SEARCHSYSTEMATIC_REVIEWendocrinology, obstetrics and gynecology

systematic_review·endocrinology, obstetrics and gynecology, nutrition, micronutrients, systematic review·PMC10023614

Iodine status and supplementation in pregnancy: an overview of the evidence provided by meta-analyses

Reviews in Endocrine & Metabolic Disorders · 10 authors, 7 centres

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TL;DR

This narrative review of seven meta-analyses found a U-shaped relationship between iodine status and maternal/neonatal outcomes, but meta-analyses of intervention trials failed to show clear benefits of iodine supplementation in mildly to moderately deficient areas.

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This narrative review synthesized findings from seven meta-analyses published between 2016 and 2022, examining the relationship between iodine status and pregnancy outcomes. However, three meta-analyses of intervention trials failed to provide straightforward conclusions on supplementation benefits in mildly to moderately deficient areas. The authors identified pooling of studies across different iodine intake levels and variable study designs as key factors explaining inconsistencies. More high-quality randomized controlled trials are needed.

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systematic_review

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endocrinology

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ORIGINAL PAPER

PMC10023614

Iodine status and supplementation in pregnancy: an overview of the evidence provided by meta-analyses

Reviews in Endocrine & Metabolic Disorders

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ABSTRACT

Iodine supplementation during pregnancy in areas with mild-moderate deficiency is still a matter of debate. The present study aimed at systematically reviewing currently available evidences provided by meta-analyses with the aim to further clarify controversial aspects regarding the need of iodine supplementation in pregnancy as well as to provide guidance on clinical decision-making, even in areas with mild-moderate deficiency. Medline, Embase and Cochrane search from 1969 to 2022 were performed. For the purpose of this review, only studies containing meta-analytic data were selected. A total of 7 meta-analyses were retrieved. Four meta-analyses evaluated the relationship between iodine status during pregnancy and neonatal and maternal outcomes suggesting the existence of a U-shaped correlation between iodine status and several maternal and neonatal consequences, especially if iodine status is evaluated at the beginning of pregnancy. Three meta-analyses evaluating the results of intervention trials failed to provide straightforward conclusions on the benefits of iodine supplementation in pregnant women in areas with mild-moderate iodine deficiency. Although evidence coming from meta-analyses suggests a role of iodine status during pregnancy in determining maternal and child outcomes, results of meta-analyses of intervention trials are still controversial. Several factors including, degree of iodine deficiency, and pooling studies conducted in areas with different iodine intake, may account for the lack of benefits reported by meta-analyses of intervention trials. More high-quality, randomized, controlled trials including information on timing, dose and regimen of iodine supplementation are needed to further elucidate this issue.

CITATION EXPORT

Laura Croce, Luca Chiovato, Massimo Tonacchera et al.. Iodine status and supplementation in pregnancy: an overview of the evidence provided by meta-analyses. Reviews in Endocrine & Metabolic Disorders. (2022). https://doi.org/10.1007/s11154-022-09760-7

AUTHORS

10 · 7 CENTRES

Laura Croce, Luca Chiovato, Massimo Tonacchera, Elena Petrosino, Maria Laura Tanda, Mariacarla Moleti, Flavia Magri, Antonella Olivieri, Elizabeth N. Pearce, Mario Rotondi

1grid.8982.b0000 0004 1762 5736Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), 27100 Pavia, Italy
2grid.511455.1Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, 27100 Pavia, PV Italy
3grid.5395.a0000 0004 1757 3729Endocrinology Section, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
4grid.18147.3b0000000121724807Department of Medicine and Surgery, University of Insubria, Varese, Italy
5grid.10438.3e0000 0001 2178 8421Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
6grid.416651.10000 0000 9120 6856Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
7grid.189504.10000 0004 1936 7558Section of Endocrinology Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA USA