A case for universal salt iodisation to correct iodine deficiency in pregnancy: another salutary lesson from Tasmania
A case for universal salt iodisation to correct iodine deficiency in pregnancy: another salutary lesson from Tasmania
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DOI：
10.5694/j.1326-5377.2007.tb01057.x
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发表时间：
2007-06-04
影响因子：
11.4
通讯作者：
Parameswaran, Venkat
中科院分区：
文献类型：
--
作者：
Burgess, John R.;Seal, Judy A.;Parameswaran, Venkat
目的：评估面包加碘对孕妇碘状况的影响，并确定对学龄儿童碘水平的研究是否可以反映妇女妊娠期的碘状况。设计：2001 年 10 月在面包加碘之前和之后对塔斯马尼亚孕妇进行尿碘调查。参与者和环境：皇家霍巴特医院 (RHH) 的 285 名妇女2000 年 10 月 1 日至 2001 年 9 月 30 日期间的产前诊所以及 2003 年至 2006 年期间到 RHH 产前诊所或初级卫生保健中心就诊的 517 名妇女进行了调查。主要结果指标：中位尿碘浓度 (UIC)，用于与世界卫生组织推荐的孕妇 150-249 微克/升进行比较。 结果：在补充补充剂之前，参加产前诊所或初级保健中心的 285 名妇女的中位 UIC RHH产前检查为76μg/L。补充后，在初级保健中心就诊的 288 名女性的 UIC 中位数为 81 μg/L，在 RHH 产前诊所就诊的 229 名女性的 UIC 中位数为 86 μg/L。与补充前组相比，产前门诊组（P = 0.237）或初级保健组（P = 0.809）的平均 UIC 差异均不显着。结论：尽管塔斯马尼亚儿童得到了纠正，但妊娠期碘缺乏症仍然存在。成功的碘补充必须针对育龄妇女和孕妇，并通过怀孕和哺乳期间的持续监测来证实。迫切需要制定一项强有力的国家计划来纠正碘缺乏症。强制性全民食盐加碘得到了国际认可，应被视为澳大利亚消除碘缺乏症的首选策略。
Objective: To assess the impact of iodine fortification of bread on the iodine status of pregnant women, and to determine if studies of iodine levels in school-age children were indicative of women's gestational iodine status.Design: Urinary iodine surveys of pregnant Tasmanian women before and after bread was fortified with iodine in October 2001.Participants and setting: 285 women attending the Royal Hobart Hospital (RHH) antenatal clinic from 1 October 2000 to 30 September 2001 and 517 women attending the RHH antenatal clinic or primary health care centres in 2003-2006.Main outcome measures: Median urinary iodine concentration (UIC) for comparison against the World Health Organization recommendation of of 150-249 mu g/L for pregnant women.Results: Before supplementation, the median UIC of the 285 women attending the RHH antenatal clinic was 76 mu g/L. After supplementation, median UICs were 81 mu g/L for 288 women attending primary healthcare centres and 86 mu g/L for 229 women attending the RHH antenatal clinic. Differences in mean UIC were not significant for either the antenatal clinic group (P = 0.237) or the primary health care group (P = 0.809) compared with the pre-supplementation group.Conclusions: Iodine deficiency in pregnancy persists despite being corrected in Tasmanian children. Successful iodine supplementation must target reproductive-age and pregnant women and be substantiated by ongoing monitoring during pregnancy and lactation. A robust national program for correcting iodine deficiency is urgently needed. Mandatory universal salt iodisation has international endorsement, and should be considered the preferred strategy for eliminating iodine deficiency in Australia.