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碘监测模型有助于避免与碘摄入过多相关的不良出生结局。

Iodine monitoring models contribute to avoid adverse birth outcomes related more than adequate iodine intake.

机构信息

Department of Gynaecology and Obstetrics, Xiangyang No.1 People's Hospital, Hubei University of Medcine, Xiangyang, 441000, China.

Department of Obstetrics, Pingdingshan No.1 People's Hospital, Pingdingshan, 467000, China.

出版信息

BMC Pregnancy Childbirth. 2021 Jun 28;21(1):454. doi: 10.1186/s12884-021-03936-w.

Abstract

BACKGROUND

Iodine plays an important role in pregnancy. How to maintain adequate iodine intake amongst pregnant women in each trimester of pregnancy to prevent adverse birth outcomes in central China is a challenge for clinical practice.

METHODS

870 pregnant women and their infants were enrolled in the study. Urinary iodine concentration (UIC) was measured using an inductively coupled plasma mass spectrometry (ICP-MS). Maternal and newborn information were obtained during follow-up. Multinomial logistic regression models were established.

RESULTS

Median UIC of pregnant women was 172 ± 135 μg/L which is currently considered to be sufficient. Multivitamin supplements containing iodine, iodized salt intake and frequent milk intake were significantly associated with higher UIC. Multivariate logistic regression analysis showed that multivitamin supplements containing iodine and milk consumption were risk factors for more than adequate iodine (UIC ≥ 250 μg/L). Iodine-rich diet was significantly related to heavier birthweight, larger head circumference and longer femur length of the newborns while more than adequate iodine intake (UIC ≥ 250 μg/L) was a risk factor for macrosomia. Logistic regression models based on potential risk factors involving iodine containing supplements and iodine-rich diet were established to predict and screen pregnant women with high risk of more than adequate iodine intake among local pregnant women in different trimesters and guide them to supplement iodine reasonably to prevent the risk.

CONCLUSIONS

Multivitamin supplements containing iodine and milk consumption were risk factors for maternal UIC ≥ 250 μg/L which was a risk factor for macrosomia. Iodine monitoring models were established to provide guidance for pregnant women to reduce the risk of more than adequate iodine intake, thereby contributing to reduce the risk of having a macrosomia.

摘要

背景

碘在妊娠中起着重要作用。如何在妊娠的每个阶段维持足够的碘摄入量,以预防中国中部不良妊娠结局,这是临床实践中的一个挑战。

方法

本研究纳入了 870 名孕妇及其婴儿。采用电感耦合等离子体质谱法(ICP-MS)检测尿碘浓度(UIC)。在随访期间收集孕妇和新生儿的信息。建立多分类逻辑回归模型。

结果

孕妇 UIC 的中位数为 172±135μg/L,目前认为这是充足的。含碘多维素补充剂、碘盐摄入和经常饮用牛奶与更高的 UIC 显著相关。多变量逻辑回归分析表明,含碘多维素补充剂和牛奶摄入是碘过量(UIC≥250μg/L)的危险因素。富含碘的饮食与新生儿体重较大、头围较大和股骨较长显著相关,而碘摄入过多(UIC≥250μg/L)是巨大儿的危险因素。基于含碘补充剂和富含碘饮食的潜在危险因素,建立了逻辑回归模型,以预测和筛选当地不同孕期孕妇中碘摄入过多的高危人群,并指导其合理补充碘,以预防风险。

结论

含碘多维素补充剂和牛奶摄入是 UIC≥250μg/L 的危险因素,而 UIC≥250μg/L 是巨大儿的危险因素。建立了碘监测模型,为孕妇提供指导,以降低碘摄入过多的风险,从而降低巨大儿的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/294d/8240367/450e7b1cbfd9/12884_2021_3936_Fig1_HTML.jpg

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