Association of Maternal Iodine Status With Child IQ: A Meta-Analysis of Individual Participant Data
Por:
Levie D, Korevaar TIM, Bath SC, Murcia, M, Dineva M, Llop, S, Espada M, van Herwaarden AE, de Rijke YB, Ibarluzea JM, Sunyer J, Tiemeier H, Rayman MP, Guxens M and Peeters RP
Publicada:
1 dic 2019
Ahead of Print:
28 mar 2019
Resumen:
Context: Although the consequences of severe iodine deficiency are beyond doubt, the effects of mild to moderate iodine deficiency in pregnancy on child neurodevelopment are less well established.
Objective: To study the association between maternal iodine status during pregnancy and child IQ and identify vulnerable time windows of exposure to suboptimal iodine availability.
Design: Meta-analysis of individual participant data from three prospective population-based birth cohorts: Generation R (Netherlands), INMA (Spain), and ALSPAC (United Kingdom); pregnant women were enrolled between 2002 and 2006, 2003 and 2008, and 1990 and 1992, respectively.
Setting: General community.
Participants: 6180 mother-child pairs with measures of urinary iodine and creatinine concentrations in pregnancy and child IQ. Exclusion criteria were multiple pregnancies, fertility treatment, medication affecting the thyroid, and preexisting thyroid disease.
Main Outcome Measure: Child nonverbal and verbal IQ assessed at 1.5 to 8 years of age.
Results: There was a positive curvilinear association of urinary iodine/creatinine ratio (UI/Creat) with mean verbal IQ only. UI/Creat,150 mu g/g was not associated with lower nonverbal IQ (-0.6 point; 95% CI: 21.7 to 0.4 points; P = 0.246) or lower verbal IQ (-0.6 point; 95% CI: -1.3 to 0.1 points; P = 0.082). Stratified analyses showed that the association of UI/Creat with verbal IQ was only present up to 14 weeks of gestation.
Conclusions: Fetal brain development is vulnerable to mild to moderate iodine deficiency, particularly in the first trimester. Our results show that potential randomized controlled trials investigating the effect of iodine supplementation in women with mild to moderate iodine deficiency on child neurodevelopment should begin supplementation not later than the first trimester.
Filiaciones:
Levie D:
The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
ISGlobal, Carrer Doctor Aiguader 88, Barcelona, Spain
Pompeu Fabra University, Barcelona, Carrer Doctor Aiguader 88, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Korevaar TIM:
The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
Bath SC:
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
:
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
Dineva M:
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
:
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
Espada M:
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Clinical Chemistry Unit, Public Health Laboratory of Bilbao, Basque Government, Parque Tecnológico de Bizkaia, Derio, Spain
van Herwaarden AE:
Department of Laboratory Medicine, Radboud University Nijmegen Medical Centre, Nijmegen
de Rijke YB:
Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
Department of Clinical Chemistry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
Ibarluzea JM:
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Departamento de Sanidad Gobierno Vasco, Subdirección de Salud Pública de Guipúzcoa, Donostia - San Sebastián, Spain
BIODONOSTIA Health Research Institute, San Sebastian, Donostia - San Sebastián, Spain
Facultad de Psicología. University of the Basque Country UPV/EHU, Donostia - San Sebastián, Spain
Sunyer J:
ISGlobal, Carrer Doctor Aiguader 88, Barcelona, Spain
Pompeu Fabra University, Barcelona, Carrer Doctor Aiguader 88, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Hospital del Mar Research Institute (IMIM), Carrer Doctor Aiguader 88, Barcelona, Spain
Tiemeier H:
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA
Rayman MP:
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
Guxens M:
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
ISGlobal, Carrer Doctor Aiguader 88, Barcelona, Spain
Pompeu Fabra University, Barcelona, Carrer Doctor Aiguader 88, Barcelona, Spain
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Peeters RP:
Department of Internal Medicine, Academic Center For Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
Green Published, Green Submitted, hybrid
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