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Comparison of urinary iodine levels in women of childbearing age during and after pregnancy

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Abstract

Purpose

Median urinary iodine concentration (UIC) is used to describe the iodine status of a population. However, the link between UIC and iodine intake may vary during pregnancy. The aim of this study was to compare UIC during and after pregnancy, adjusting for factors that affect iodine intake.

Methods

Two repeated measures of UIC and data on maternal iodine intake estimated through questionnaires were collected during pregnancy and 1–4 years after pregnancy in a subsample of women (n = 598) from a mother and child cohort study in Spain. Random-effects interval regression was used to assess the changes in UIC according to pregnancy status.

Results

Median UIC was similar during (133 μg/L) and after pregnancy (139 μg/L). After adjusting for iodised salt, iodine supplement consumption, and socio-demographic related variables, UIC was 24.0% (95% CI 11.3, 38.2) higher after than during pregnancy. This difference was maintained in a subsample of women with exhaustive information on diet (n = 291): 26.2%, 95% CI 10.3, 44.4.

Conclusions

In an iodine sufficient area for the general population, iodine excretion was lower during than after pregnancy when factors affecting iodine intake were controlled for. Current recommendations of median UIC during pregnancy are based on the equivalence between iodine intake and UIC estimated from studies in non-pregnant populations, which might lead to overestimation of iodine deficiency during gestation. Further studies should evaluate the equivalence between iodine intake and its urinary excretion during pregnancy.

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Acknowledgements

This study was funded by grants from Spain: Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041; FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 04/2018, 04/1436, 05/1079, 05/1052, 06/1213, 07/0314, 08/1151, 09/02647, 09/02311, 11/01007, 11/02591, 11/02038, 13/1944, 13/02429, 14/00891, and 14/01687; and Miguel Servet CP11/00178 and CP13/00054), Conselleria de Sanitat Generalitat Valenciana, Generalitat de Catalunya (CIRIT 1999SGR 00241), Department of Health of the Basque Government (2005111093 and 2009111069), the Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001), Obra Social Cajastur and University of Oviedo; and Grants from the EU: NEWGENERIS FP6-2003-Food-3-A-016320, FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1.

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Authors and Affiliations

  1. Public Health Laboratory, Basque Government, Bilbao, Spain

    Ane Miren Castilla & Mercedes Espada

  2. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain

    Mario Murcia, Jordi Julvez, Mikel Basterrechea, Mar Alvarez-Pedrerol, Marisa Estarlich, Mònica Guxens, Jesús Vioque & Marisa Rebagliato

  3. Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain

    Mario Murcia, Marisa Estarlich & Marisa Rebagliato

  4. Endocrinology and Nutrition Service, University Hospital of Álava, Basque Health Service, Vitoria Gasteiz, Spain

    Juan José Arrizabalaga

  5. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain

    Jordi Julvez, Mar Alvarez-Pedrerol & Mònica Guxens

  6. Department of Epidemiology, Public Health Division of Gipuzkoa, Basque Government, Gipuzkoa, Spain

    Mikel Basterrechea

  7. Health Research Institute, Biodonostia, San Sebastian, Spain

    Mikel Basterrechea

  8. Universitat Pompeu Fabra (UFP), Barcelona, Spain

    Mar Alvarez-Pedrerol & Mònica Guxens

  9. Health Centre of Beasain, Basque Health Service, Beasain, Gipuzkoa, Spain

    Elena Moreno

  10. Department of Public Health, History of Medicine and Gynecology, Universidad Miguel Hernández, San Juan de Alicante, Spain

    Jesús Vioque

  11. Department of Medicine, University Jaume I, Castelló de la Plana, Spain

    Marisa Rebagliato

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  1. Ane Miren Castilla
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  2. Mario Murcia
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  3. Juan José Arrizabalaga
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Contributions

All authors of this paper have directly participated in the planning, execution, or analysis of the study. AMC, MM, and MR designed the study and directed its implementation, conducted the statistical analyses, and wrote the initial draft of the paper. M. Espada conducted the laboratory assays to determine urinary iodine, interpreted the laboratory results, and provided feedback on drafts of the paper. JJA contributed to the interpretation of the iodine nutritional status and to the drafting of the article, and provided feedback and critical revision on drafts of the paper. JV performed the analyses of nutritional data, and provided feedback and critical revision on drafts of the paper. JJ, MB, MAP, M. Estarlich, EM, and MG collaborated in the design of the study and data collection, and provided feedback and critical revision on drafts of the paper.

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Correspondence to Mario Murcia.

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Castilla, A.M., Murcia, M., Arrizabalaga, J.J. et al. Comparison of urinary iodine levels in women of childbearing age during and after pregnancy. Eur J Nutr 57, 1807–1816 (2018). https://doi.org/10.1007/s00394-017-1465-4

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