Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort
Abstract Background Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined...
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2020-06-01
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Series: | BMC Medicine |
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Online Access: | http://link.springer.com/article/10.1186/s12916-020-01602-0 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Charles Jonathan Peter Snart Diane Erin Threapleton Claire Keeble Elizabeth Taylor Dagmar Waiblinger Stephen Reid Nisreen A. Alwan Dan Mason Rafaq Azad Janet Elizabeth Cade Nigel A. B. Simpson Sarah Meadows Amanda McKillion Gillian Santorelli Amanda H. Waterman Michael Zimmermann Paul M. Stewart John Wright Mark Mon-Williams Darren Charles Greenwood Laura J. Hardie |
spellingShingle |
Charles Jonathan Peter Snart Diane Erin Threapleton Claire Keeble Elizabeth Taylor Dagmar Waiblinger Stephen Reid Nisreen A. Alwan Dan Mason Rafaq Azad Janet Elizabeth Cade Nigel A. B. Simpson Sarah Meadows Amanda McKillion Gillian Santorelli Amanda H. Waterman Michael Zimmermann Paul M. Stewart John Wright Mark Mon-Williams Darren Charles Greenwood Laura J. Hardie Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort BMC Medicine Birthweight Iodine Pregnancy Insufficiency SGA |
author_facet |
Charles Jonathan Peter Snart Diane Erin Threapleton Claire Keeble Elizabeth Taylor Dagmar Waiblinger Stephen Reid Nisreen A. Alwan Dan Mason Rafaq Azad Janet Elizabeth Cade Nigel A. B. Simpson Sarah Meadows Amanda McKillion Gillian Santorelli Amanda H. Waterman Michael Zimmermann Paul M. Stewart John Wright Mark Mon-Williams Darren Charles Greenwood Laura J. Hardie |
author_sort |
Charles Jonathan Peter Snart |
title |
Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort |
title_short |
Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort |
title_full |
Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort |
title_fullStr |
Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort |
title_full_unstemmed |
Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort |
title_sort |
maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a uk birth cohort |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2020-06-01 |
description |
Abstract Background Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outcomes, finding inconsistent evidence for specific outcomes. Methods Maternal iodine status was estimated from spot urine samples collected at 26–28 weeks’ gestation from 6971 mothers in the Born in Bradford birth cohort. Associations with outcomes were examined for both urinary iodine concentration (UIC) and iodine-to-creatinine ratio (I:Cr). Outcomes assessed included customised birthweight (primary outcome), birthweight, small for gestational age (SGA), low birthweight, head circumference and APGAR score. Results There was a small positive association between I:Cr and birthweight in adjusted analyses. For a typical participant, the predicted birthweight centile at the 25th percentile of I:Cr (59 μg/g) was 2.7 percentage points lower than that at the 75th percentile of I:Cr (121 μg/g) (99% confidence interval (CI) 0.8 to 4.6), birthweight was predicted to be 41 g lower (99% CI 13 to 69) and the predicted probability of SGA was 1.9 percentage points higher (99% CI 0.0 to 3.7). There was no evidence of associations using UIC or other birth outcomes, including stillbirth, preterm birth, ultrasound growth measures or congenital anomalies. Conclusion Lower maternal iodine status was associated with lower birthweight and greater probability of SGA. Whilst small, the effect size for lower iodine on birthweight is comparable to environmental tobacco smoke exposure. Iodine insufficiency is avoidable, and strategies to avoid deficiency in women of reproductive age should be considered. Trial registration ClinicalTrials.gov NCT03552341 . Registered on June 11, 2018. |
topic |
Birthweight Iodine Pregnancy Insufficiency SGA |
url |
http://link.springer.com/article/10.1186/s12916-020-01602-0 |
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doaj-0ebb4878455b4f7fa34843605f26436e2020-11-25T03:38:26ZengBMCBMC Medicine1741-70152020-06-0118111110.1186/s12916-020-01602-0Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohortCharles Jonathan Peter Snart0Diane Erin Threapleton1Claire Keeble2Elizabeth Taylor3Dagmar Waiblinger4Stephen Reid5Nisreen A. Alwan6Dan Mason7Rafaq Azad8Janet Elizabeth Cade9Nigel A. B. Simpson10Sarah Meadows11Amanda McKillion12Gillian Santorelli13Amanda H. Waterman14Michael Zimmermann15Paul M. Stewart16John Wright17Mark Mon-Williams18Darren Charles Greenwood19Laura J. Hardie20Leeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of LeedsLeeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of LeedsLeeds Institute for Data Analytics, University of LeedsLeeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of LeedsBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustEarth Surface Science Institute, School of Earth and Environment, University of LeedsSchool of Primary Care and Population Sciences, Faculty of Medicine, Southampton General Hospital, University of SouthamptonBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustNutritional Epidemiology Group, School of Food Science & Nutrition, University of LeedsDivision of Women’s and Children’s Health, School of Medicine, University of LeedsElsie Widdowson Laboratory, University of CambridgeElsie Widdowson Laboratory, University of CambridgeBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustSchool of Psychology, University of LeedsLaboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH ZurichFaculty of Medicine and Health, University of LeedsBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustSchool of Psychology, University of LeedsLeeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of LeedsLeeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of LeedsAbstract Background Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outcomes, finding inconsistent evidence for specific outcomes. Methods Maternal iodine status was estimated from spot urine samples collected at 26–28 weeks’ gestation from 6971 mothers in the Born in Bradford birth cohort. Associations with outcomes were examined for both urinary iodine concentration (UIC) and iodine-to-creatinine ratio (I:Cr). Outcomes assessed included customised birthweight (primary outcome), birthweight, small for gestational age (SGA), low birthweight, head circumference and APGAR score. Results There was a small positive association between I:Cr and birthweight in adjusted analyses. For a typical participant, the predicted birthweight centile at the 25th percentile of I:Cr (59 μg/g) was 2.7 percentage points lower than that at the 75th percentile of I:Cr (121 μg/g) (99% confidence interval (CI) 0.8 to 4.6), birthweight was predicted to be 41 g lower (99% CI 13 to 69) and the predicted probability of SGA was 1.9 percentage points higher (99% CI 0.0 to 3.7). There was no evidence of associations using UIC or other birth outcomes, including stillbirth, preterm birth, ultrasound growth measures or congenital anomalies. Conclusion Lower maternal iodine status was associated with lower birthweight and greater probability of SGA. Whilst small, the effect size for lower iodine on birthweight is comparable to environmental tobacco smoke exposure. Iodine insufficiency is avoidable, and strategies to avoid deficiency in women of reproductive age should be considered. Trial registration ClinicalTrials.gov NCT03552341 . Registered on June 11, 2018.http://link.springer.com/article/10.1186/s12916-020-01602-0BirthweightIodinePregnancyInsufficiencySGA |