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Effect of Iodine Nutrition Status on Thyroid Function and Pregnancy Outcomes

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Abstract

Iodine is essential for normal thyroid function, supporting healthy fetal and child development. The relevance between maternal iodine nutrition status and pregnancy outcomes remains controversial. The aim was to explore whether urinary iodine concentrations (UIC)/urinary creatinine (UCr) was associated with thyroid function and adverse pregnancy outcomes. This study was performed in the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Nanjing Medical University. A total of 212 pregnant women were enrolled from May 2018 to November 2021, from the first visit until postpartum. Maternal serum samples were obtained in the second half of pregnancy, and then thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), UIC, and UCr were tested. The correlation of UIC/UCr, which represented maternal iodine nutrition status, with TSH, FT4, and FT3 was studied using linear regression. And we assessed associations between UIC/UCr and pregnancy outcomes. Notably, we explored consistency between UIC/UCr and the incidence of low birth weight (LBW) by application of logistic regression analysis. A total of 212 women were divided into 3 groups according to the upper and lower quartiles of UIC/UCr. There were 53 women in group 1 (UIC/UCr < 106.96 ug/g), 106 women in group 2 (UIC/UCr 106.96–259.08 ug/g), and 53 women in group 3 (UIC/UCr > 259.08 ug/g). The level of UIC/UCr had a negative correlation with FT4 (r =  − 0.139, p = 0.043) but a positive correlation with TSH (r = 0.096, p = 0.162 > 0.05). There was a significant difference in the incidence of LBW among the 3 groups (p = 0.007). Logistic regression analysis found that the level of UIC/UCr was an independent factor for LBW (p = 0.048, OR = 0.991, 95%CI (0.982, 0.999)). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) for UIC/UCr predicting the incidence of low birth weight was 0.687 (p = 0.013, 95%CI 0.575, 0.799). Lower UIC/UCr during pregnancy was associated with higher FT4 and lower TSH. And iodine deficiency during pregnancy is a risk factor for low birth weight. Our findings indicated that more attention should be paid to the appropriate iodine nutrition status in pregnant women, which can help prevent suffering from adverse pregnancy outcomes.

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Data Availability

The data of this study are available from the corresponding author upon request.

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Author notes

  1. Hongying Zha and Lin Yu contributed equally to this study.

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Hongying Zha, Yi Tang & Qingxin Yuan

  2. Department of Endocrinology and Metabolism, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China

    Lin Yu

  3. Department of Endocrinology and Metabolism, Jiangsu University Affiliated People’s Hospital, Zhenjiang, China

    Lu Sun

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  1. Hongying Zha
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  5. Qingxin Yuan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Hongying Zha, Lin Yu, Yi Tang and Lu Sun. The first draft of the manuscript was written by Hongying Zha and Lin Yu, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Qingxin Yuan.

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Hongying Zha and Lin Yu are contributed equally to this work.

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Zha, H., Yu, L., Tang, Y. et al. Effect of Iodine Nutrition Status on Thyroid Function and Pregnancy Outcomes. Biol Trace Elem Res 201, 5143–5151 (2023). https://doi.org/10.1007/s12011-023-03600-8

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