Prevalence of Excessive Iodine Intake in Pregnancy and Its Health Consequences: Systematic Review and Meta-analysis

Biol Trace Elem Res. 2023 Jun;201(6):2784-2794. doi: 10.1007/s12011-022-03401-5. Epub 2022 Aug 26.

Abstract

The objective was to estimate the prevalence of excessive iodine intake in pregnant women and to investigate the consequences for maternal-fetal health. The systematic review was based on PRISMA. The search was conducted in September 2021 in LILACS, PubMed/MEDLINE, Science Direct, and SCOPUS databases. Observational studies that assessed excessive nutritional iodine status in pregnancy diagnosed by urinary iodine concentration and associated it with biomarkers of thyroid health function were included. Study selection, data extraction, and risk of biased evaluation were performed independently. Meta-analysis was calculated using a fixed and random effect model, and heterogeneity was assessed by the chi-square test. Meta-regressions were performed to identify the causes of heterogeneity using the Knapp and Hartung test. Nine studies were included in the systematic review, and eight in the meta-analysis. The prevalence of excessive iodine intake in 10,736 pregnant women in different regions of the world was 52%. The main implications for pregnant women were hypothyroxinemia, hypothyroidism, and hyperthyroidism. For the newborn, macrosomia and thyroid dysfunction. In addition, drinking water with high iodine intake contributed to excessive iodine intake. Therefore, the prevalence of iodine excess was 52%, with high heterogeneity among studies, explained by trimester of gestation and FT4 level; therefore, the farther the trimester of gestation and the lower the FT4, the higher the prevalence of iodine excess. PROSPERO Registration: CRD420206467 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206467 ).

Keywords: Health; Iodine; Pregnancy; Thyroid Gland.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Female
  • Humans
  • Hypothyroidism* / epidemiology
  • Infant, Newborn
  • Iodine*
  • Pregnancy
  • Pregnant Women
  • Prevalence
  • Thyroid Diseases*

Substances

  • Iodine