Iodine deficiency in children.

Iodine is an essential trace mineral, required for the production of thyroid hormone. Iodine deficiency may result in goiter, hypothyroidism, miscarriage, stillbirth, congenital anomalies, infant and neonatal mortality, and impaired growth. Adequate thyroid hormone is critically important for normal growth and neurodevelopment in fetal life, infancy and childhood. The population iodine status is most commonly assessed using median urinary iodine concentration values, but goiter prevalence (determined by palpation or by ultrasound), serum thyroglobulin levels, and neonatal thyroid-stimulating hormone values can also be used. Universal salt iodization programs have been the mainstay of public health efforts to eliminate iodine deficiency worldwide. However, in some regions targeted fortification of foods such as bread has been used to combat iodine deficiency. Iodine supplementation may be required in areas where dietary fortification is not feasible or where it is not sufficient for vulnerable groups such as pregnant women. Although international public health efforts over the past several decades have been highly effective, nearly one third of children worldwide remain at risk for iodine deficiency, and iodine deficiency is considered the leading preventable cause of preventable intellectual deficits.