Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Endocrinology and Metabolism, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Biol Trace Elem Res. 2023 Nov;201(11):5143-5151. doi: 10.1007/s12011-023-03600-8. Epub 2023 Feb 10.
Iodine is essential for normal thyroid function, supporting healthy fetal and child development. The relevance between maternal iodine nutrition status and pregnancy outcomes remains controversial. The aim was to explore whether urinary iodine concentrations (UIC)/urinary creatinine (UCr) was associated with thyroid function and adverse pregnancy outcomes. This study was performed in the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Nanjing Medical University. A total of 212 pregnant women were enrolled from May 2018 to November 2021, from the first visit until postpartum. Maternal serum samples were obtained in the second half of pregnancy, and then thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), UIC, and UCr were tested. The correlation of UIC/UCr, which represented maternal iodine nutrition status, with TSH, FT4, and FT3 was studied using linear regression. And we assessed associations between UIC/UCr and pregnancy outcomes. Notably, we explored consistency between UIC/UCr and the incidence of low birth weight (LBW) by application of logistic regression analysis. A total of 212 women were divided into 3 groups according to the upper and lower quartiles of UIC/UCr. There were 53 women in group 1 (UIC/UCr < 106.96 ug/g), 106 women in group 2 (UIC/UCr 106.96-259.08 ug/g), and 53 women in group 3 (UIC/UCr > 259.08 ug/g). The level of UIC/UCr had a negative correlation with FT4 (r = - 0.139, p = 0.043) but a positive correlation with TSH (r = 0.096, p = 0.162 > 0.05). There was a significant difference in the incidence of LBW among the 3 groups (p = 0.007). Logistic regression analysis found that the level of UIC/UCr was an independent factor for LBW (p = 0.048, OR = 0.991, 95%CI (0.982, 0.999)). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) for UIC/UCr predicting the incidence of low birth weight was 0.687 (p = 0.013, 95%CI 0.575, 0.799). Lower UIC/UCr during pregnancy was associated with higher FT4 and lower TSH. And iodine deficiency during pregnancy is a risk factor for low birth weight. Our findings indicated that more attention should be paid to the appropriate iodine nutrition status in pregnant women, which can help prevent suffering from adverse pregnancy outcomes.
碘是甲状腺功能正常所必需的，支持胎儿和儿童的健康发育。母体碘营养状况与妊娠结局的相关性仍存在争议。本研究旨在探讨尿碘浓度（UIC）/尿肌酐（UCr）是否与甲状腺功能和不良妊娠结局相关。本研究在南京医科大学第一附属医院内分泌代谢科进行。2018 年 5 月至 2021 年 11 月期间，共招募了 212 名孕妇，从第二次产检开始至产后。在妊娠后半期采集母体血清样本，检测促甲状腺激素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、UIC 和 UCr。采用线性回归研究 UIC/UCr 与 TSH、FT4 和 FT3 的相关性。并评估 UIC/UCr 与妊娠结局的关系。值得注意的是，我们通过应用逻辑回归分析来探讨 UIC/UCr 与低出生体重（LBW）发生率之间的一致性。根据 UIC/UCr 的上下四分位数将 212 名女性分为 3 组。组 1（UIC/UCr<106.96μg/g）有 53 名女性，组 2（UIC/UCr 106.96-259.08μg/g）有 106 名女性，组 3（UIC/UCr>259.08μg/g）有 53 名女性。UIC/UCr 水平与 FT4 呈负相关（r=-0.139，p=0.043），与 TSH 呈正相关（r=0.096，p=0.162>0.05）。3 组间 LBW 的发生率有显著差异（p=0.007）。逻辑回归分析发现 UIC/UCr 水平是 LBW 的独立因素（p=0.048，OR=0.991，95%CI（0.982，0.999））。受试者工作特征（ROC）曲线显示，UIC/UCr 预测低出生体重的曲线下面积（AUC）为 0.687（p=0.013，95%CI 0.575，0.799）。妊娠期间 UIC/UCr 较低与 FT4 较高和 TSH 较低相关。妊娠期间碘缺乏是低出生体重的危险因素。我们的研究结果表明，应更加关注孕妇适当的碘营养状况，这有助于预防不良妊娠结局。
