The relationship between excessive iodine during pregnancy and adverse pregnancy complications.

IF 3.7 3区医学 Q2 Medicine Endocrine Pub Date : 2024-12-20 DOI:10.1007/s12020-024-04134-2

Shasha Li, Hongying Zha, Yumeng Cui, Lu Sun, Lin Yu, Qingxin Yuan

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Abstract

Purpose: Iodine nutrition during pregnancy plays an important role in fetal development and maternal outcomes. Iodine deficiency has been proved to be associated with maternal thyroid dysfunction, adverse fetal outcomes and neurodevelopmental disorders in offspring. At present, there are few studies concentrate on the effects of iodine excess during pregnancy on thyroid function, maternal and neonatal outcomes, and the results are still controversial. The aim of this study was to evaluate the effects of excessive iodine status on thyroid function, glycolipid metabolism, and maternal and neonatal outcomes.

Methods: A total of 595 pregnant women who gave birth at the First Affiliated Hospital of Nanjing Medical University from January 2023 to December 2023 were included in this study. Blood and urine samples were collected during the second trimester of pregnancy. Thyroid function include thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and urinary iodine concentrations (UIC) were measured. Maternal and neonatal outcomes were collected.

Results: Participants were divided into four groups based on UIC, with median UIC values of 100.5, 200, 314.2, and 655 μg/L, respectively. UIC was found to be positively associated with TSH, and negatively associated with FT3 and FT4. Fasting blood glucose (FBG) levels were elevated both in iodine deficiency and excess group. A U-shaped relationship between UIC and thyroid dysfunction were found. Iodine deficiency, excess iodine and even more than adequate iodine can lead to increased incidence of thyroid diseases such as isolated hypothyroxinaemia and overt hyperthyroidism. Importantly, iodine excess was found to be related with higher prevalence of umbilical cord around neck and eclampsia as well as higher blood glucose and low-density lipoprotein(LDL) level.

Conclusion: Abnormal iodine status especially iodine excess during pregnancy was found to be related with higher prevalence of adverse mother and fetus outcomes, abnormal blood glucose and lipid level.

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妊娠期过量碘与不良妊娠并发症的关系。

目的：孕期碘营养对胎儿发育和产妇结局有重要影响。碘缺乏已被证明与母亲甲状腺功能障碍、不良胎儿结局和后代神经发育障碍有关。目前，关于妊娠期碘过量对甲状腺功能、母婴结局影响的研究较少，研究结果仍存在争议。本研究的目的是评估过量碘对甲状腺功能、糖脂代谢以及孕产妇和新生儿结局的影响。方法：选取2023年1月至2023年12月在南京医科大学第一附属医院分娩的孕妇595例为研究对象。在妊娠中期采集血液和尿液样本。甲状腺功能包括促甲状腺激素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）和尿碘浓度（UIC）。收集产妇和新生儿结局。结果：受试者根据UIC分为4组，UIC中位数分别为100.5、200、314.2、655 μg/L。UIC与TSH呈正相关，与FT3和FT4呈负相关。缺碘组和碘过量组空腹血糖（FBG）水平均升高。UIC与甲状腺功能障碍呈u型关系。碘缺乏、碘过量、甚至碘过足可导致甲状腺疾病的发病率增加，如孤立性甲状腺功能减退症和明显的甲状腺功能亢进。重要的是，碘过量被发现与脐带绕颈和子痫患病率较高以及血糖和低密度脂蛋白（LDL）水平升高有关。结论：孕期碘状态异常，尤其是碘过量，与不良母婴结局、血糖、血脂异常发生率增高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.