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Meta-Analysis
. 2017 Mar 5;3(3):CD011761.
doi: 10.1002/14651858.CD011761.pub2.

Iodine supplementation for women during the preconception, pregnancy and postpartum period

Kimberly B Harding  1 , Juan Pablo Peña-Rosas  2 , Angela C Webster  3 , Constance My Yap  4 , Brian A Payne  5 , Erika Ota  6 , Luz Maria De-Regil  1
Affiliations
Meta-Analysis

Iodine supplementation for women during the preconception, pregnancy and postpartum period

Kimberly B Harding et al. Cochrane Database Syst Rev. .

Abstract

Background: Iodine is an essential nutrient required for the biosynthesis of thyroid hormones, which are responsible for regulating growth, development and metabolism. Iodine requirements increase substantially during pregnancy and breastfeeding. If requirements are not met during these periods, the production of thyroid hormones may decrease and be inadequate for maternal, fetal and infant needs. The provision of iodine supplements may help meet the increased iodine needs during pregnancy and the postpartum period and prevent or correct iodine deficiency and its consequences.

Objectives: To assess the benefits and harms of supplementation with iodine, alone or in combination with other vitamins and minerals, for women in the preconceptional, pregnancy or postpartum period on their and their children's outcomes.

Search methods: We searched Cochrane Pregnancy and Childbirth's Trials Register (14 November 2016), and the WHO International Clinical Trials Registry Platform (ICTRP) (17 November 2016), contacted experts in the field and searched the reference lists of retrieved studies and other relevant papers.

Selection criteria: Randomized and quasi-randomized controlled trials with randomisation at either the individual or cluster level comparing injected or oral iodine supplementation (such as tablets, capsules, drops) during preconception, pregnancy or the postpartum period irrespective of iodine compound, dose, frequency or duration.

Data collection and analysis: Two review authors independently assessed trial eligibility, risk of bias, extracted data and conducted checks for accuracy. We used the GRADE approach to assess the quality of the evidence for primary outcomes.We anticipated high heterogeneity among trials, and we pooled trial results using random-effects models and were cautious in our interpretation of the pooled results.

Main results: We included 14 studies and excluded 48 studies. We identified five ongoing or unpublished studies and two studies are awaiting classification. Eleven trials involving over 2700 women contributed data for the comparisons in this review (in three trials, the primary or secondary outcomes were not reported). Maternal primary outcomesIodine supplementation decreased the likelihood of the adverse effect of postpartum hyperthyroidism by 68% (average risk ratio (RR) 0.32; 95% confidence interval (CI) 0.11 to 0.91, three trials in mild to moderate iodine deficiency settings, 543 women, no statistical heterogeneity, low-quality evidence) and increased the likelihood of the adverse effect of digestive intolerance in pregnancy by 15 times (average RR 15.33; 95% CI 2.07 to 113.70, one trial in a mild-deficiency setting, 76 women, very low-quality evidence).There were no clear differences between groups for hypothyroidism in pregnancy or postpartum (pregnancy: average RR 1.90; 95% CI 0.57 to 6.38, one trial, 365 women, low-quality evidence, and postpartum: average RR 0.44; 95% CI 0.06 to 3.42, three trials, 540 women, no statistical heterogeneity, low-quality evidence), preterm birth (average RR 0.71; 95% CI 0.30 to 1.66, two trials, 376 women, statistical heterogeneity, low-quality evidence) or the maternal adverse effects of elevated thyroid peroxidase antibodies (TPO-ab) in pregnancy or postpartum (average RR 0.95; 95% CI 0.44 to 2.07, one trial, 359 women, low-quality evidence, average RR 1.01; 95% CI 0.78 to 1.30, three trials, 397 women, no statistical heterogeneity, low-quality evidence), or hyperthyroidism in pregnancy (average RR 1.90; 95% CI 0.57 to 6.38, one trial, 365 women, low-quality evidence). All of the trials contributing data to these outcomes took place in settings with mild to moderate iodine deficiency. Infant/child primary outcomesCompared with those who did not receive iodine, those who received iodine supplements had a 34% lower likelihood of perinatal mortality, however this difference was not statistically significant (average RR 0.66; 95% CI 0.42 to 1.03, two trials, 457 assessments, low-quality evidence). All of the perinatal deaths occurred in one trial conducted in a severely iodine-deficient setting. There were no clear differences between groups for low birthweight (average RR 0.56; 95% CI 0.26 to 1.23, two trials, 377 infants, no statistical heterogeneity, low-quality evidence), neonatal hypothyroidism/elevated thyroid-stimulating hormone (TSH) (average RR 0.58; 95% CI 0.11 to 3.12, two trials, 260 infants, very low-quality evidence) or the adverse effect of elevated neonatal thyroid peroxidase antibodies (TPO-ab) (average RR 0.61; 95% CI 0.07 to 5.70, one trial, 108 infants, very low-quality evidence). All of the trials contributing data to these outcomes took place in areas with mild to moderate iodine deficiency. No trials reported on hypothyroidism/elevated TSH or any adverse effect beyond the neonatal period.

