Best Practice & Research Clinical Endocrinology & Metabolism
Volume 24, Issue 1 , Pages 29-38 , February 2010

Iodine deficiency in pregnancy, infancy and childhood and its consequences for brain development

  • Alida Melse-Boonstra, PhD (Dr)

      Affiliations

    • Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, the Netherlands
    • Corresponding Author InformationCorresponding author. Tel.: +31 317 484317, Fax: +31 317 483342.
  • ,
  • Nidhi Jaiswal, MSc

      Affiliations

    • St. John's Research Institute, St. John's National Academy of Health Sciences Koramangala, Bangalore, Karnataka 560034, India
    • Tel.: +91 80 22065059x225.

References 

  1. De Benoist B, Andersson M, Takkouche B, et al. Prevalence of iodine deficiency worldwide. Lancet. 2003;362:1859–1860
  2. WHO. Elimination of iodine deficiency disorders in South-East Asia. Report of an expert consultative meeting. June 2007 Bangkok, Thailand pp. 25–26.
  3. Jolly R. Early childhood development: the global challenge. Lancet. 2007;369:6
  4. Walker SP, Wachs TD, Meeks Gardner J, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145–157
  5. Pandav CS. IDD in India: the ICCIDD perspective. IDD Newsletter. 2005;21(4):4–6
  6. Pharaoh POD, Ellis SM, Ekins RP, et al. Maternal thyroid function, idoine deficiency and fetal development. Clinical Endocrinology. 1976;5:159–166
  7. Glinoer D. Maternal and fetal impact of chronic iodine deficiency. Clinical Obstetrics and Gynecology. 1997;40(1):102–116
  8. Sethi V, Kapil U. Iodine deficiency and development of brain. Indian Journal of Pediatrics. 2004;71(4):325–329
  9. Stanbury JB. The damaged brain of iodine deficiency. New York, NY: Cognizant Communication; 1994;
  10. Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. The American Journal of Clinical Nutrition. 2009;89(Suppl.):668S–672S
  11. Ramji S. Iodine deficiency disorders: epidemiology, clinical profile and diagnosis. In:  Sachdev P,  Choudhary HPS editor. Nutrition in children. Developing country concerns. India: Conveners; 1994;
  12. Obregon MJ, Escobar del Rey F, Morreale de Escobar G. The effects of iodine deficiency on thyroid hormone deiodination. Thyroid. 2005;15:917–929
  13. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia?. The Journal of Clinical Endocrinology & Metabolism. 2000;85:3975–3987
  14. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Role of thyroid hormone during early brain development. European Journal of Endocrinology. 2004;151:25–37
  15. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Maternal thyroid hormones early in pregnancy and fetal brain dvelopment. Best Practice & Research Clinical Endocrinology & Metabolism. 2004;18:225–248
  16. Berbel P, Obregon MJ, Bernal J, et al. Iodine supplementation during pregnancy: a public health challenge. Trends in Endocrinology and Metabolism. 2007;18(9):338–343
  17. Rovet J, Daneman D. A review of current diagnostic and treatment practices in relation to neuropsychologic outcome. Paediatric Drugs. 2003;6:141–149
  18. Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. The New England Journal of Medicine. 1999;341:549–555
  19. Pop VJ, Kuijpens JL, van Baar AL, et al. Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clinical Endocrinology. 1999;50:149–155
  20. Pop VJ, Brouwers EP, Vader HL, et al. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clinical Endocrinology. 2003;59:282–288
  21. Zoeller RT, Rovet J. Timing of thyroid hormone action in the developing brain: clinical observations and experimental findings. Journal of Neuroendocrinology. 2004;16:809–818
  22. Delange F, Lecomte P. Iodine supplementation: benefits outweigh risks. Drug Safety. 2000;22:89–95
  23. Toft AD. Increased thyroxine requirements in pregnancy - why, when and how much?. The New England Journal of Medicine. 2004;351:292–294
  24. Kooistra L, Crawford S, van Baar AL, et al. Neonatal effects of maternal hypothyroxinemia during early pregnancy. Pediatrics. 2006;117:161–167
  25. Vermiglio F, Lo Presti VP, Moleti M, et al. Deficit and hyperactivity disorders in the offspring of mothers exposed to mild-moderate iodine deficiency: a possible novel iodine deficiency disorder in developed countries. The Journal of Clinical Endocrinology & Metabolism. 2004;89:6054–6060
