F Guo1,2, Y Liu1,2, Z Ding1,2, C Zhang1,2,3, Z Liu1,2,3, J Fan4,5,6. 1. Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China. 2. Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China. 3. Shanghai Municipal Key Clinical Specialty, Shanghai, China. 4. Obstetrical Department, School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910 Hengshan Rd, Shanghai, China. fanjianxia122@126.com. 5. Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China. fanjianxia122@126.com. 6. Shanghai Municipal Key Clinical Specialty, Shanghai, China. fanjianxia122@126.com.
Abstract
PURPOSE: The use and contribution of prenatal multivitamins (PMV) as iodine source for pregnant women in China, especially in mildly iodine-deficient region, have not been well studied. This study aimed to explore the association between PMV intake during pregnancy and thyroid function in mothers and newborns. METHODS: We performed a study involving women with a history of taking PMV during pregnancy between January 2013 and October 2015, in Shanghai, a mildly iodine-deficient region. Maternal thyroid function in early and late pregnancy, and neonatal TSH on postnatal d 3 were obtained from medical records. We compared the outcomes in pregnant women who took exclusively iodine-containing PMV (I + PMV) with those who took exclusively non-contained PMV (I- PMV). Propensity score matching (PSM) was used to identify women with similar baseline characteristics. RESULTS: After PSM, 1280 women in I + PMV and 2560 in I- PMV had similar propensity scores and were included in the analyses. Introduction of I + PMV to women was associated with slightly higher maternal thyroid hormone production (higher maternal FT4, p = 0.01, non-significantly lower TSH, p = 0.79) and lower neonatal TSH levels (p < 0.0001). The frequency of adverse pregnancy outcomes or thyroid dysfunctions did not differ between groups in late pregnancy. Mothers received I + PMV (0.2 SD) had a stronger association of maternal TSH with neonatal TSH than those who received I- PMV (0.1 SD). These effects were only shown in TPOAb-negative mothers, not in TPOAb-positive mothers. CONCLUSION: TPOAb-positive women display an impaired iodine transport in thyroid and placenta, and this may explain the lack of changes in maternal and neonatal thyroid parameters with I + PMV supplementation in these women. This phenomenon might suggest that these women require different iodine doses or treatment approach in comparison with TPOAb-negative women.
PURPOSE: The use and contribution of prenatal multivitamins (PMV) as iodine source for pregnant women in China, especially in mildly iodine-deficient region, have not been well studied. This study aimed to explore the association between PMV intake during pregnancy and thyroid function in mothers and newborns. METHODS: We performed a study involving women with a history of taking PMV during pregnancy between January 2013 and October 2015, in Shanghai, a mildly iodine-deficient region. Maternal thyroid function in early and late pregnancy, and neonatal TSH on postnatal d 3 were obtained from medical records. We compared the outcomes in pregnant women who took exclusively iodine-containing PMV (I + PMV) with those who took exclusively non-contained PMV (I- PMV). Propensity score matching (PSM) was used to identify women with similar baseline characteristics. RESULTS: After PSM, 1280 women in I + PMV and 2560 in I- PMV had similar propensity scores and were included in the analyses. Introduction of I + PMV to women was associated with slightly higher maternal thyroid hormone production (higher maternal FT4, p = 0.01, non-significantly lower TSH, p = 0.79) and lower neonatal TSH levels (p < 0.0001). The frequency of adverse pregnancy outcomes or thyroid dysfunctions did not differ between groups in late pregnancy. Mothers received I + PMV (0.2 SD) had a stronger association of maternal TSH with neonatal TSH than those who received I- PMV (0.1 SD). These effects were only shown in TPOAb-negative mothers, not in TPOAb-positive mothers. CONCLUSION: TPOAb-positive women display an impaired iodine transport in thyroid and placenta, and this may explain the lack of changes in maternal and neonatal thyroid parameters with I + PMV supplementation in these women. This phenomenon might suggest that these women require different iodine doses or treatment approach in comparison with TPOAb-negative women.
Entities:
Keywords:
Iodine-deficient area; Neonates; Pregnancy; Prenatal multivitamins; Thyroid function
Authors: Michael B Zimmermann; Małgorzata Gizak; Karen Abbott; Maria Andersson; John H Lazarus Journal: Lancet Diabetes Endocrinol Date: 2015-08-09 Impact factor: 32.069
Authors: Marianne H Abel; Ida H Caspersen; Helle Margrete Meltzer; Margaretha Haugen; Ragnhild E Brandlistuen; Heidi Aase; Jan Alexander; Liv E Torheim; Anne-Lise Brantsæter Journal: J Nutr Date: 2017-05-17 Impact factor: 4.798
Authors: Kris Poppe; Daniel Glinoer; Herman Tournaye; Johan Schiettecatte; Paul Devroey; Andre van Steirteghem; Patrick Haentjens; Brigitte Velkeniers Journal: J Clin Endocrinol Metab Date: 2004-08 Impact factor: 5.958
Authors: D Sukkhojaiwaratkul; P Mahachoklertwattana; P Poomthavorn; P Panburana; La-or Chailurkit; P Khlairit; S Pongratanakul Journal: J Perinatol Date: 2014-04-17 Impact factor: 2.521