Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Iodine deficiency in pregnant women after the adoption of the new provincial standard for salt iodization in Zhejiang Province, China

Authors: Guangming Mao, Wenming Zhu, Zhe Mo, Yuanyang Wang, Xiaofeng Wang, Xiaoming Lou, Zhifang Wang

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

Zhejiang has achieved the goal of elimination of iodine deficiency disorders (IDD) via the implementation of universal salt iodization (USI) since 2011. Iodine content in household table salt decreased from the national standard (35 ppm) to the Zhejiang provincial standard (25 ppm) in 2012. It is crucial to periodically monitor iodine status in pregnant women because IDD in pregnancy have adverse effects on fetal neurodevelopment.

Methods

We carried out a cross-sectional study between April 2014 and September 2015 in the eight sentinel surveillance counties across Zhejiang Province, where IDD was previously known to be endemic. A total of 1304 pregnant women participated and provided a random spot urine sample and a household table salt sample. Urinary iodine concentration (UIC) was determined using arsenic-cerium catalytic spectrophotometry. Iodine content in salt was measured using a titration method with sodium thiosulphate.

Results

Overall, the median UIC of the total study population of pregnant women was 129.3 μg/L, with a higher UIC in inland (152.54 μg/L) and a lower UIC in coastal counties (107.54 μg/L). Household coverage of iodized salt was 94.6% and the rate of adequately iodized salt was 89.9%.