  26. WHO , UNICEF , ICCIDD . Assessment of the iodine deficiency disorders and monitoring their elimination. A guide for programme managers. Geneva: World Health Organization; 2001;
  27. Melse-Boonstra A, Rexwinkel H, Bulux J, et al. Comparison of three methods for estimating daily individual discretionary salt intake: 24 hour recall, duplicate-portion method, urinary lithium-labelled household salt excretion. European Journal of Clinical Nutrition. 1999;53(4):281–287
  28. Mustafa A, Muslimatun S, Untoro J, et al. Determination of discretionary salt intake in an iodine deficient area of East Java-Indonesia using three different methods. Asia Pacific Journal of Clinical Nutrition. 2006;15(3):362–367
  29. WHO , UNICEF , ICCIDD . Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers. 3rd ed.. Geneva: World Health Organization; 2007;
  30. Dorey CM, Zimmermann MB. Reference values for spot urinary iodine concentrations in iodine-sufficient newborns using a new pad collection method. Thyroid. 2008;18(3):347–352
  31. Gowachirapant S, Winichagoon P, Wyass L, et al. Urinary iodine concentrations indicate iodine deficiency in pregnant Thai women but iodine sufficiency in their school-aged children. The Journal of Nutrition. 2009;139(6):1169–1172
  32. Zimmermann MB, Hess SY, Molinari L, et al. New reference values for thyroid volume by ultrasound in iodine sufficient schoolchildren: a World Health Organization/Nutrition for Health and Devlopment Iodine Deficiency Study Group Report. The American Journal of Clinical Nutrition. 2004;79:231–237
  33. Sullivan KM, May W, Nordenberg D, et al. Use of thryoid stimulating hormone testing in newborns to identify iodine deficiency. The Journal of Nutrition. 1997;127:55–58
  34. Zimmermann MB. Methods to assess iron and iodine status. The British Journal of Nutrition. 2008;99(Suppl. 3):S2–S9
  35. Sobrero G, Munoz L, Bazzara L, et al. Thyroglobulin reference values in a pediatric infant population. Thyroid. 2007;17(11):1049–1054
  36. Zimmermann MB, Moretti D, Chaouki N, et al. Development of a dried whole-blood spot thyroglobulin assay and its evaluation as an indicator of thyroid status in goitrous children receiving iodized salt. The American Journal of Clinical Nutrition. 2003;77:1453–1458
  37. Zimmermann MB, de Benoist B, Corigliano S, et al. Assessment of iodine status using dried blood spot thyroglobulin: development of reference material and establishment of an international reference range in iodine-sufficient children. The Journal of Clinical Endocrinology & Metabolism. 2006;91:4881–4887
  38. Ristic-Medic D, Piskackova Z, Hooper L, et al. Methods of assessment of iodine status in humans: a systematic review. The American Journal of Clinical Nutrition. 2009;89(Suppl.):2052S–2069S
  39. O'Donnell KJ, Rakeman MA, Zhi-Hong D, et al. Effects of iodine supplementation during pregnancy on child growth and development at school age. Developmental Medicine and Child Neurology. 2002;44:76–81
  40. Antonangeli L, Maccherini D, Cavaliere R, et al. Comparison of two different doses of iodide in the prevention of gestational goiter in marginal iodine deficiency: a longitudinal study. European Journal of Endocrinology. 2002;147:29–34
  41. Glinoer D, de Nayer P, Delange F, et al. A randomized trial for the treatment of mild iodine deficiency during pregnancy: maternal and neonatal effects. The Journal of Clinical Endocrinology & Metabolism. 1995;80:258–269
  42. Romano R, Jannini EA, Pepe M, et al. The effects of iodoprophylaxis on thyroid size during pregnancy. American Journal of Obstetrics and Gynecology. 1991;164:482–485
  43. Nohr SB, Laurberg P. Opposite variations in maternal and neonatal thyroid function induced by iodine supplementation during pregnancy. The Journal of Clinical Endocrinology & Metabolism. 2000;85:623–627
  44. Pedersen KM, Laurberg P, Iversen E, et al. Amelioration of some pregnancy-associated variations in thyroid function by iodine supplementation. The Journal of Clinical Endocrinology & Metabolism. 1993;77:1078–1083
  45. Liesenkötter KP, Gopel W, Bogner U, et al. Earliest prevention of endemic goiter by iodine supplementation during pregnancy. European Journal of Endocrinology. 1996;134:443–448
  46. Zimmermann MB, Delange F. Iodine supplementation of pregnant women in Europe: a review and recommendations. European Journal of Clinical Nutrition. 2004;58:979–984