Authors' conclusions: There were insufficient data to reach any meaningful conclusions on the benefits and harms of routine iodine supplementation in women before, during or after pregnancy. The available evidence suggested that iodine supplementation decreases the likelihood of postpartum hyperthyroidism and increases the likelihood of the adverse effect of digestive intolerance in pregnancy - both considered potential adverse effects. We considered evidence for these outcomes low or very low quality, however, because of study design limitations and wide confidence intervals. In addition, due to the small number of trials and included women in our meta-analyses, these findings must be interpreted with caution. There were no clear effects on other important maternal or child outcomes though these findings must also be interpreted cautiously due to limited data and low-quality trials. Additionally, almost all of the evidence came from settings with mild or moderate iodine deficiency and therefore may not be applicable to settings with severe deficiency.More high-quality randomised controlled trials are needed on iodine supplementation before, during and after pregnancy on maternal and infant/child outcomes. However, it may be unethical to compare iodine to placebo or no treatment in severe deficiency settings. Trials may also be unfeasible in settings where pregnant and lactating women commonly take prenatal supplements with iodine. Information is needed on optimal timing of initiation as well as supplementation regimen and dose. Future trials should consider the outcomes in this review and follow children beyond the neonatal period. Future trials should employ adequate sample sizes, assess potential adverse effects (including the nature and extent of digestive intolerance), and be reported in a way that allows assessment of risk of bias, full data extraction and analysis by the subgroups specified in this review.

PubMed Disclaimer

Conflict of interest statement

Luz Maria De‐Regil is employed by the Micronutrient Initiative (MI), an international not‐for‐profit organization that implements salt fortification programmes, to ensure populations have adequate iodine levels. As an employee of MI she recused herself from assessing the eligibility of one study sponsored by MI that was excluded as determined by another author. She is also a board member for the Iodine Global Network, a non‐profit, non‐government organization for the sustainable elimination of iodine deficiency worldwide.

Kimberly Harding is employed by the Micronutrient Initiative (MI), an international not‐for‐profit organization that implements salt fortification programmes, to ensure populations have adequate iodine levels. As an employee of MI she recused herself from assessing the eligibility of one study sponsored by MI that was excluded as determined by another author.

Part of this updated review was developed during the World Health Organization (WHO)/Cochrane/Micronutrient Initiative/Cornell University Summer Institute for Systematic Reviews in Nutrition for Global Policy Making hosted at the Division of Nutritional Sciences, Cornell University, Ithaca, USA in 7‐18 July, 2014 (Kimberly Harding) and in 27 July ‐ 7 August 2015 (Brian Payne). The World Health Organization supported this programme.

Brian Payne received financial support from the first multidisciplinary training programme on global nutrition policy for sustainable development designed by the Latin American Society of Nutrition (SLAN), World Health Organization (WHO), PanAmerican Health Organization (PAHO), the World Food Programme (WFP) and the Micronutrient Initiative (MI) in 2015.

Juan Pablo Peña‐Rosas: The Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development, World Health Organization receives financial resources from several external sources for the biennium 2014‐2015 from the Bill & Melinda Gates Foundation (2013‐2016); US Centers for Disease Control and Prevention (CDC) (2014‐2019); The Micronutrient Initiative (2014‐2017); US Agency for International Development (USAID) (2014‐2016) and Harvest Plus (2014‐2015). Donors do not fund specific guidelines and do not participate in any decision related to the guideline development process including the composition of policy questions, membership of the guideline groups, the conduct and interpretation of systematic reviews, or the formulation of recommendations.

Angela C Webster: none known.

Constance is employed by a public hospital and in her role she reviews women with gestational diabetes and thyroid dysfunction. In her clinical role she encourages all pregnant women and women contemplating pregnancy to have sufficient iodine supplementation (without any preference for a specific brand) in accordance with local and international recommendations.

