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产后妇女及其 3、6 和 12 个月大婴儿的碘状况:母婴营养调查(MINI)。

Iodine status of postpartum women and their infants aged 3, 6 and 12 months: Mother and Infant Nutrition Investigation (MINI).

机构信息

School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand.

Nutrition Science, School of Food and Advanced Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North4474, New Zealand.

出版信息

Br J Nutr. 2022 Feb 28;127(4):570-579. doi: 10.1017/S000711452100129X. Epub 2021 Apr 16.

Abstract

To alleviate the re-emergence of iodine deficiency in New Zealand, two strategies, the mandatory fortification of bread with iodised salt (2009) and a government-subsidised iodine supplement for breast-feeding women (2010), were introduced. Few studies have investigated mother and infant iodine status during the first postpartum year; this study aimed to describe iodine status of mothers and infants at 3, 6 and 12 months postpartum (3MPP, 6MPP and 12MPP, respectively). Partitioning of iodine excretion between urine and breast milk of exclusive breast-feeding (EBF) women at 3MPP was determined. In total, eighty-seven mother-infant pairs participated in the study. Maternal and infant spot urinary iodine concentration (UIC) and breast milk iodine concentration (BMIC) were determined. The percentage of women who took iodine-containing supplements decreased from 46 % at 3MPP to 6 % at 12MPP. Maternal median UIC (MUIC) at 3MPP (82 (46, 157) µg/l), 6MPP (85 (43, 134) µg/l) and 12MPP (95 (51, 169) µg/l) were <100 µg/l. The use of iodine-containing supplements increased MUIC and BMIC only at 3MPP. Median BMIC at all time points were below 75 µg/l. Infant MUIC at 3MPP (115 (69, 182) µg/l) and 6MPP (120 (60, 196) µg/l) were below 125 µg/l. Among EBF women at 3MPP, an increased partitioning of iodine into breast milk (highest proportion 60 %) was shown at lower iodine intakes, along with a reduced fractional iodine excretion in urine (lowest proportion 40 %), indicating a protective mechanism for breastfed infants' iodine status. In conclusion, this cohort of postpartum women was iodine-deficient. Iodine status of their breastfed infants was suboptimal. Lactating women who do not consume iodine-rich foods and those who become pregnant again should take iodine-containing supplements.

摘要

为了缓解新西兰碘缺乏症的再次出现,该国采取了两项策略,即强制在面包中添加碘化盐(2009 年)和为哺乳期妇女提供政府补贴的碘补充剂(2010 年)。很少有研究调查过产妇和婴儿在产后第一年的碘状况;本研究旨在描述产后 3、6 和 12 个月(3MPP、6MPP 和 12MPP)时母亲和婴儿的碘状况。还确定了纯母乳喂养(EBF)妇女在 3MPP 时碘排泄在尿液和母乳之间的分配情况。共有 87 对母婴参与了这项研究。测定了母婴点尿碘浓度(UIC)和母乳碘浓度(BMIC)。在 3MPP 时服用含碘补充剂的女性比例从 46%下降到 12MPP 时的 6%。3MPP、6MPP 和 12MPP 时产妇的中位数 UIC(MUIC)分别为 82(46,157)µg/L、85(43,134)µg/L 和 95(51,169)µg/L,均<100µg/L。含碘补充剂的使用仅在 3MPP 时增加了 MUIC 和 BMIC。所有时间点的中位数 BMIC 均低于 75µg/L。3MPP 和 6MPP 时婴儿的 MUIC 分别为 115(69,182)µg/L 和 120(60,196)µg/L,均<125µg/L。在 3MPP 时的 EBF 妇女中,随着碘摄入量的增加,更多的碘被分配到母乳中(最高比例为 60%),而尿液中碘的排泄分数减少(最低比例为 40%),这表明了一种保护机制,可以维持母乳喂养婴儿的碘状况。总之,这群产后妇女碘缺乏。她们哺乳期婴儿的碘状况不理想。那些不食用富含碘的食物的哺乳期妇女和再次怀孕的妇女应该服用含碘补充剂。

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