Neonatology Unit, University Hospital LA PAZ, Paseo de la Castellana 261, 28046, Madrid, Spain.
Facultad de Educacion, Universidad Complutense, Madrid, Spain.
Eur J Pediatr. 2022 Mar;181(3):959-972. doi: 10.1007/s00431-021-04288-5. Epub 2021 Oct 15.
The trace element iodine (I) is essential for the synthesis of thyroid hormones. Parenteral nutrition solutions, formula milk, and human breast milk contain insufficient iodine to meet recommended intake for preterm infants. Iodine deficiency may affect thyroid function and may be associated with morbidity or neurological outcomes. The primary objective is to assess the evidence that dietary supplementation with iodine affects thyroid function during the neonatal period. The design was a randomised controlled pilot trial. Infants who met the inclusion criteria were enrolled through consecutive sampling and assigned to two different groups. The setting was a Spanish university hospital. Ninety-four patients with very low birth weight (under 1500 g) were included. Intervention group: 30 µg I/kg/day of iodine in oral drops given to 47 infants from their first day of life until hospital discharge. Control group: 47 infants without supplements. Formula and maternal milk samples for the determination of iodine content were collected at 1, 7, 15, 21, 30 days, and at discharge. Blood samples were collected for thyroid hormones. Neurological development was assessed at 2 years of age (Bayley III Test). Infants in the supplemented group reached the recommended levels from the first days of life. The researchers detected the effects of iodine balance on the plasma levels of thyroid hormones measured during the first 12 weeks of age. The trial assessed the impact of the intervention on neurodevelopmental morbidity.Conclusion: Thyroid function is related to iodine intake in preterm infants. Therefore, supplements should be added if iodine intake is found to be inadequate. The analyses found no effects of iodine supplementation on the composite scores for Bayley-III assessments in all major domains. The study results indicate potentially important effects on language development related to low iodine excretion during the first 4 weeks of life What is Known: • Thyroid function is related to iodine intake in preterm infants. • Preterm babies on formula preparations and with exclusive parenteral nutrition are at high risk of iodine deficiency. What is New: • Iodine intake should be monitored during the neonatal period. • Iodine supplements should be added if iodine intake is found to be inadequate.
微量元素碘（I）是合成甲状腺激素所必需的。肠外营养溶液、配方奶和人乳中碘含量不足，无法满足早产儿的推荐摄入量。碘缺乏可能会影响甲状腺功能，并可能与发病率或神经发育结果有关。主要目的是评估补充碘对新生儿期甲状腺功能的影响的证据。设计为随机对照试验。通过连续抽样纳入符合纳入标准的婴儿，并将其分为两组。研究地点为西班牙一家大学医院。共纳入 94 名极低出生体重（<1500g）的患儿。干预组：30µg I/kg/天的碘口服滴剂，47 名婴儿从出生第一天开始服用，直至出院。对照组：47 名婴儿未补充碘。在 1、7、15、21、30 天和出院时采集配方奶和母乳样本，以测定碘含量。采集血样检测甲状腺激素。在 2 岁时进行神经发育评估（Bayley III 测试）。补充组的婴儿从出生第一天起就达到了推荐水平。研究人员检测了碘平衡对婴儿 12 周内血浆甲状腺激素水平的影响。该试验评估了干预对神经发育发病率的影响。结论：早产儿的甲状腺功能与碘摄入量有关。因此，如果发现碘摄入量不足，应补充碘。分析发现，在所有主要领域，补充碘对 Bayley-III 评估的综合评分均无影响。研究结果表明，与生命的头 4 周内碘排泄量低有关的语言发育可能存在潜在的重要影响。已知：•早产儿的甲状腺功能与碘摄入量有关。•使用配方奶和完全肠外营养的早产儿有发生碘缺乏的高风险。新发现：•应在新生儿期监测碘摄入量。•如果发现碘摄入量不足，应补充碘。
