determine (1) women's iodine intake and status among supplement users and nonusers; (2) women's intake and status of iodine, selenium, and iron relating to thyroid function; (3) associations between women's selenium status, thyroid function, and postnatal depression; (4) infants' iodine and selenium status relating to first year neurodevelopment.
Breastfeeding women aged over 16 years with a healthy term singleton infant were recruited from Manawatu, New Zealand. Participants attended study visits 3, 6, and 12 months postpartum. Maternal questionnaires investigated supplement use before and after birth, iodine knowledge, and demographic information. Dietary assessment and urine, blood, and breast milk samples were taken to measure iodine, selenium, and iron intake/status. The Edinburgh Postnatal Depression Scale was used repeatedly to screen for postnatal depression. Thyroid hormones (free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin, antithyroglobulin antibodies, and antithyroid peroxidase) were measured in blood samples, and thyroid gland volume was measured by ultrasound at 6 months postpartum. Infant iodine and selenium concentrations were determined in urine. The Ages and Stages Questionnaire was used to assess infant development at 4, 8, and 12 months.
Data collection was completed. Biological samples analysis, excluding nail clippings, is complete. Data analysis and presentation of the results will be available after 2020.
This study will provide data on the current iodine status of breastfeeding women. It will also provide a greater understanding of the three essential minerals required for optimal thyroid function among breastfeeding women. The prospective longitudinal design allows opportunities to examine women's mental health and infant neurodevelopment throughout the first year, a crucial time for both mothers and their infants.
Australian New Zealand Clinical Trials Registry ACTRN12615001028594; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/18560.
甲状腺功能障碍与认知障碍、情绪紊乱及产后抑郁有关。充足的甲状腺激素合成需要适量摄入碘、硒和铁。历史上，碘缺乏一直是新西兰面临的一个问题，为此采取了多项举措来解决这一问题：（1）对所有面包（有机面包除外）强制添加碘盐（2009年）；（2）为孕妇和哺乳期妇女提供补贴碘补充剂（2010年）。实施这些举措后，大多数成年人和儿童的碘状况充足；然而，哺乳期妇女及其婴儿的碘状况仍不明确。本文概述了母婴营养调查（MINI）研究的方法：一项对哺乳期妇女及其婴儿进行的观察性纵向队列研究。
本研究将确定：（1）补充剂使用者和非使用者中女性的碘摄入量和碘状况；（2）女性碘、硒和铁的摄入量及与甲状腺功能相关的状况；（3）女性硒状况、甲状腺功能与产后抑郁之间的关联；（4）婴儿碘和硒状况与一岁时神经发育的关系。
从新西兰马纳瓦图招募年龄在16岁以上、足月分娩单胎健康婴儿的哺乳期妇女。参与者在产后3个月、6个月和12个月参加研究访视。产妇问卷调查了分娩前后的补充剂使用情况、碘知识和人口统计学信息。采集饮食评估、尿液、血液和母乳样本以测量碘、硒和铁的摄入量/状况。反复使用爱丁堡产后抑郁量表筛查产后抑郁。检测血样中的甲状腺激素（游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素、甲状腺球蛋白、抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶），并在产后6个月通过超声测量甲状腺体积。测定婴儿尿液中的碘和硒浓度。使用年龄与发育进程问卷在4个月、8个月和12个月时评估婴儿发育情况。
数据收集已完成。除指甲剪外的生物样本分析已完成。结果的数据分析和呈现将于2020年后提供。
本研究将提供哺乳期妇女当前碘状况的数据。它还将使人们更深入了解哺乳期妇女甲状腺功能最佳所需的三种必需矿物质。前瞻性纵向设计使我们有机会在整个第一年检查女性的心理健康和婴儿神经发育情况，这对母亲和婴儿来说都是关键时期。
澳大利亚新西兰临床试验注册中心ACTRN12615001028594；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324。
国际注册报告识别码（IRRID）：DERR1-10.2196/18560。