Conclusions

Our results indicate deficient iodine status in the pregnant population of Zhejiang, according to the lower cut-off value of optimal iodine nutrition (150 μg/L) recommended by the World Health Organization. In addition to sustaining USI, more efforts are urgently needed to improve iodine intake in women during pregnancy, especially those residing in the coastal counties.
Literature
1.
2.
Glinoer D. The importance of iodine nutrition during pregnancy. Public Health Nutr. 2007;10:1542–6.CrossRefPubMed
3.
Yu CR, Wang YQ, Yao SR, Han YX, Chen YM, Zhu WM. An epidemiological investigation on endemic goiter and endemic cretinism in Zhejiang province. In: Iodine deficiency disorders work group in Zhejiang provincial Center for Disease Control and Prevention, editors, A data Compilation of preventing and controlling Zhejiang endemic diseases during 1984–1986. Hangzhou: Academic; 1987. p. 3–5.
4.
Endemic Disease Control Department in Ministry of Public Health. China National Programme 1989-1995 for the control of iodine deficiency disorders. Chin J Endemiol. 1989;8:252–4.
5.
Huang SM, Zhu WM, Yao SR, Zhou JS, Tu XG, Chen Y. Analysis of surveillance on iodine deficiency disorders in Zhejiang province during 1995-2004. Chin J Endemiol. 2006;25:297–9.
6.
Zhou JS, Chen YM, Yao SR, Huang XM, Wang YQ, Tu XG, et al. Investigation and evaluation on the quality of iodine salt and the urine iodine level in the population of Zhejiang province. Zhongguo Di Fang Bing Xue Zazhi. 1999;18(1):1–4.
7.
8.
Liu P, Su XH, Shen HM, Meng FG, Fan LJ, Liu SJ, et al. A report on the 2011 China’s National Surveillance on IDD. In: Sun DJ, Xiao DL, Liu SJ, editors. The China’s national iodine deficiency diseases surveillance in 2011. Beijing: Academic; 2014. p. 5–10.
9.
Shan Z, Chen L, Lian X, Liu C, Shi B, Shi L, et al. Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in China: a cross-sectional study in 10 cities. Thyroid. 2016;26:1126–30.CrossRef
10.
Fan LJ, Su XH, Shen HM, Liu P, Meng FG, Li M, et al. A report on the 2011 China’s National Surveillance on IDD. In: Sun DJ, Lei ZL, Liu SJ, editors. The China’s National Surveillance Programme on IDD in 2014. Beijing: Academic; 2014. p. 5–8.
11.
Zimmermann MB, Andersson M. Assessment of iodine nutrition in population: past, present, and future. Nutr Rev. 2012;70:553–70.CrossRefPubMed
12.
13.
Mao GM, Ding GQ, Lou XM, Zhang RH, Zheng P, Mo Z, et al. Survey of iodine nutritional status in 2011, Zhejiang China. Asia Pac J Clin Nut. 2015;24:234–44.
14.
15.
Zou Y, Ding GQ, Lou XM, Mo Z, Zhu WM, Mao GM, et al. A study on the influencing factors of urinary iodine concentration and the relationship between iodized salt concentration and urinary iodine concentration. Br J Nutr. 2015;113:142–6.CrossRefPubMed
16.
17.
Zou Y, Lou XM, Ding GQ, Mo Z, Zhu WM, Mao GM, et al. An assessment of iodine nutritional status and thyroid hormone levels in children aged 8-10 years living in Zhejiang province, China: a cross-sectional study. Eur J Pediatr. 2014;173:929–34.CrossRefPubMed
18.
Mo Z, Lou XM, Zhu WM, Wang XF, Mao GM, Zhou JS, et al. A cross-sectional study on iodine nutrition in general population from Zhejiang province China. Chin J Endemiol. 2013;34:464–70.
19.
Zimmermann MB, Delange F. Iodine deficiency of pregnant women in Europe: a review and recommendations. Eur J Clin Nutr. 2004;58:979–84.CrossRefPubMed
20.
21.
Clifton VL, Hodyl NA, Fogarty PA, Torpy DJ, Roberts R, Nettelbeck T, et al. The impact of iodine supplementation and bread fortification on urinary iodine concentration in a mildly iodine deficient population of pregnant women in South Australia. Nutr J. 2013; https://​doi.​org/​10.​1186/​1475-2891-12-32.
22.
Delshad H, Touhidi M, Abdollahi Z, Hedayati M, Salehi F, Azizi F. Inadequate iodine nutrition of pregnant women in an an area of iodine sufficiency. J Endocrinol Investig. 2016;39:755–62.CrossRef
23.
24.
Versloot PM, Schroder-van JP, Heide D, Boogerd L. Effects of marginal iodine deficiency during pregnancy: iodide uptake by the maternal and fetal thyroid. Am J Phys. 1997;273:E1121–6.
25.
Liu Y, Zhang L, Li J, Shan Z, Teng W. Maternal marginal iodine efficiency affects the expression of relative proteins during brain development in rat offspring. J Endocrinol. 2013;217:21–9.CrossRefPubMed
26.
Caron P. Neurocognitive outcomes of children secondary to mild iodine deficiency in pregnant women. Ann Endocrinol. 2015;76:248–52.CrossRef
27.
Hynes KL, Otahal P, Hay I, Burgess JR. Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort. J Clin Endocrinol Metab. 2013;98:l954–62.CrossRef
28.
Bath SC, Steer CD, Golding J, Emmett P, Rayman MP. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: results from the Avon longitudinal study of parents and children (ALSPAC). Lancet. 2013;382:331–7.CrossRefPubMed
29.
Abel MH, Caspersen IH, Meltzer HM, Haugen M, Brandlistuen RE, Aase H, et al. Suboptimal maternal iodine intake is associated with impaired child neurodevelopment at 3 years of age in the Norwegian mother and child cohort study. J Nutr. 2017;147:1314–24.CrossRefPubMed
30.
Liu SJ, Su XH, Sun DJ, Shen HM, Zhang ST, Wei HL, et al. A report on the 2005 China’s National Surveillance on IDD. In: Xiao DL, Sun DJ, Bai HQ, Liu SJ, editors. The China’s national iodine deficiency diseases surveillance in 2005. Beijing: Academic; 2007. p. 5–8.
31.
Wu Y, Li X, Chang S, Liu L, Zou S, Hipgrave DB. Variable iodine intake persists in the context of universal salt iodization in China. J Nutr. 2012;142:1728–34.CrossRefPubMedPubMedCentral
32.
Chen ZH, Xu LS, Wang MH, Wu JN, Meng HE, Min H, et al. Iodine nutritional status of residents in coastal areas of Fujian province. Chin J Endemiol. 2011;30:606–10.
33.
Wang MH, Chen ZH, Wu JN, Lan Y, Wu XY, Chen DQ. Typical population iodine nutrition and health survey results analysis of Fujian province in 2014. Chin J Ctrl Endem Dis. 2016;31:245–83.
34.
Yang J, Zhu L, Li XF, Zheng HM, Wang Z, Liu Y, et al. Iodine status of vulnerable population in Henan province of China 2013-2014 after the implementation of the new iodized salt standard. Biol Trace Elem Res. 2016;173:7–13.CrossRefPubMed
35.
36.
Ahad F, Ganie SA. Iodine, iodine metabolism and iodine deficiency disorders revisited. Indian J Endocrinol Metab. 2010;14:13–7.PubMedPubMedCentral
37.
Mao GM, Ding GQ, Huang LC, Lou XM, Zhang RH, Zhu WM, et al. Study on level of dietary iodine intake and its contribution rate of residents in Zhejiang. Chin J Prev Med. 2013;47:1031–5.
38.
Lou XM, Mo Z, Ding GQ, Zhu WM, Mao GM, Zhou JS, et al. Surveys on iodine nutritional status of pregnant and lactating women in coastal areas of Zhejiang province. Chin J Endemiol. 2011;30:602–5.
Metadata
Title
Iodine deficiency in pregnant women after the adoption of the new provincial standard for salt iodization in Zhejiang Province, China
Authors
Guangming Mao
Wenming Zhu
Zhe Mo
Yuanyang Wang
Xiaofeng Wang
Xiaoming Lou
Zhifang Wang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1952-5

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue

Research article

The fourth delay and community-driven solutions to reduce maternal mortality in rural Haiti: a community-based action research study

Debate

Report on an international workshop on kangaroo mother care: lessons learned and a vision for the future

Study protocol

Prospective observations study protocol to investigate cost-effectiveness of various prenatal test strategies after the introduction of noninvasive prenatal testing

Research article

“We know it’s labour pain, so we don’t do anything”: healthcare provider’s knowledge and attitudes regarding the provision of pain relief during labour and after childbirth

Research article

Risk factors for peripartum hysterectomy among women with postpartum haemorrhage: analysis of data from the WOMAN trial

Research article

Care quality following intrauterine death in Spanish hospitals: results from an online survey