Suboptimal Maternal Iodine Intake Is Associated with Impaired Child Neurodevelopment at 3 Years of Age in the Norwegian Mother and Child Cohort Study
Suboptimal Maternal Iodine Intake Is Associated with Impaired Child Neurodevelopment at 3 Years of Age in the Norwegian Mother and Child Cohort Study
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DOI：
10.3945/jn.117.250456
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发表时间：
2017-07-01
影响因子：
4.2
通讯作者：
Brantsaeter, Anne-Lise
中科院分区：
文献类型：
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作者：
Abel, Marianne H.;Caspersen, Ida H.;Brantsaeter, Anne-Lise
背景：妊娠期严重缺碘对儿童神经发育有重要影响，但对轻、中度缺碘和补碘的潜在后果知之甚少。目的：探讨母亲碘摄入量与3岁儿童神经发育的关系，以及母亲从补充剂中摄取碘对同样结果的潜在影响。方法：这项基于人群的前瞻性观察研究从2002年至2008年招募了48,297对孕期母婴。孕妇的碘摄入量是根据孕中期回答的有效食物频率问卷计算的，该问卷涵盖了自怀孕开始以来的平均摄入量。结果：在33,047对母婴中，除补碘者外，母亲碘摄入量与儿童语言迟缓(P=0.024)、外化和内化行为问题(均为P<；0.001)和精细运动技能(P=0.002)有关，但与粗大运动技能或17个月时不能独立行走的风险无关。在74%的碘摄入量和160mgd(估计平均需要量)的参与者中，估计不适宜的碘摄入量占语言延迟病例的5%(95%可信区间：-5%，14%)，外化性行为问题病例的16%(95%可信区间：0%，21%)，内化性行为问题病例的16%(95%可信区间：10%，21%)。在48,297对母子中，包括补碘者，我们没有发现孕期补充碘对神经发育的保护作用。结论：母亲孕期碘摄入量低于估计的平均需要量与3岁时儿童语言迟缓、行为问题和精细运动技能下降的症状有关。结果显示，没有证据表明孕期补碘有保护作用。
Background: Severe iodine deficiency in pregnancy has major effects on child neurodevelopment, but less is known about the potential consequences of mild-to-moderate deficiency and iodine supplement use.Objective: We explored the associations between maternal iodine intake and child neurodevelopment at 3 y of age and the potential impact of maternal intake of iodine from supplements on the same outcomes.Methods: This population-based prospective observational study included 48,297 mother-child pairs recruited during pregnancy from 2002 to 2008. Maternal iodine intake was calculated based on a validated food-frequency questionnaire answered during midpregnancy that covered mean intake since the beginning of pregnancy. Associations between iodine intake and maternal-reported child language and motor development and behavior problems were explored by multivariable regression analyses.Results: In 33,047 mother-child pairs, excluding iodine supplement users, maternal iodine intake was associated with child language delay (P = 0.024), externalizing and internalizing behavior problems (both P < 0.001), and fine motor skills (P = 0.002) but not gross motor skills or the risk of not walking unaided at 17 mo of age. In 74% of the participants who had an iodine intake < 160 mu g/d (Estimated Average Requirement), suboptimal iodine intake was estimated to account for; 5% (95% CI: -5%, 14%) of the cases of language delay, 16% (95% CI: 0%, 21%) of the cases of externalizing behavior problems >1.5 SD, and 16% (95% CI: 10%, 21%) of the cases of internalizing behavior problems >1.5 SD. In 48,297 mother-child pairs, including iodine supplement users, we found no protective effects of supplemental iodine during pregnancy on neurodevelopment.Conclusions: Maternal iodine intake below the Estimated Average Requirement during pregnancy was associated with symptoms of child language delay, behavior problems, and reduced fine motor skills at 3 y of age. The results showed no evidence of a protective effect of iodine supplementation during pregnancy.