Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK.
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK.
BMC Pediatr. 2020 Dec 5;20(1):544. doi: 10.1186/s12887-020-02440-y.
Maternal iodine requirements increase during pregnancy to supply thyroid hormones essential for fetal brain development. Maternal iodine deficiency can lead to hypothyroxinemia, a reduced fetal supply of thyroid hormones which, in the first trimester, has been linked to an increased risk of autism spectrum disorder (ASD) in the child. No study to date has explored the direct link between maternal iodine deficiency and diagnosis of ASD in offspring.
Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6955 mothers at 26-28 weeks gestation participating in the Born in Bradford (BiB) cohort. Maternal iodine status was examined in relation to the probability of a Read (CTV3) code for autism being present in a child's primary care records through a series of logistic regression models with restricted cubic splines.
Median (inter-quartile range) UIC was 76 μg/L (46, 120) and I:Cr was 83 μg/g (59, 121) indicating a deficient population according to WHO guidelines. Ninety two children (1·3%) in our cohort had received a diagnosis of ASD by the census date. Overall, there was no evidence to support an association between I:Cr or UIC and ASD risk in children aged 8-12 years (p = 0·3).
There was no evidence of an increased clinical ASD risk in children born to mothers with mild-to-moderate iodine deficiency at 26 weeks gestation. Alternative functional biomarkers of exposure and a wider range of conditions may provide further insight.
孕妇在怀孕期间对碘的需求增加,以提供甲状腺激素,这对胎儿大脑发育至关重要。母体碘缺乏可导致甲状腺功能减退症,胎儿甲状腺激素供应减少,而在妊娠早期,这与儿童自闭症谱系障碍(ASD)的风险增加有关。迄今为止,尚无研究探讨母体碘缺乏与后代 ASD 诊断之间的直接联系。
在参与布拉德福德出生(BiB)队列的 6955 名 26-28 周妊娠的母亲中测量了尿碘浓度(UIC)和碘/肌酐比值(I:Cr)。通过一系列逻辑回归模型和限制性立方样条,检查了母体碘状况与儿童初级保健记录中存在自闭症阅读(CTV3)编码的可能性之间的关系。
中位数(四分位距)UIC 为 76μg/L(46,120),I:Cr 为 83μg/g(59,121),根据世界卫生组织的指南,表明人群处于碘缺乏状态。我们队列中有 92 名儿童(1.3%)在普查日期前被诊断为 ASD。总体而言,I:Cr 或 UIC 与 8-12 岁儿童 ASD 风险之间没有证据表明存在关联(p=0.3)。
在妊娠 26 周时,母体轻度至中度碘缺乏的儿童中,没有证据表明临床 ASD 风险增加。替代暴露的功能生物标志物和更广泛的条件可能会提供进一步的见解。