A viewpoint in this week's Journal of the American Medical Association (JAMA) discusses the issue of iodine deficiency in pregnant women in the U.S. and the potential negative health implications for both mothers and their children from this deficiency.
Alex Stagnaro-Green, MD, MHPE, professor of medicine and professor of obstetrics and gynecology at the George Washington University (GW) School of Medicine and Health Sciences (SMHS), is the paper's lead author. Elizabeth Pearce, MD, MSc, associate professor of medicine at Boston University School of Medicine (BUSM), serves as co-author on the paper. The authors hope to start a conversation in the healthcare community on how to better protect the health of mothers and their children.
"Iodine levels in the US have been decreasing, which has the potential to negatively impact the mother and unborn child," said Stagnaro-Green. "It's time for all healthcare professionals to make sure that every pregnant and breast-feeding woman gets supplemental iodine during pregnancy and while they are breast-feeding."
Iodine, which is not naturally made in the human body, must be consumed through foods rich in the element or through supplements. Iodine is required for the production of thyroid hormone, and adequate thyroid hormone levels are critical for normal fetal neurodevelopment. National and international health organizations currently recommend that pregnant women take at least 150 µg of potassium iodide daily.
"There is concern that even mild iodine deficiency in pregnant women could lead to children with lower IQ's," said Pearce. Iodine deficiency remains the leading cause of preventable mental retardation worldwide. Other risks of iodine deficiency include maternal and fetal goiter and increased pregnancy loss and infant mortality. Guidelines from the American Thyroid Association, Endocrine Society and Teratology Society have recommended daily iodine supplements for women in the U.S. who are pregnant, lactating or planning a pregnancy. However, these recommendations have not been widely adopted and many prenatal multivitamins sold do not contain iodine. Previous studies have shown that approximately only 20 percent of women in the U.S. take supplements with iodine.
"It is imperative that collaborations develop among health care providers and the pharmaceutical industry to ensure that all prenatal vitamins contain at least 150 µg of iodine," said Pearce.
Dr. Stagnaro-Green recommends that, "every prenatal vitamin in the US should have iodine supplementation."
- Alex Stagnaro-Green, Scott Sullivan, Elizabeth N. Pearce. Iodine Supplementation During Pregnancy and Lactation. JAMA, 2012; 308 (23): 2463-2464 DOI: 10.1001/jama.2012.45423
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