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母体碘缺乏:新生儿超重的风险因素?一项前瞻性研究。

Maternal iodine deficiency: a newborns' overweight risk factor? A prospective study.

机构信息

Obstetrics and Gynecology Department, Barzilai University Medical Center Ashkelon, Ashkeon, Israel.

Foreign studies department; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rhovot, Israel.

出版信息

Arch Gynecol Obstet. 2022 Mar;305(3):777-787. doi: 10.1007/s00404-021-06261-x. Epub 2021 Oct 2.

Abstract

OBJECTIVES

Childhood obesity and iodine deficiency are global public health concerns. Whether maternal iodine status mediates overweight in infancy has yet to be explored. We aimed to assess the relationship between maternal iodine status and infant birth weight, including small and large for gestational age (SGA and LGA, respectively).

METHODS

A prospective study was carried out among 134 mother-infant pairs from Israel. Maternal iodine intake and status were estimated via questionnaire and serum thyroglobulin (Tg), respectively. Estimated iodine intake below the Recommended Daily Allowance for iodine sufficiency in pregnancy (220 μg/d) considered Inadequate. Maternal and neonatal thyroid function and anthropometric measurements, as well as maternal thyroid antibodies were also tested.

RESULTS

After screening, 118 participants met the inclusion criteria (distributed trimesters I, II and III: n = 3, n = 21, and n = 94, respectively). There was a negative association of iodine intake with Tg values among the study population. Maternal median Tg value was higher than the sufficiency cutoff (16.5 vs 13 µg/L), indicating insufficient iodine status. No SGA cases were found. Inadequate iodine intake was associated with maternal isolated hypothyroxinemia (OR = 3.4; 95% CI 1.2, 9.9) and higher birthweight (including macrosomia and LGA) rates. A suggestive association of elevated Tg with a greater risk of LGA was observed. Offsprings' birth weight percentiles were associated with Tg values in pregnant women with suggestive sufficient iodine status (n = 62, R = 0.11, p < 0.05).

CONCLUSIONS

Iodine status during pregnancy can be associated with newborn anthropometric index. Maternal inadequate iodine intake may alter fetal growth and might increase the risk of LGA among newborns. These initial findings support the need to further study the impact of iodine deficiency on newborns overweight in Israel and elsewhere.

摘要

目的

儿童肥胖和碘缺乏是全球公共卫生关注的问题。母体碘状况是否会影响婴儿超重仍有待探讨。本研究旨在评估母体碘状况与婴儿出生体重的关系,包括小于胎龄儿(SGA)和大于胎龄儿(LGA)。

方法

在以色列进行了一项前瞻性研究,纳入了 134 对母婴对。通过问卷和血清甲状腺球蛋白(Tg)分别评估母体碘摄入量和状况。碘摄入量低于妊娠碘充足的推荐日摄入量(220μg/d)被认为是不足的。还检测了母体和新生儿的甲状腺功能和人体测量学指标以及母体甲状腺抗体。

结果

经过筛选,有 118 名参与者符合纳入标准(分布在妊娠第一、二、三期的分别有 n=3、n=21 和 n=94)。在研究人群中,碘摄入量与 Tg 值呈负相关。母体 Tg 值中位数高于充足的临界值(16.5μg/L 对 13μg/L),表明碘状态不足。未发现 SGA 病例。碘摄入不足与母体孤立性甲状腺功能减退症(OR=3.4;95%CI 1.2,9.9)和较高的出生体重(包括巨大儿和 LGA)发生率相关。提示 Tg 升高与 LGA 风险增加有关。在具有提示性充足碘状态的孕妇中(n=62),婴儿出生体重百分位数与 Tg 值相关(R=0.11,p<0.05)。

结论

妊娠期间的碘状况可能与新生儿的人体测量指数有关。母体碘摄入不足可能会改变胎儿的生长,增加新生儿 LGA 的风险。这些初步发现支持需要进一步研究碘缺乏对以色列和其他地区新生儿超重的影响。

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