Erika Ota received partial financial support from the Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development, World Health Organization to contribute to this review.

Figures

1
1
Study flow diagram
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
1.1
1.1. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 1 Maternal hypothyroidism ‐ pregnancy.
1.2
1.2. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 2 Maternal hypothyroidism ‐ postpartum.
1.3
1.3. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 3 Preterm birth.
1.4
1.4. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 4 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ pregnancy.
1.5
1.5. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 5 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ postpartum.
1.6
1.6. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 6 Maternal adverse effect: hyperthyroidism ‐ pregnancy.
1.7
1.7. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 7 Maternal adverse effect: hyperthyroidism ‐ postpartum.
1.8
1.8. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 8 Maternal adverse effect: digestive intolerance ‐ pregnancy.
1.9
1.9. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 9 Perinatal mortality.
1.10
1.10. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 10 Low birthweight.
1.11
1.11. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 11 Neonatal hypothyroidism or elevated TSH.
1.12
1.12. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 12 Neonatal adverse effect: elevated thyroid peroxidase antibodies.
1.13
1.13. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 13 Spontaneous miscarriage.
1.14
1.14. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 14 Maternal goitre ‐ pregnancy.
1.15
1.15. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 15 Maternal goitre ‐ postpartum.
1.16
1.16. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 16 Maternal insufficient iodine intake ‐ pregnancy.
1.17
1.17. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 17 Maternal insufficient iodine intake ‐ postpartum.
1.18
1.18. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 18 Maternal excessive iodine intake ‐ pregnancy.
1.19
1.19. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 19 Small‐for‐gestational age.
1.20
1.20. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 20 Congenital anomalies.
1.21
1.21. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 21 Neonatal goitre.
1.22
1.22. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 22 Neonatal thyroid volume (in mL).
1.23
1.23. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 23 Neonatal insufficient iodine intake.
1.24
1.24. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 24 Child mental or motor development (IQ points).
1.25
1.25. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 25 Child mental or motor development (cognitive score).
1.26
1.26. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 26 Child mental or motor development (language score).
1.27
1.27. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 27 Child mental or motor development (motor score).
1.28
1.28. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 28 Child mental or motor development (social‐emotional score).
1.29
1.29. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 29 Child mental or motor development (adaptive behaviour score).
1.30
1.30. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 30 Child mental or motor development (cognitive score < 85).
1.31
1.31. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 31 Child mental or motor development (cognitive score < 70).
1.32
1.32. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 32 Child mental or motor development (language score < 85).
1.33
1.33. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 33 Child mental or motor development (language score < 70).
1.34
1.34. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 34 Child mental or motor development (motor score < 85).
1.35
1.35. Analysis
Comparison 1 Any supplement containing iodine versus same supplement without iodine or no intervention/placebo, Outcome 35 Child mental or motor development (motor score < 70).
2.1
2.1. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 1 Maternal hypothyroidism ‐ pregnancy.
2.2
2.2. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 2 Maternal hypothyroidism ‐ postpartum.
2.3
2.3. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 3 Preterm birth.
2.4
2.4. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 4 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ pregnancy.
2.5
2.5. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 5 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ postpartum.
2.6
2.6. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 6 Maternal adverse effect: hyperthyroidism ‐ pregnancy.
2.7
2.7. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 7 Maternal adverse effect: hyperthyroidism ‐ postpartum.
2.8
2.8. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 8 Maternal adverse effect: digestive intolerance ‐ pregnancy.
2.9
2.9. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 9 Perinatal mortality.
2.10
2.10. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 10 Low birthweight.
2.11
2.11. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 11 Neonatal hypothyroidism or elevated TSH.
2.12
2.12. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 12 Neonatal adverse effect: elevated thyroid peroxidase antibodies.
2.13
2.13. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 13 Spontaneous miscarriage.
2.14
2.14. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 14 Maternal goitre ‐ pregnancy.
2.15
2.15. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 15 Maternal goitre ‐ postpartum.
2.16
2.16. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 16 Maternal insufficient iodine intake ‐ pregnancy.
2.17
2.17. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 17 Maternal insufficient iodine intake ‐ postpartum.
2.18
2.18. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 18 Maternal excessive iodine intake ‐ pregnancy.
2.19
2.19. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 19 Small‐for‐gestational age.
2.20
2.20. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 20 Congenital anomalies.
2.21
2.21. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 21 Neonatal goitre.
2.22
2.22. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 22 Neonatal thyroid volume (in mL).
2.23
2.23. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 23 Neonatal insufficient iodine intake.
2.24
2.24. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 24 Child mental or motor development (cognitive score).
2.25
2.25. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 25 Child mental or motor development (language score).
2.26
2.26. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 26 Child mental or motor development (motor score).
