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碘缺乏工作组(AKJ)的关键信息:碘缺乏和内分泌干扰物导致的母体甲状腺素血症是儿童神经认知发育的风险因素。

Key Messages of the Iodine Deficiency Working Group (AKJ): Maternal Hypothyroxinemia Due to Iodine Deficiency and Endocrine Disruptors as Risks for Child Neurocognitive Development.

作者信息

Grossklaus Rolf, Liesenkötter Klaus-Peter, Doubek Klaus, Völzke Henry, Gaertner Roland

机构信息

Mitglied des Wissenschaftlichen Beirats des Arbeitskreises Jodmangel e.V. (AKJ), Frankfurt/Main, Germany.

ehemals Abteilung Lebensmittelsicherheit, Bundesinstitut für Risikobewertung, Berlin, Germany.

出版信息

Geburtshilfe Frauenheilkd. 2025 Mar 26;85(8):796-809. doi: 10.1055/a-2505-1944. eCollection 2025 Aug.


DOI:10.1055/a-2505-1944
PMID:40771831
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12324869/
Abstract

Iodine deficiency with the resultant maternal hypothyroxinemia and the effects of endocrine disruptors can, individually or together, have a negative effect on embryonic and fetal brain development. This is the conclusion of a recent review by the authors which examined and critically discussed a total of 279 publications from the past 30 years on the effects of mild to moderate iodine deficiency, reduced maternal thyroxine levels, and the influence of endocrine disruptors on child brain development during pregnancy. Adequate iodine intake is important for all women of childbearing age to prevent negative psychological and social consequences for their children. An additional threat to the thyroid hormone system is the ubiquitous exposure to endocrine disruptors, which can increase the impact of maternal iodine deficiency on the neurocognitive development of their offspring. Ensuring an adequate iodine intake is therefore not only crucial for healthy fetal and neonatal development in general, but could also prevent the potential effects of endocrine disruptors. Due to the current deficient iodine status of women of childbearing age and of children and adolescents in Germany and most European countries, urgent measures are needed to improve the iodine intake of the population. Therefore, in the opinion of the AKJ, young women of childbearing age should be instructed to take iodine supplements continuously for at least 3 months before conception and during pregnancy. In addition, detailed strategies for detecting and reducing exposure to endocrine disruptors in accordance with the "precautionary principle" should be urgently developed.

摘要

碘缺乏以及由此导致的母体甲状腺素血症和内分泌干扰物的影响,单独或共同作用,都可能对胚胎和胎儿的大脑发育产生负面影响。这是作者最近一篇综述的结论,该综述审视并批判性地讨论了过去30年中总共279篇关于轻度至中度碘缺乏、母体甲状腺素水平降低以及内分泌干扰物对孕期儿童大脑发育影响的出版物。充足的碘摄入量对于所有育龄妇女都很重要,可防止给其子女带来负面心理和社会后果。甲状腺激素系统面临的另一个威胁是无处不在的内分泌干扰物暴露,这会增加母体碘缺乏对其后代神经认知发育的影响。因此,确保充足的碘摄入量不仅对胎儿和新生儿的总体健康发育至关重要,还可以预防内分泌干扰物的潜在影响。由于德国和大多数欧洲国家目前育龄妇女以及儿童和青少年的碘状况不足,需要采取紧急措施来提高人群的碘摄入量。因此,在AKJ看来,应该指导育龄年轻女性在受孕前至少3个月以及怀孕期间持续服用碘补充剂。此外,应根据“预防原则”紧急制定详细的检测和减少内分泌干扰物暴露的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/57db8ee813ec/10-1055-a-2505-1944_25053402.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/0cfa2b4bc5cd/10-1055-a-2505-1944_25394344.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/e20dbc60360b/10-1055-a-2505-1944_25394345.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/f8df336ea227/10-1055-a-2505-1944_25053401.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/57db8ee813ec/10-1055-a-2505-1944_25053402.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/0cfa2b4bc5cd/10-1055-a-2505-1944_25394344.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/e20dbc60360b/10-1055-a-2505-1944_25394345.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/f8df336ea227/10-1055-a-2505-1944_25053401.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc6/12324869/57db8ee813ec/10-1055-a-2505-1944_25053402.jpg

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[1]
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本文引用的文献

[1]
Local Thyroid Hormone Action in Brain Development.

Int J Mol Sci. 2023-8-2

[2]
Iodine Deficiency, Maternal Hypothyroxinemia and Endocrine Disrupters Affecting Fetal Brain Development: A Scoping Review.

Nutrients. 2023-5-9

[3]
Iodine and Thyroid Maternal and Fetal Metabolism during Pregnancy.

Metabolites. 2023-5-6

[4]
The effect of endocrine-disrupting chemicals on placental development.

Front Endocrinol (Lausanne). 2023

[5]
Preconception Counseling and Care for Pregnant Women with Thyroid Disease.

Endocrinol Metab Clin North Am. 2022-6

[6]
Iodine status in pregnant women and infants in Finland.

Eur J Nutr. 2022-9

[7]
Impact of endocrine disrupting chemicals on neurodevelopment: the need for better testing strategies for endocrine disruption-induced developmental neurotoxicity.

Expert Rev Endocrinol Metab. 2022-3

[8]
Early Levothyroxine Treatment for Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy: The St Carlos Gestational and Thyroid Protocol.

Front Endocrinol (Lausanne). 2021

[9]
Thyroid hormone system disrupting chemicals.

Best Pract Res Clin Endocrinol Metab. 2021-9

[10]
Reducing Prenatal Exposure to Toxic Environmental Agents: ACOG Committee Opinion, Number 832.

Obstet Gynecol. 2021-7-1

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