Public Health Nutrition

Research Paper

Evaluating iodine deficiency in pregnant women and young infants—complex physiology with a risk of misinterpretation

P Laurberga1 c1, S Andersena1, R I Bjarnadóttira2, A Carléa1, AB Hreidarssona2, N Knudsena3, L Ovesena4, IB Pedersena1 and LB Rasmussena4

a1 Department of Endocrinology, Aalborg Hospital, Aalborg, Denmark

a2 Landspitali University Hospital, Reykjavik, Iceland

a3 Medical Clinic I, Bispebjerg Hospital, Copenhagen, Denmark

a4 Danish Institute for Food and Veterinary Research, Copenhagen, Denmark

Abstract

Objective: To review methods for evaluating iodine deficiency in pregnant women and young infants and to discuss factors to be considered in the interpretation of their results.

Design: Review of the literature regarding the various methods available for assessing iodine status.

Setting: Population surveys and research studies.

Subjects: Pregnant women and young infants.

Results: Several factors to consider when assessing iodine status in pregnant women and young infants include: 1) the urinary iodine (UI) concentration (μg l-1) is not interchangeable with 24 h UI excretion (μg per 24 h); 2) the concentration of iodine in a spot or casual urine sample cannot be used to diagnose iodine deficiency in an individual; 3) a moderate fall in the concentration of serum free T4 during pregnancy is not a sign of maternal iodine deficiency; 4) an increase in the concentration of serum thyroglobulin (Tg) during pregnancy is not a sign of maternal iodine deficiency; 5) a higher concentration of TSH and Tg in cord blood than in maternal blood is not a sign of iodine deficiency in the mother or neonate; and 6) thyroid function in a full-term foetus, a neonate or a small child is not more sensitive to a mild iodine deficiency than in the mother.

Conclusions: If the iodine status of pregnant women and small children is not to be misjudged, the above six factors need to be taken into account.

Correspondence

c1 Corresponding author: Email laurberg@aas.nja.dk

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