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The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo

The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo

Published on: August 2, 2017

Evolving Concepts in Gestational Iodine Requirements.

Charalampos Milionis¹, Eftychia G Koukkou¹, Kostas B Markou²

¹Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, 11521 Athens, Greece.

Healthcare (Basel, Switzerland)

|May 13, 2026

Summary

Maternal iodine needs during pregnancy are complex. Current guidelines may overestimate requirements, as both low and high iodine intake negatively impact thyroid health and fetal development, emphasizing a narrow optimal intake window.

Keywords:

iodine pregnancy public health surveillance

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Published on: June 28, 2024

Area of Science:

Endocrinology and Nutritional Science
Maternal-Fetal Medicine
Public Health Nutrition

Background:

Iodine is crucial for thyroid hormone synthesis, metabolic regulation, and fetal neurodevelopment.
Pregnancy significantly increases maternal iodine requirements.
Current global recommendations rely on population-level biomarkers, potentially not reflecting individual needs.

Purpose of the Study:

To review international iodine adequacy guidelines for pregnancy.
To evaluate limitations of population-based iodine biomarkers (e.g., urinary iodine concentration, serum thyroglobulin).
To explore physiological adaptations, functional biomarkers, and individualized factors influencing iodine requirements.

Main Methods:

Literature review of studies published between 2016-2025 from PubMed/MEDLINE and Scopus.
Inclusion of population surveillance, thyroid adaptation mechanisms, and clinical outcome research.
Analysis of international guidelines and biomarker data.

Main Results:

Existing World Health Organization (WHO) iodine intake ranges for pregnant women may be higher than physiologically necessary.
A U-shaped curve illustrates adverse effects on maternal thyroid function and fetal neurodevelopment from both insufficient and excessive iodine intake.
Individual factors like autoimmune thyroid disease and nutrient deficiencies modify iodine needs.

Conclusions:

Optimal iodine intake during pregnancy is a narrow window, necessitating a move beyond population-level metrics.
Functional biomarkers, such as the Thyroid Feedback Quantile-based Index (TFQI), show promise for personalized iodine status assessment.
Individualized assessment is key to ensuring adequate iodine for maternal and fetal health.