2.27
2.27. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 27 Child mental or motor development (social‐emotional score).
2.28
2.28. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 28 Child mental or motor development (adaptive behaviour score).
2.29
2.29. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 29 Child mental or motor development (cognitive score < 85).
2.30
2.30. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 30 Child mental or motor development (cognitive score < 70).
2.31
2.31. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 31 Child mental or motor development (language score < 85).
2.32
2.32. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 32 Child mental or motor development (language score < 70).
2.33
2.33. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 33 Child mental or motor development (motor score < 85).
2.34
2.34. Analysis
Comparison 2 Any oral iodine supplement versus same supplement without iodine or no intervention/placebo, Outcome 34 Child mental or motor development (motor score < 70).
3.1
3.1. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 1 Maternal hypothyroidism ‐ postpartum.
3.2
3.2. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 2 Preterm birth.
3.3
3.3. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 3 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ postpartum.
3.4
3.4. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 4 Maternal adverse effect: hyperthyroidism ‐ postpartum.
3.5
3.5. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 5 Perinatal mortality.
3.6
3.6. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 6 Low birthweight.
3.7
3.7. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 7 Neonatal hypothyroidism or elevated TSH.
3.8
3.8. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 8 Neonatal adverse effect: elevated thyroid peroxidase antibodies.
3.9
3.9. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 9 Spontaneous miscarriage.
3.10
3.10. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 10 Maternal goitre ‐ pregnancy.
3.11
3.11. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 11 Maternal goitre ‐ postpartum.
3.12
3.12. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 12 Maternal insufficient iodine intake ‐ postpartum.
3.13
3.13. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 13 Small‐for‐gestational age.
3.14
3.14. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 14 Congenital anomalies.
3.15
3.15. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 15 Neonatal goitre.
3.16
3.16. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 16 Neonatal thyroid volume (in mL).
3.17
3.17. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 17 Child mental or motor development (cognitive score).
3.18
3.18. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 18 Child mental or motor development (language score).
3.19
3.19. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 19 Child mental or motor development (motor score).
3.20
3.20. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 20 Child mental or motor development (social‐emotional score).
3.21
3.21. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 21 Child mental or motor development (adaptive behaviour score).
3.22
3.22. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 22 Child mental or motor development (cognitive score < 85).
3.23
3.23. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 23 Child mental or motor development (cognitive score < 70).
3.24
3.24. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 24 Child mental or motor development (language score < 85).
3.25
3.25. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 25 Child mental or motor development (language score < 70).
3.26
3.26. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 26 Child mental or motor development (motor score < 85).
3.27
3.27. Analysis
Comparison 3 Oral iodine‐only supplement versus no intervention or placebo, Outcome 27 Child mental or motor development (motor score < 70).
4.1
4.1. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 1 Maternal hypothyroidism ‐ pregnancy.
4.2
4.2. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 2 Maternal hypothyroidism ‐ postpartum.
4.3
4.3. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 3 Preterm birth.
4.4
4.4. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 4 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ pregnancy.
4.5
4.5. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 5 Maternal adverse effect: elevated thyroid peroxidase antibodies ‐ postpartum.
4.6
4.6. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 6 Maternal adverse effect: hyperthyroidism ‐ pregnancy.
4.7
4.7. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 7 Maternal adverse effect: hyperthyroidism ‐ postpartum.
4.8
4.8. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 8 Maternal adverse effect: digestive intolerance ‐ pregnancy.
4.9
4.9. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 9 Low birthweight.
4.10
4.10. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 10 Neonatal hypothyroidism or elevated TSH.
4.11
4.11. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 11 Spontaneous miscarriage.
4.12
4.12. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 12 Maternal goitre ‐ pregnancy.
4.13
4.13. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 13 Maternal goitre ‐ postpartum.
4.14
4.14. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 14 Maternal insufficient iodine intake ‐ pregnancy.
4.15
4.15. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 15 Maternal insufficient iodine intake ‐ postpartum.
4.16
4.16. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 16 Maternal excessive iodine intake ‐ pregnancy.
4.17
4.17. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 17 Small‐for‐gestational age.
4.18
4.18. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 18 Neonatal thyroid volume (in mL).
4.19
4.19. Analysis
Comparison 4 Oral iodine supplement with other vitamins and/or minerals versus only other vitamins and/or minerals but no iodine, Outcome 19 Neonatal insufficient iodine intake.
5.1
5.1. Analysis
Comparison 5 Any injected iodine supplement versus same supplement without iodine or no treatment/placebo, Outcome 1 Perinatal mortality.
5.2
5.2. Analysis
Comparison 5 Any injected iodine supplement versus same supplement without iodine or no treatment/placebo, Outcome 2 Congenital anomalies.
5.3
5.3. Analysis
Comparison 5 Any injected iodine supplement versus same supplement without iodine or no treatment/placebo, Outcome 3 Neonatal goitre.
5.4
5.4. Analysis
Comparison 5 Any injected iodine supplement versus same supplement without iodine or no treatment/placebo, Outcome 4 Child mental or motor development (IQ points).
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References

