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Maternal iodine deficiency: a newborns’ overweight risk factor? A prospective study

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

Childhood obesity and iodine deficiency are global public health concerns. Whether maternal iodine status mediates overweight in infancy has yet to be explored. We aimed to assess the relationship between maternal iodine status and infant birth weight, including small and large for gestational age (SGA and LGA, respectively).

Methods

A prospective study was carried out among 134 mother–infant pairs from Israel. Maternal iodine intake and status were estimated via questionnaire and serum thyroglobulin (Tg), respectively. Estimated iodine intake below the Recommended Daily Allowance for iodine sufficiency in pregnancy (220 μg/d) considered Inadequate. Maternal and neonatal thyroid function and anthropometric measurements, as well as maternal thyroid antibodies were also tested.

Results

After screening, 118 participants met the inclusion criteria (distributed trimesters I, II and III: n = 3, n = 21, and n = 94, respectively). There was a negative association of iodine intake with Tg values among the study population. Maternal median Tg value was higher than the sufficiency cutoff (16.5 vs 13 µg/L), indicating insufficient iodine status. No SGA cases were found. Inadequate iodine intake was associated with maternal isolated hypothyroxinemia (OR = 3.4; 95% CI 1.2, 9.9) and higher birthweight (including macrosomia and LGA) rates. A suggestive association of elevated Tg with a greater risk of LGA was observed. Offsprings' birth weight percentiles were associated with Tg values in pregnant women with suggestive sufficient iodine status (n = 62, R2 = 0.11, p < 0.05).

Conclusions

Iodine status during pregnancy can be associated with newborn anthropometric index. Maternal inadequate iodine intake may alter fetal growth and might increase the risk of LGA among newborns. These initial findings support the need to further study the impact of iodine deficiency on newborns overweight in Israel and elsewhere.

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References

  1. Jameson JL, De Groot LJ, de Kretser DM, Giudice LC, Grossman AB, Melmed S, Weir GC (eds) (2016) Endocrinology: Adult & Pediatric, 7th edn. Elsevier, Philadelphia

    Google Scholar 

  2. Francis A, Hugh O, Gardosi J (2018) Customized vs INTERGROWTH-21st standards for the assessment of birthweight and stillbirth risk at term. Am J Obstet Gynecol. https://doi.org/10.1016/j.ajog.2017.12.013

    Article  PubMed  Google Scholar 

  3. Winter JD, Taylor Y, Mowrer L, Winter KM, Dulin MF (2017) BMI at birth and overweight at age four. Obes Res Clin Pract. https://doi.org/10.1016/j.orcp.2016.03.010

    Article  PubMed  Google Scholar 

  4. Nordman H, Jääskeläinen J, Voutilainen R (2020) Birth size as a determinant of cardiometabolic risk factors in children. Horm Res Paediatr 93:144–153. https://doi.org/10.1159/000509932

    Article  CAS  PubMed  Google Scholar 

  5. Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA et al (2019) The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med. https://doi.org/10.1186/s12916-019-1449-8

    Article  PubMed  PubMed Central  Google Scholar 

  6. Grieger JA, Clifton VL (2014) A review of the impact of dietary intakes in human pregnancy on infant birthweight. Nutrients. https://doi.org/10.3390/nu7010153

    Article  PubMed  PubMed Central  Google Scholar 

  7. Morrison JL, Regnault TR (2016) Nutrition in pregnancy: optimising maternal diet and fetal adaptations to altered nutrient supply. Nutrients. https://doi.org/10.3390/nu8060342

    Article  PubMed  PubMed Central  Google Scholar 

  8. Abel MH, Caspersen IH, Sengpiel V et al (2020) Insufficient maternal iodine intake is associated with subfecundity, reduced foetal growth, and adverse pregnancy outcomes in the Norwegian Mother, Father and Child Cohort Study. BMC Med. https://doi.org/10.1186/s12916-020-01676-w

    Article  PubMed  PubMed Central  Google Scholar 

  9. Eastman CJ, Zimmermann MB (2018) The iodine deficiency disorders. In: Feingold KR, Anawalt B, Boyce A, et al (eds) Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc; Available from: https://www.ncbi.nlm.nih.gov/books/NBK285556. Accessed 14 Aug 2020

  10. Soskolne V, Cohen-Dar M, Obeid S, Cohen N, Rudolf M (2018) Risk and protective factors for child overweight/obesity among low socio-economic populations in Israel: a cross sectional study. Front Endocrinol. https://doi.org/10.3389/fendo.2018.00456

    Article  Google Scholar 

  11. Zimmermann MB, Boelaert K (2015) Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. https://doi.org/10.1016/S2213-8587(14)70225-6

