Association of Maternal Iodine Status With Child IQ: A Meta-Analysis of Individual Participant Data
Association of Maternal Iodine Status With Child IQ: A Meta-Analysis of Individual Participant Data
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DOI：
10.1210/jc.2018-02559
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发表时间：
2019-12-01
影响因子：
5.8
通讯作者：
Peeters, Robin P.
中科院分区：
文献类型：
--
作者：
Levie, Deborah;Korevaar, Tim I. M.;Peeters, Robin P.
内容：虽然严重碘缺乏的后果是毋庸置疑的，但妊娠期轻度至中度碘缺乏对儿童神经发育的影响还不太明确。目的：研究妊娠期母亲碘水平与儿童智商之间的关系，并确定暴露于次优碘可用性的脆弱时间窗。设计：对来自三个前瞻性基于人群的出生队列的个体参与者数据进行荟萃分析：Generation R（荷兰）、INMA（西班牙）和ALSPAC（英国）;分别于2002年至2006年、2003年至2008年、1990年至1992年招募孕妇。设置：一般社区。参与者：6180对母亲-儿童，测量妊娠期尿碘和肌酐浓度以及儿童智商。排除标准是多胎妊娠，生育治疗，药物影响甲状腺，和预先存在的甲状腺diseases.Main结果Measure：儿童非语言和语言智商评估在1.5至8岁age.Results：有一个积极的曲线相关的尿碘/肌酐比（UI/Creat）与平均语言智商。UI/Creat，150 μ g/g与较低的非语言智商（-0.6分; 95% CI：21.7至0.4分; P = 0.246）或较低的语言智商（-0.6分; 95% CI：-1.3至0.1分; P = 0.082）无关。分层分析表明，UI/Creat与口头IQ的关联只存在到14 weeks of gestation.Conclusions：胎儿大脑发育容易受到轻度至中度碘缺乏的影响，特别是在孕早期。我们的研究结果表明，调查轻度至中度碘缺乏症妇女补碘对儿童神经发育影响的潜在随机对照试验应开始补碘不晚于孕早期。
Context: Although the consequences of severe iodine deficiency are beyond doubt, the effects of mild to moderate iodine deficiency in pregnancy on child neurodevelopment are less well established.Objective: To study the association between maternal iodine status during pregnancy and child IQ and identify vulnerable time windows of exposure to suboptimal iodine availability.Design: Meta-analysis of individual participant data from three prospective population-based birth cohorts: Generation R (Netherlands), INMA (Spain), and ALSPAC (United Kingdom); pregnant women were enrolled between 2002 and 2006, 2003 and 2008, and 1990 and 1992, respectively.Setting: General community.Participants: 6180 mother-child pairs with measures of urinary iodine and creatinine concentrations in pregnancy and child IQ. Exclusion criteria were multiple pregnancies, fertility treatment, medication affecting the thyroid, and preexisting thyroid disease.Main Outcome Measure: Child nonverbal and verbal IQ assessed at 1.5 to 8 years of age.Results: There was a positive curvilinear association of urinary iodine/creatinine ratio (UI/Creat) with mean verbal IQ only. UI/Creat,150 mu g/g was not associated with lower nonverbal IQ (-0.6 point; 95% CI: 21.7 to 0.4 points; P = 0.246) or lower verbal IQ (-0.6 point; 95% CI: -1.3 to 0.1 points; P = 0.082). Stratified analyses showed that the association of UI/Creat with verbal IQ was only present up to 14 weeks of gestation.Conclusions: Fetal brain development is vulnerable to mild to moderate iodine deficiency, particularly in the first trimester. Our results show that potential randomized controlled trials investigating the effect of iodine supplementation in women with mild to moderate iodine deficiency on child neurodevelopment should begin supplementation not later than the first trimester.