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妊娠期间补充碘对孕妇及其后代的影响:过去 30 年试验的系统评价和荟萃分析。

Effects of iodine supplementation during pregnancy on pregnant women and their offspring: a systematic review and meta-analysis of trials over the past 3 decades.

机构信息

Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Family Health Institute, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Endocrinol. 2021 Jan;184(1):91-106. doi: 10.1530/EJE-20-0927.

Abstract

OBJECTIVE

The current systematic review aimed to provide comprehensive data on the effects of iodine supplementation in pregnancy and investigate its potential benefits on infant growth parameters and neurocognitive development using meta-analysis.

METHODS

A systematic review was conducted on trials published from January 1989 to December 2019 by searching MEDLINE, Web of Science, the Cochrane Library, Scopus, and Google Scholar. For most maternal and neonatal outcomes, a narrative synthesis of the data was performed. For birth anthropometric measurements and infant neurocognitive outcomes, the pooled standardized mean differences (SMDs) with 95% CIs were estimated using fixed/random effect models.

RESULTS

Fourteen trials were eligible for inclusion in the systematic review, of which five trials were included in the meta-analysis. Although the findings of different thyroid parameters are inconclusive, more consistent evidence showed that iodine supplementation could prevent the increase in thyroglobulin concentration during pregnancy. In the meta-analysis, no differences were found in weight (-0.11 (95% CI: -0.23 to 0.01)), length (-0.06 (95% CI: -0.21 to 0.09)), and head circumference (0.26 (95% CI: -0.35 to 0.88)) at birth, or in cognitive (0.07 (95% CI: -0.07 to 0.20)), language (0.06 (95% CI: -0.22 to 0.35)), and motor (0.07 (95% CI: -0.06 to 0.21)) development during the first 2 years of life in infants between the iodine-supplemented and control groups.

CONCLUSION

Iodine supplementation during pregnancy can improve the iodine status in pregnant women and their offspring; however, according to our meta-analysis, there was no evidence of improved growth or neurodevelopmental outcomes in infants of iodine-supplemented mothers.

摘要

目的

本系统评价旨在提供关于妊娠期间碘补充的影响的综合数据,并通过荟萃分析研究其对婴儿生长参数和神经认知发育的潜在益处。

方法

从 1989 年 1 月至 2019 年 12 月,通过检索 MEDLINE、Web of Science、Cochrane 图书馆、Scopus 和 Google Scholar,对已发表的试验进行了系统评价。对于大多数母婴结局,对数据进行了叙述性综合。对于出生时的人体测量指标和婴儿神经认知结局,使用固定/随机效应模型估计汇总标准化均数差(SMD)及其 95%置信区间。

结果

共有 14 项试验符合纳入系统评价的标准,其中 5 项试验纳入了荟萃分析。虽然不同甲状腺参数的结果尚无定论,但更一致的证据表明,碘补充可以防止妊娠期间甲状腺球蛋白浓度的增加。在荟萃分析中,两组间出生时的体重(-0.11(95%置信区间:-0.23 至 0.01))、长度(-0.06(95%置信区间:-0.21 至 0.09))和头围(0.26(95%置信区间:-0.35 至 0.88)),以及婴儿在出生后 2 年内的认知(0.07(95%置信区间:-0.07 至 0.20))、语言(0.06(95%置信区间:-0.22 至 0.35))和运动(0.07(95%置信区间:-0.06 至 0.21))发育均无差异。

结论

妊娠期间补充碘可以改善孕妇及其后代的碘营养状况;然而,根据我们的荟萃分析,补充碘的母亲所生婴儿的生长和神经发育结局并无改善。

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