Title:Iodine Deficiency and Iodine Prophylaxis in Pregnancy
VOLUME: 10 ISSUE: 2
Author(s):Malgorzata Trofimiuk-Mudlner* and Alicja Hubalewska-Dydejczyk
Affiliation:Department of Endocrinology, Jagiellonian University Medical College Ul. Kopernika 17, 31-501 Krakow, Department of Endocrinology, Jagiellonian University Medical College ul. Kopernika 17, 31-501 Krakow
Keywords:Cognition, iodine deficiency, iodine excess, neurodevelopment, pregnancy, prophylaxis.
Abstract:Background: Physiological changes in pregnancy result in increased iodine demand, which
may not be met in areas of mild-to-moderate iodine deficiency or borderline sufficiency. As a pregnant
woman is the only source of thyroid hormones for her child during early gestation, iodine deficiencyinduced
hypothyroxinemia may have deleterious effects on fetal development.
Objective: To present the current approach to iodine deficiency and its prophylaxis during pregnancy.
Methods: A review of the current literature including patents on iodine deficiency in pregnancy has
been performed.
Results: Negative influence of severe iodine deficiency on fetal development has been proved, and
evidence on a deleterious impact of milder forms of iodine deficiency on cognition of the offspring is
rapidly growing. Although the WHO has addressed the issues of monitoring iodine status during pregnancy,
prophylactic measures and assessment of their effectiveness, there are some controversies, regarding
for example the best methods for control of iodine status. New patents in urinary iodine measurement
methods may make iodine nutrition monitoring easier. The main method of iodine prophylaxis,
in pregnancy also, is universal salt iodization. However, particularly if there is not sufficient coverage
of the households with iodized salt, additional measures, such as oral supplementation with potassium
iodide tablets, are necessary in pregnant women to provide adequate iodine nutrition. Iodine supplementation
improves maternal thyroid function indices; particularly, it prevents goiter formation.
Conclusion: Stronger evidence on beneficial effects of iodine supplementation of mild-to-moderate
iodine deficient pregnant women on cognitive function of their children is still needed. It may be provided
by randomized controlled trials and international initiatives. Changes in the iodine prophylaxis
system should be monitored, both to prevent decreased or excessive iodine intake.