  47. Berbel P, Mestre JL, Santamaria A, et al. Delayed neurobehavioral development in children born to pregnant women with mild hypothyroxinemia during the first month of gestation: the importance of early iodine supplementation. Thyroid. 2009;19(5):511–519
  48. Bleichrodt N, Born MP. A metaanalysis of research on iodine and its relationship to cognitive development. In:  Stanbury JB editors. The damaged brain of iodine deficiency. New York: Cognizant Communications; 1994;p. 195–200
  49. Huda SN, Gratham-McGregor SM, Rahman KM, et al. Biochemical hypothyroidism secondary to iodine deficiency is associated with poor school achievement and cognition in Bangladeshi children. The Journal of Nutrition. 1999;129(5):159–166
  50. Tiwari BD, Godbole MM, Chattopadhyay N, et al. Learning disabilities and poor motivation to achieve due to prolonged iodine deficiency. The American Journal of Clinical Nutrition. 1996;63:782–786
  51. Qian M, Wang D, Watkins WE, et al. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pacific Journal of Clinical Nutrition. 2005;14:32–42
  52. Santiago-Fernandez P, Torres-Barahona R, Muela-Martinez JA, et al. Intelligence qotient and iodine intake: a cross-sectional study in children. The Journal of Clinical Endocrinology & Metabolism. 2004;89:3851–3857
  53. Connolly KJ, Kvalsvig JD. Infection, nutrition and cognitive performance in children. Parasitology. 1993;107:S187–S200
  54. Van Stuijvenberg ME, Kvalsvig JD, Faber M, et al. Effect of iron-, iodine-, B-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial. The American Journal of Clinical Nutrition. 1999;69:497–503
  55. Skar Manger M, McKenzie JE, Winichagoon P, et al. A micronutrient-fortified seasoning powder reduces morbidity and improves short-term cognitive function, but has no effect on anthropometric measures in primary school children in northeast Thailand: a randomized controlled trial. The American Journal of Clinical Nutrition. 2008;87:1715–1722
  56. Zimmermann MB, Connolly K, Bozo M, et al. Iodine supplementation improves cognition in iodine-deficient schoolchildren in Albania: a randomized, controlled, double- blind study. The American Journal of Clinical Nutrition. 2006;83:108–114
  57. Conolly KJ, Pharoah POD, Hetzel BS. Fetal iodine deficiency and motor performance during childhood. Lancet. 1979;2(8153):1149–1151
  58. Shrestha RM. The effect of iodine and iron supplementation on physical, psychomotor and mental development in primary school children in Malawi. PhD thesis. Division of Human Nutrition, Wageningen University: the Netherlands; 1994.
  59. Van den Briel T, West CE, Bleichrodt N, et al. Improved iodine status is associated with improved mental performance of schoolchildren in Benin. The American Journal of Clinical Nutrition. 2000;72(5):1179–1185
  60. Bautista A, Barker PA, Dunn JT, et al. The effects of oral iodized oil on intelligence, thyroid status, somatic growth in school-age children from an area of endemic goiter. The American Journal of Clinical Nutrition. 1982;35:127–134
  61. Isa ZM, Alias IZ, Kadir KA, et al. Effect of iodized oil supplementation on thyroid hormone levels and mental performance among Orang Asli schoolchildren and pregnant mothers in an endemic goiter area in Peninsular Malaysia. Asia Pacific Journal of Clinical Nutrition. 2000;9(4):274–281
  62. Huda SN, Gratham-McGregor SM, Tomkins A. Cognitive and motor functions of iodine-deficient but euthyroid children in Bangladesh do not benefit from iodized poppy seed oil (Lipiodol). The Journal of Nutrition. 2001;131:72–77
  63. Zimmermann MB. The impact of iodised salt or iodine supplements on iodine status during pregnancy, lactation and infancy. Public Health Nutrition. 2007;10:1584–1595
  64. Untoro J, Mangasaryan N, de Benoist B, et al. Reaching optimal iodine nutrition in pregnant and lactating women and young children: programmatic recommendations. Public Health Nutrition. 2007;10:1527–1529
  65. Zimmermann MB, Jooste PL, Mabapa NS, et al. Treatment of iodine deficiency in school-age children increases Insulin-ike Growth Factor (IGF)-I and IGF Binding Protein-3 concentrations and improves somatic growth. The Journal of Clinical Endocrinology & Metabolism. 2007;92:437–442

PII: S1521-690X(09)00109-2

doi: 10.1016/j.beem.2009.09.002

Best Practice & Research Clinical Endocrinology & Metabolism
Volume 24, Issue 1 , Pages 29-38 , February 2010