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Effects of iodine supplementation during pregnancy on child growth and development at school age
Karen J O'Donnell1, Murdon Abdul Rakeman, Dou Zhi-Hong
1Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA. odonn002@mc.duke.edu
Insights
Maternal iodine supplementation during pregnancy, especially before the third trimester, improved head circumference and psychomotor development in children. Early iodine intake is crucial for optimal child growth and cognitive outcomes.
Area of Science:
- Endocrinology
- Pediatrics
- Public Health
Background:
- Iodine deficiency is a global health concern, particularly in regions with low iodine levels in soil and water.
- Maternal iodine status during pregnancy significantly impacts fetal neurodevelopment and overall child growth.
- Optimal timing for iodine supplementation in public health programs remains a critical question.
Purpose of the Study:
- To investigate the effects of maternal iodine supplementation timing on child growth and neurodevelopment.
- To compare outcomes between children whose mothers received iodine during pregnancy versus those supplemented later.
- To inform global public health strategies for iodine supplementation.
Main Methods:
- A comparative study involving children in Xinjiang Province, China, with historically low iodine levels.
- Two groups of children were assessed: those whose mothers received iodine during pregnancy and those supplemented at age 2.
- Measurements included head circumference, height, psychomotor development, and cognitive function tests.
Main Results:
- Maternal iodine supplementation during pregnancy improved head circumference compared to supplementation at age 2.
- Supplementation before the end of the second trimester showed better head circumference outcomes than supplementation during the third trimester.
- Iodine intake before the third trimester was associated with higher psychomotor scores.
- Cognitive development showed only trend differences between groups.
Conclusions:
- Maternal iodine supplementation during pregnancy, particularly before the third trimester, is beneficial for child head circumference and psychomotor development.
- These findings support the initiation of maternal iodine supplementation early in pregnancy for public health initiatives.
- The results are relevant for managing maternal and newborn thyroid deficiency in industrialized nations, especially for preterm infants.
Abstract:
Growth and development of 207 children (49% males; mean age 5.4 years [SD 0.2], range 4 to 7.3 years whose mothers received iodine during pregnancy, and children who received iodine first in their 2nd year, were examined in 1996; 192 children (49% males; mean age 6.5 years [SD 0.2], range 5.8 to 6.9 years) whose mothers received iodine while pregnant were seen in 1998. Children were from the southern part of China's Xinjiang Province which has the lowest levels of iodine in water and soil ever recorded. Head circumference but not height was improved for those who received iodine during pregnancy (compared with those receiving iodine at age 2) and for those supplemented before the end of the 2nd trimester (relative to those supplemented during the 3rd trimester). Iodine before the 3rd trimester predicted higher psychomotor test scores for children relative to those provided iodine later in pregnancy or at 2 years. Results from the test for cognitive development resulted in trend only differences between those children supplemented during pregnancy versus later. The results address the question of when maternal iodine supplements should begin in public health programs world wide. Findings may be relevant to the treatment of maternal and newborn thyroid deficiency in industrialized countries, particularly for those infants delivered before the end of the second trimester.
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