References to studies included in this review

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    1. Hiéronimus S, Ferrari P, Gal J, Berthier F, Azoulay S, Bongain A, et al. Relative impact of iodine supplementation and maternal smoking on cord blood thyroglobulin in pregnant women with normal thyroid function. European Thyroid Journal 2013;1(4):264‐73. - PMC - PubMed
Glinoer 1993 {published data only}
    1. Glinoer D. Maternal thyroid function in pregnancy. Journal of Endocrinological Investigation 1993;16:374‐8. - PubMed
    1. Glinoer D, Nayer P, Delange F, Lemone M, Toppet V, Sephl M, et al. A randomized trial for the treatment of mild iodine deficiency during pregnancy: maternal and neonatal effects. Journal of Clinical Endocrinology and Metabolism 1995;80:258‐69. - PubMed
Gowachirapant 2014 {published data only}
    1. Gowachirapant S. Effects of iodine supplementation in mild‐to‐moderately iodine‐deficient pregnant women on thyroid function, pregnancy outcomes and newborn development in Thailand [Doctoral dissertation]. Wageningen: Wageningen University, 2014.
    1. Melse‐Boonstra A, Gowachirapant S, Jaiswal N, Winichagoon P, Srinivasan K, Zimmermann MB. Iodine supplementation in pregnancy and its effect on child cognition. Journal of Trace Elements in Medicine and Biology 2012;26:134–6. - PubMed
Kämpe 1990 {published data only}
    1. Kampe O, Jansson R, Karlsson FA. Effects of L‐thyroxine and iodide on the development of autoimmune postpartum thyroiditis. Journal of Clinical Endocrinology & Metabolism 1990;70(4):1014‐8. - PubMed
Kevany 1969 {published data only}
    1. Kevany J, Fierro‐Benitez R, Pretell EA, Stanbury JB. Prophylaxis and treatment of endemic goiter with iodized oil in rural Ecuador and Peru. American Journal of Clinical Nutrition 1969;22(12):1597‐607. - PubMed
    1. Pretell E, Palacios P, Tello L, Wan M, Utiger R, Stanbury JB. Iodine deficiency and the maternal/fetal relationship. In: Dunn JT, Medeiros‐Neto GA editor(s). Endemic Goiter and Cretinism: Continuing Threats to World Health. Washington, DC: PAHO, 1974:143‐55.
    1. Pretell EA, Caceres A. Impairment of mental development by iodine deficiency and its correction. In: Stanbury JB editor(s). The Damaged Brain of Iodine Deficiency: Cognitive, Behavioral, Neuromotor and Educative Aspects. New York: Cognizant Communication, 1994:187–91.
    1. Pretell EA, Moncloa F, Salinas R, Guerra‐Garcia R, Kawano A, Gutierrez L, et al. Endemic goiter in rural Peru: effect of iodized oil on prevalence and size of goiter and on thyroid iodine metabolism in known endemic goitrous populations. Chapter 34. Endemic Goiter, Report of the Meeting of the PAHO Scientific Group on Research in Endemic Goiter; 1968 June 27‐29, Puebla, Mexico. Washington DC: PAHO, 1969:419‐437.
    1. Pretell EA, Torres T, Zenteno V, Cornejo M. Prophylaxis of endemic goiter with iodized oil in rural Peru. Advances in Experimental Medicine and Biology 1972;30:249‐65. - PubMed
Liesenkotter 1996 {published data only}
    1. Liesenkotter KP, Gopel W, Bogner U, Stach B, Gruters A. Earliest prevention of endemic goiter by iodine supplementation during pregnancy. European Journal of Endocrinology 1996;134(4):443‐8. - PubMed
Mulrine 2010 {published data only}
    1. Mulrine HM, Skeaff SA, Ferguson EL, Gray AR, Valeix P. Breast‐milk iodine concentration declines over the first 6 mo postpartum in iodine‐deficient women. American Journal of Clinical Nutrition 2010;92(4):849‐56. - PubMed
    1. Skeaff S. A randomised double‐blind, placebo‐controlled intervention trial to study the effect of iodine supplementation on breast milk iodine concentration and iodine status in lactating women and their breast‐fed infants. Australian Clinical Trials Register (www.actr.org.au) (accessed 6 December 2005).
Nohr 2000 {published data only}
    1. Nohr SB, Jorgensen A, Pedersen KM, Laurberg P. Postpartum thyroid dysfunction in pregnant thyroid peroxidase antibody‐positive women living in an area with mild to moderate deficiency: is iodine supplementation safe?. Journal of Clinical Endocrinology and Metabolism 2000;85(9):3191‐8. - PubMed
