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Effect of Iodine Nutrition on Pregnancy Outcomes in an Iodine-Sufficient Area in China

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Abstract

Many studies focused on the association between thyroid disease and pregnancy outcomes. The present study explored the effect of iodine nutrition during the first trimester on pregnancy outcomes. One thousand five hundred sixty-nine pregnant, euthyroid women at ≤12 weeks of gestation in an iodine-sufficient area in China were recruited. According to the World Health Organization (WHO) criteria for iodine nutrition during pregnancy, participants were divided into four groups: adequate iodine (median urinary iodine concentration (UIC), 150–249 μg/L), mild deficiency (UIC, 100–150 μg/L), moderate and severe deficiency (UIC, <100 μg/L), and more than adequate and excessive (UIC, ≥250 μg/L) groups. Pregnancy outcomes, including abortion, gestational hypertension, pre-eclampsia, gestational diabetes mellitus (GDM), placenta previa, placental abruption, preterm labor, low birth weight infants, macrosomia, breech presentation, and cord entanglement, were obtained during follow-up. The results showed that there was no significant difference in general characteristics, including age, body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, heart rate, smoking rate, and drinking rate, among the four groups. In the more than adequate and excessive group, thyroid-stimulating hormone (TSH) was greater and free thyroxine (FT4) was lower than any other groups but still within normal range. The thyroglobulin (Tg) level was greater in the moderate and severe deficiency group. The incidence of GDM was significantly greater in women with mild iodine deficiency than in women with adequate iodine nutriture (18.38 vs. 13.70%, p < 0.05). Compared with the adequate group, incidence of macrosomia was significantly greater in the more than adequate and excessive group (12.42 vs. 9.79%, p < 0.05). Mild iodine deficiency was an independent risk factor for GDM (odds ratio = 1.566, 95% confidence interval = 1.060–2.313, p = 0.024); more than adequate and excessive iodine was an independent risk factor for macrosomia (OR = 1.917, CI = 1.128–3.256, p = 0.016). In summary, during 1st trimester, both mild iodine deficiency and excessive iodine intake had adverse impacts on pregnancy outcomes in an iodine-sufficient area.

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Acknowledgments

We gratefully acknowledged the residents who participated in this study. The study was supported by the National Science and Technology Support Program (grant number 2014BAI06B02); Chinese National Natural Science Foundation (grant numbers 81170730 and 81570709); Research Foundation of Key Laboratory of Endocrine Diseases, Department of Education in Liaoning Province of China (grant number LZ2014035); and Key Platform Foundation of Science and Technology for the Universities in Liaoning Province of China (grant number 16010).

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China

    Yue Xiao, Chenyan Li, Yongze Li, Shiqiao Peng, Chenling Fan, Weiping Teng & Zhongyan Shan

  2. Department of Rheumatism and Hematology, First Hospital of Dandong, Dandong, Liaoning Province, People’s Republic of China

    Huakun Sun

  3. NO.155 Nanjing North Street, Heping District, Shenyang, Liaoning Province, 110001, China

    Zhongyan Shan

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  1. Yue Xiao
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  2. Huakun Sun
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  3. Chenyan Li
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Correspondence to Zhongyan Shan.

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Xiao, Y., Sun, H., Li, C. et al. Effect of Iodine Nutrition on Pregnancy Outcomes in an Iodine-Sufficient Area in China. Biol Trace Elem Res 182, 231–237 (2018). https://doi.org/10.1007/s12011-017-1101-4

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  • DOI: https://doi.org/10.1007/s12011-017-1101-4

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