    Article  PubMed  Google Scholar 

  12. Ovadia YS, Gefel D, Aharoni D, Turkot S, Fytlovich S, Troen AM (2016) Can desalinated seawater contribute to iodine-deficiency disorders? An observation and hypothesis. Public Health Nutr. https://doi.org/10.1017/S1368980016000951

    Article  PubMed  Google Scholar 

  13. Ovadia YS, Arbelle JE, Gefel D, Brik H, Wolf T, Nadler V, Hunziker S, Zimmermann MB, Troen AM (2017) First Israeli national iodine survey demonstrates iodine deficiency among school-aged children and pregnant women. Thyroid. https://doi.org/10.1089/thy.2017.0251

    Article  PubMed  Google Scholar 

  14. Israel Center for Disease Control, Ministry of Health, Israel (2003) MABAT: First Israeli National Health and Nutrition Survey 1999–2001, Food & Nutrition Services 2003: Publication 225. Available at: http://www.health.gov.il/UnitsOffice/ICDC/mabat/Pages/Mabat1999_2001.aspx

  15. Standing committee on the Scientific Evaluation of Dietary Reference Intakes, Institute of Health, The United states of America; (2001) Iodine: National Academy Press, pp 258–289

  16. Ma ZF, Skeaff SA (2014) Thyroglobulin as a biomarker of iodine deficiency: a review. Thyroid. https://doi.org/10.1089/thy.2014.0052

    Article  PubMed  PubMed Central  Google Scholar 

  17. Dosiou C, Medici M (2017) Management of endocrine disease: Isolated maternal hypothyroxinemia during pregnancy: knowns and unknowns. Eur J Endocrinol. https://doi.org/10.1530/EJE-16-0354

    Article  PubMed  Google Scholar 

  18. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S (2017) Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. https://doi.org/10.1089/thy.2016.0457

    Article  PubMed  PubMed Central  Google Scholar 

  19. Pearce EN, Caldwell KL (2016) Urinary iodine, thyroid function, and thyroglobulin as biomarkers of iodine status. Am J Clin Nutr. https://doi.org/10.3945/ajcn.115.110395

    Article  PubMed  PubMed Central  Google Scholar 

  20. Moreno-Reyes R, Glinoer D, Van Oyen H, Vandevijvere S (2013) High prevalence of thyroid disorders in pregnant women in a mildly iodine-deficient country: a population-based study. J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2013-2149

    Article  PubMed  Google Scholar 

  21. Dollberg S, Haklai Z, Mimouni FB, Gorfein I, Gordon ES (2005) Birth weight standards in the live-born population in Israel. Isr Med Assoc J 7(5):311–314

    PubMed  Google Scholar 

  22. Davidson S, Sokolover N, Erlich A, Litwin A, Linder N, Sirota L (2008) New and improved Israeli reference of birth weight, birth length, and head circumference by gestational age: a hospital-based study. Isr Med Assoc J 10(2):130–134

    PubMed  Google Scholar 

  23. WHO, UNICEF, ICCIDD (2007) Assessment of the iodine deficiency disorders and monitoring their elimination. World Health Organization, Geneva

    Google Scholar 

  24. Agay-Shay K, Rudolf M, Rubin L, Haklai Z, Grotto I (2018) Trends in fetal growth between 2000 to 2014 in singleton live births from Israel. Sci Rep. https://doi.org/10.1038/s41598-018-19396-w

    Article  PubMed  PubMed Central  Google Scholar 

  25. Yang J, Liu Y, Liu H, Zheng H, Li X, Zhu L, Wang Z (2018) Associations of maternal iodine status and thyroid function with adverse pregnancy outcomes in Henan Province of China. J Trace Elem Med Biol. https://doi.org/10.1016/j.jtemb.2018.01.013

    Article  PubMed  Google Scholar 

  26. Vermiglio F, Lo Presti VP, Castagna MG, Violi MA, Moleti M, Finocchiaro MD et al (1999) Increased risk of maternal thyroid failure with pregnancy progression in an iodine deficient area with major iodine deficiency disorders. Thyroid. https://doi.org/10.1089/thy.1999.9.19

    Article  PubMed  Google Scholar 

  27. León G, Murcia M, Rebagliato M, Álvarez-Pedrerol M, Castilla AM, Basterrechea M et al (2015) Maternal thyroid dysfunction during gestation, preterm delivery, and birthweight. The Infancia y Medio Ambiente Cohort, Spain. Paediatr Perinat Epidemiol. https://doi.org/10.1111/ppe.12172

    Article  PubMed  Google Scholar 

  28. Harris SE, De Blasio MJ, Zhao X, Ma M, Davies K, Wooding F et al (2020) Thyroid deficiency before birth alters the adipose transcriptome to promote overgrowth of white adipose tissue and impair thermogenic capacity. Thyroid. https://doi.org/10.1089/thy.2019.0749

