Ma Zheng Feei, Brough Louise
School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol BS16 1QY, UK.
School of Food Technology and Natural Sciences, College of Sciences, Massey University, Palmerston North 4410, New Zealand.
Nutrients. 2025 Jun 16;17(12):2016. doi: 10.3390/nu17122016.
Iodine deficiency remains one of the most serious global public health challenges, recognised as the leading cause of preventable brain damage worldwide. It is widely accepted as the primary aetiological factor underlying iodine deficiency disorders (IDD). Inadequate maternal iodine intake reduces thyroxine synthesis, impairing foetal brain development and leading to long-term deficits in cognitive function across childhood and adulthood. However, emerging evidence also suggests that excessive iodine intake may disrupt thyroid function, particularly in individuals with underlying thyroid autoimmunity, potentially leading to adverse neurodevelopmental outcomes. In this state-of-the-art review, we examine the effects of iodine nutrition during pregnancy and lactation on child cognitive outcomes. We provide an overview of the recent global iodine status, critically appraise the current evidence linking both iodine deficiency and excess to neurodevelopmental outcomes, and offer expert interpretation of the key findings. We further highlight areas of uncertainty, introduce emerging evidence from contemporary studies, and propose directions for future research to inform and optimise public health policies and clinical practice. Our findings highlight a U-shaped association, whereby both insufficient and excessive iodine exposure during pregnancy and lactation may impair optimal brain development in the offspring.
碘缺乏仍然是最严重的全球公共卫生挑战之一，被认为是全球可预防脑损伤的主要原因。它被广泛认为是碘缺乏病（IDD）的主要病因。孕妇碘摄入不足会减少甲状腺素合成，损害胎儿大脑发育，并导致儿童期和成年期认知功能长期缺陷。然而，新出现的证据也表明，碘摄入过量可能会扰乱甲状腺功能，尤其是在患有潜在甲状腺自身免疫性疾病的个体中，这可能会导致不良的神经发育结果。在这篇最新综述中，我们研究了孕期和哺乳期碘营养对儿童认知结果的影响。我们概述了近期全球碘状况，批判性地评估了将碘缺乏和碘过量与神经发育结果联系起来的现有证据，并对关键发现提供了专家解读。我们进一步强调了不确定性领域，介绍了当代研究的新证据，并提出了未来研究的方向，以为公共卫生政策和临床实践提供信息并进行优化。我们的研究结果突出了一种U型关联，即孕期和哺乳期碘暴露不足和过量都可能损害后代的最佳大脑发育。