Pedersen 1993 {published data only}
    1. Pedersen KM, Laurberg P, Iversen E, Knudsen PR, Gregersen HE, Rasmussen OS, et al. Amelioration of some pregnancy‐associated variations in thyroid function by iodine supplementation. Journal of Clinical Endocrinology and Metabolism 1993;77:1078‐83. - PubMed
Pharoah 1971 (C) {published data only}
    1. Connolly KJ, Pharoah PO, Hetzel BS. Fetal iodine deficiency and motor performance during childhood. Lancet 1979;2(8153):1149‐51. - PubMed
    1. Pharoah P, Buttfield IH, Hetzel BS. Neurological damage to the fetus resulting from severe iodine deficiency during pregnancy. International Journal of Epidemiology 2012;41(3):589‐92. - PubMed
    1. Pharoah PO, Buttfield IH, Hetzel BS. The effect of iodine prophylaxis on the incidence of endemic cretinism. Advances in Experimental Medicine and Biology 1972;30:201‐21. - PubMed
    1. Pharoah PO, Connolly KJ, Ekins RP, Harding AG. Maternal thyroid hormone levels in pregnancy and the subsequent cognitive and motor performance of the children. Clinical Endocrinology 1984;21(3):265‐70. - PubMed
    1. Pharoah PO, Ellis SM, Ekins RP, Williams ES. Maternal thyroid function, iodine deficiency and fetal development. Clinical Endocrinology 1976;5(2):159‐66. - PubMed
Silva 1981 {published data only}
    1. Silva JE, Silva S. Interrelationships among serum thyroxine, triiodothyronine, reverse triiodothyronine, and thyroid‐stimulating hormone in iodine‐deficient pregnant women and their offspring: effects of iodine supplementation. Journal of Clinical Endocrinology and Metabolism 1981; Vol. 52, issue 4:671‐7. - PubMed
Thilly 1978 {published data only}
    1. Moreno‐Reyes R, Swennen B, Gillies J, Thilly CH. Oral iodized oil in the prevention of neonatal hypothyroidism. Annales d'Endocrinologie 1991;52:58.
    1. Thilly CH, Delange F, Lagasse R, Bourdoux P, Ramioul L, Berquist H, et al. Fetal hypothyroidism and maternal thyroid status in severe endemic goiter. Journal of Clinical Endocrinology and Metabolism 1978;47:354‐60. - PubMed
    1. Thilly CH, Lagasse R, Roger G, Bourdoux P, Ermans AM. Impaired fetal and postnatal development and high perinatal death‐rate in a severe iodine deficient area. In: Thyroid research VIII. Proceedings of the Eighth International Thyroid Congress. Sydney, Australia: Oxford, UK: Pergamon, February 3‐8, 1980:20‐3.
    1. Thilly CH, Roger G, Lagasse R, Tshibangu D, Vanderpas JB, Berquist H, et al. Fetomaternal relationship, fetal hypothyroidism, and psychomotor retardation. In Role of Cassava in the etiology of endemic goitre and cretinism. International Development Research Centre. Ottawa, Canada, 1980:111–82.
    1. Thilly CH, Swennen B, Moreno‐Reyes R, Hindlet JY, Bourdoux P, Vanderpas JB. Maternal, fetal, and juvenile hypothyroidism, birth weight and infant mortality in the etiopathogenesis of the IDD spectra in Zaire and Malawi. In: Stanbury JB editor(s). The Damaged Brain of Iodine Deficiency: Cognitive, Behavioral, Neuromotor and Educative Aspects. New York: Cognizant Communication Corporation, 1994:241‐50.
Zhou 2015 {published data only}
    1. Zhou J. Pregnancy iodine and neurodevelopment in kids (PINK). Australian New Zealand Clinical Trials Register (www.anzctr.org.au) (accessed 21 May 2010).
    1. Zhou SJ, Skeaff S, Ryan P, Doyle LW, Anderson PJ, Kornman L, et al. Effect of iodine supplementation in pregnancy on childhood development: results from a randomised controlled trial (RCT). Journal of Paediatrics and Child Health 2015; Vol. 51, issue Suppl 1:34.
    1. Zhou SJ, Skeaff SA, Ryan P, Doyle LW, Anderson PJ, Kornman L, et al. The effect of iodine supplementation in pregnancy on early childhood neurodevelopment and clinical outcomes: results of an aborted randomised placebo‐controlled trial. Trials 2015;16:563. [PUBMED: 26654905] - PMC - PubMed