    Article  PubMed  PubMed Central  Google Scholar 

  29. Haddow JE, Craig WY, Neveux LM, Palomaki GE, Lambert-Messerlian G, Malone FD et al (2016) Free thyroxine during early pregnancy and risk for gestational diabetes. PLoS ONE. https://doi.org/10.1371/journal.pone.0149065

    Article  PubMed  PubMed Central  Google Scholar 

  30. Buschur E, Stetson B, Barbour LA (2018) Diabetes in Pregnancy. In: Feingold KR, Anawalt B, Boyce A, et al (eds) Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279010/

  31. HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. https://doi.org/10.1056/NEJMoa0707943

    Article  Google Scholar 

  32. Farebrother J, Naude CE, Nicol L, Sang Z, Yang Z, Jooste PL, Andersson M, Zimmermann MB (2018) Effects of iodized salt and iodine supplements on prenatal and postnatal growth: a systematic review. Adv Nutr. https://doi.org/10.1093/advances/nmy009

    Article  PubMed  PubMed Central  Google Scholar 

  33. Rubin R, Pearl M, Kharrazi M, Blount BC, Miller MD, Pearce EN, Valentin-Blasini L, DeLorenze G, Liaw J, Hoofnagle AN, Steinmaus C (2017) Maternal perchlorate exposure in pregnancy and altered birth outcomes. Environ Res. https://doi.org/10.1016/j.envres.2017.05.030

    Article  PubMed  PubMed Central  Google Scholar 

  34. Zhu YD, Han Y, Huang K et al (2018) The impact of isolated maternal hypothyroxinaemia on the incidence of large-for-gestational-age infants: the Ma’anshan Birth Cohort study. BJOG: Int J Obstet Gynaecol. https://doi.org/10.1111/1471-0528.15107

    Article  Google Scholar 

  35. Snart CJP, Threapleton DE, Keeble C et al (2020) Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort. BMC Med 18:132. https://doi.org/10.1186/s12916-020-01602-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Zimmermann MB, Andersson M (2012) Assessment of iodine nutrition in populations: past, present, and future. Nutr Rev. https://doi.org/10.1111/j.1753-4887.2012.00528.x

    Article  PubMed  Google Scholar 

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Acknowledgements

We are indebted to all of the PW participants who volunteered for this study; we wish to thank Prof. Lisa Rubin from Haifa University (Community Health Department) for discussion and reviewing this manuscript; and to Mrs. Ruhama Kremer and Hagit Afuta of the BUMCA Department of Obstetrics and Gynecology for their assistance with the ethical procedures and administration of the study at BUMCA.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Shmuel Zangen and Simon Shenhav have contributed equally to this work.

Authors and Affiliations

  1. Obstetrics and Gynecology Department, Barzilai University Medical Center Ashkelon, Ashkeon, Israel

    Yaniv S. Ovadia, Eyal Y. Anteby & Simon Shenhav

  2. Foreign studies department; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rhovot, Israel

    Yaniv S. Ovadia

  3. Department of Neonatology, Barzilai University Medical Center Ashkelon, Ashkelon, Israel

    Shmuel Zangen

  4. Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel

    Shmuel Zangen, Eyal Y. Anteby & Simon Shenhav

  5. School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel

    Shani R. Rosen & Dov Gefel

  6. National Newborn Screening Program, Ministry of Health, Tel-Hashomer, Israel

    Shlomo Almashanu

  7. Endocrine Institute, Shamir Medical Center, Zerifin, Israel

    Carlos Benbassat

  8. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Carlos Benbassat

  9. Laboratory of Clinical Biochemistry, Barzilai University Medical Center Ashkelon, Ashkelon, Israel

    Shlomo Fytlovich & Dorit Aharoni

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  1. Yaniv S. Ovadia
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Contributions

YSO, SZ, EYA, and SS initiated and designed the study. DG, YSO, and SRR obtained the ethical approval. DG and SS recruited participants and obtained informed consent. SRR administered the dietary interviews and questionnaires and supervised the collection of the blood samples. SF, DA, and SA performed the assays. YSO collected and matched the PW and newborns results, analyzed the data, and prepared the draft and revisions of the manuscript. SZ, SRR, and CB had a significant role in the manuscript revision. All authors provided comments on the draft and approved the final manuscript.

Corresponding author

Correspondence to Yaniv S. Ovadia.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The research proposal was approved by the Helsinki Committee at BUMCA.

Consent to participate

All PW who participated in this study provided written informed consent after the research protocols were explained in detail.

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Ovadia, Y.S., Zangen, S., Rosen, S.R. et al. Maternal iodine deficiency: a newborns’ overweight risk factor? A prospective study. Arch Gynecol Obstet 305, 777–787 (2022). https://doi.org/10.1007/s00404-021-06261-x

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  • DOI: https://doi.org/10.1007/s00404-021-06261-x

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