Candido Aline Carare, Vieira Almir Antônio, de Souza Ferreira Emily, Moreira Tiago Ricardo, do Carmo Castro Franceschini Sylvia, Cotta Rosângela Minardi Mitre
Department of Nutrition and Health, Ed. Centro de Ciências Biológicas II, Universidade Federal de Viçosa, Peter Henry Rolfs Avenue, w/o. Campus Universitário, Viçosa, Minas Gerais, 36570.900, Brazil.
Department of Agricultural Engineering, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
Biol Trace Elem Res. 2023 Jun;201(6):2784-2794. doi: 10.1007/s12011-022-03401-5. Epub 2022 Aug 26.
The objective was to estimate the prevalence of excessive iodine intake in pregnant women and to investigate the consequences for maternal-fetal health. The systematic review was based on PRISMA. The search was conducted in September 2021 in LILACS, PubMed/MEDLINE, Science Direct, and SCOPUS databases. Observational studies that assessed excessive nutritional iodine status in pregnancy diagnosed by urinary iodine concentration and associated it with biomarkers of thyroid health function were included. Study selection, data extraction, and risk of biased evaluation were performed independently. Meta-analysis was calculated using a fixed and random effect model, and heterogeneity was assessed by the chi-square test. Meta-regressions were performed to identify the causes of heterogeneity using the Knapp and Hartung test. Nine studies were included in the systematic review, and eight in the meta-analysis. The prevalence of excessive iodine intake in 10,736 pregnant women in different regions of the world was 52%. The main implications for pregnant women were hypothyroxinemia, hypothyroidism, and hyperthyroidism. For the newborn, macrosomia and thyroid dysfunction. In addition, drinking water with high iodine intake contributed to excessive iodine intake. Therefore, the prevalence of iodine excess was 52%, with high heterogeneity among studies, explained by trimester of gestation and FT4 level; therefore, the farther the trimester of gestation and the lower the FT4, the higher the prevalence of iodine excess. PROSPERO Registration: CRD420206467 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206467 ).
目的是估计孕妇碘摄入过量的患病率，并调查其对母婴健康的影响。该系统评价基于PRISMA。检索于2021年9月在LILACS、PubMed/MEDLINE、Science Direct和SCOPUS数据库中进行。纳入了通过尿碘浓度诊断妊娠期间营养碘过量状况并将其与甲状腺健康功能生物标志物相关联的观察性研究。研究选择、数据提取和偏倚评估风险均独立进行。使用固定效应模型和随机效应模型计算荟萃分析，并通过卡方检验评估异质性。使用Knapp和Hartung检验进行荟萃回归以确定异质性的原因。系统评价纳入了9项研究，荟萃分析纳入了8项研究。世界不同地区10736名孕妇碘摄入过量的患病率为52%。对孕妇的主要影响是低甲状腺素血症、甲状腺功能减退和甲状腺功能亢进。对新生儿的影响是巨大儿和甲状腺功能障碍。此外，高碘摄入的饮用水导致碘摄入过量。因此，碘过量的患病率为52%，研究间异质性高，由妊娠 trimester和FT4水平解释；因此，妊娠 trimester越晚且FT4越低，碘过量的患病率越高。PROSPERO注册编号：CRD420206467(https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206467)。 （注：原文中“trimester”未翻译完整，推测可能是“妊娠中期”等意思，具体需结合更完整医学知识确定准确含义）