References to studies excluded from this review

Amiri 2016 {published data only}
    1. Amiri P, Hamzavi‐Zarghani N, Nazeri P, Ghofranipour F, Karimi M, Amouzegar A, et al. Can an educational intervention improve iodine nutrition status in pregnant women? A randomized controlled trial. Thyroid: Official Journal of the American Thyroid Association 2016 Nov 3 [Epub ahead of print]. - PubMed
Anees 2015 {published data only}
    1. Anees M, Anis RA, Yousaf S, Murtaza I, Sultan A, Arslan M, et al. Effect of maternal iodine supplementation on thyroid function and birth outcome in goiter endemic areas. Current Medical Research and Opinion 2015;1(4):667‐74. - PubMed
Antonangeli 2002 {published data only}
    1. Antonangeli L, Maccherini D, Cavaliere R, Giulio C, Reinhardt B, Pinchera A, 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(1):29‐34. - PubMed
Azizi 2003 {published data only}
    1. Azizi F, Aminorroya A, Hedayati M, Rezvanian H, Amini M, Mirmiran P. Urinary iodine excretion in pregnant women residing in areas with adequate iodine intake. Public Health Nutrition 2003;6(1):95‐8. - PubMed
Berbel 2009 {published data only}
    1. Berbel P, Mestre JL, Santamaria A, Palazon I, Franco A, Graells M, 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;19:511–9. - PubMed
Cao 1994 {published data only}
    1. Cao XY, Jiang XM, Kareem A, Dou ZH, Abdul Rakeman M, Zhang ML, et al. Iodination of irrigation water as a method of supplying iodine to a severely iodine‐deficient population in Xinjiang, China. Lancet 1994;344(8915):107‐10. - PubMed
Chaouki 1994 {published data only}
    1. Chaouki ML, Benmiloud M. Prevention of iodine deficiency disorders by oral administration of lipiodol during pregnancy. European Journal of Endocrinology 1994;130:547‐51. - PubMed
Chiovato 1994 {published data only}
    1. Chiovato L, Aghini‐Lombardi F, Vitti P, Ferretti G, Marcheschi M, Pinchera A. The impact of iodine deficiency on the neurological and cognitive development: the European experience. Stambury JB, editor(s). The Damaged Brain of Iodine Deficiency: Neuromotor, Cognitive, Behavioral and Educative Aspects. New York: Cognizant Communication Company, 1994:293‐8.
Connelly 2012 {published data only}
    1. Connelly KJ, Boston BA, Pearce EN, Sesser D, Snyder D, Braverman LE, et al. Congenital hypothyroidism caused by excess prenatal maternal iodine ingestion. Journal of Pediatrics 2012;161:760‐2. - PMC - PubMed
Dean 1950 {published data only}
    1. Dean RFA. Iodine as an aid to lactation. Lancet 1950;1:762‐3. - PubMed
Delange 1996 {published data only}
    1. Delange F. Administration of iodized oil during pregnancy: a summary of the published evidence. Bulletin of the World Health Organization 1996;74(1):101‐8. - PMC - PubMed
Delange 2004 {published data only}
    1. Delange F. Optimal iodine nutrition during pregnancy, lactation and the neonatal period. International Journal of Endocrinology and Metabolism 2004;2:1‐12.
Fierro‐Benitez 1988 {published data only}
    1. Fierro‐Benitez R, Cazar R, Stanbury JB, Rodriguez P, Garces F, Fierro‐Renoy F, et al. Effects on school children of prophylaxis of mothers with iodized oil in an area of iodine deficiency. Journal of Endocrinological Investigation 1988;11(5):327‐35. - PubMed
Gruñeiro‐Papendieck 2004 {published data only}
    1. Gruñeiro‐Papendieck L, Chiesa A, Mendez V, Bengolea S, Prieto L. Neonatal TSH levels as an index of iodine sufficiency: differences related to time of screening sampling and methodology. Hormone Research in Paediatrics 2004;62(6):272‐6. - PubMed
Hetzel 2002 {published data only}
    1. Hetzel BS. Eliminating iodine deficiency disorders ‐ the role of the International Council in the global partnership. Bulletin of the World Health Organanization 2002;80(5):413‐7; 410‐3. - PMC - PubMed
Isa 2000 {published data only}
    1. Isa ZM, Alias IZ, Kadir KA, Ali O. Effect of iodized oil supplementation on thyroid hormone levels and mental performance among Orang Asli schoolchildren and pregnant mothers in an endemic goitre area in Peninsular Malaysia. Asia Pacific Journal of Clinical Nutrition 2000;9(4):274‐81. - PubMed
Joshi 2011 {published data only}
    1. Joshi A, Pokhrel T, Bastola SP, Banjara R, Joshi AB. Iodine supplementation in pregnancy and its effects on perinatal outcome. Nepal Medical College Journal 2011;13(2):128‐30. - PubMed
Kamiński 2003 {published data only}
    1. Kamiński M, Drewniak W, Szymański W, Junik R, Kamińska A. Urinary iodine excretion and thyroid function in pregnant women of Bydgoszcz District prior to and after the introduction of iodized salt. Ginekologia Polska 2003;74(10):1126‐9. - PubMed
Klett 1999 {published data only}
    1. Klett M, Ohlig M, Manz F, Tröger J, Heinrich U. Effect of iodine supply on neonatal thyroid volume and TSH. Acta Paediatrica. Supplement 1999;88(432):18‐20. - PubMed
Kurtoglu 2004 {published data only}
    1. Kurtoglu S, Akcakus M, Kocaoglu C, Gunes T, Budak N, Atabek ME, et al. Iodine status remains critical in mother and infant in Central Anatolia (Kayseri) of Turkey. European Journal of Nutrition 2004;43(5):297‐303. - PubMed
McDonnell 2003 {published data only}
    1. McDonnell CM, Harris M, Zacharin MR. Iodine deficiency and goitre in schoolchildren in Melbourne. Medical Journal of Australia 2003;178(4):159‐62. - PubMed
Mohammed 2015 {published data only}
    1. Mohammed H, Marquis G, Aboud F, Bougma K, Samuel A. A cluster RCT evaluating the effect of iodized salt on infant development in amhara region of Ethiopia. FASEB Journal 2015;29(1 Suppl):LB264.
Moleti 2008 {published data only}
    1. Moleti M, Lo Presti VP, Campolo MC, Mattina F, Galletti M, Mandolfino M, et al. Iodine prophylaxis using iodized salt and risk of maternal thyroid failure in conditions of mild iodine deficiency. Journal of Clinical Endocrinology and Metabolism 2008;93(7):2616‐21. - PubMed
Morreale de Escobar 1993 {published data only}
    1. Morreale de Escobar G, Obregón MJ, Calvo R, Escobar del Rey F. Effects of iodine deficiency on thyroid hormone metabolism and the brain in fetal rats: the role of the maternal transfer of thyroxin. American Journal of Clinical Nutrition 1993;57(2 Suppl):280S‐285S. - PubMed
Murcia 2011 {published data only}
    1. Murcia M, Rebagliato M, Iñiguez C, Lopez‐Espinosa MJ, Estarlich M, Plaza B, et al. Effect of iodine supplementation during pregnancy on infant neurodevelopment at 1 year of age. American Journal of Epidemiology 2011;173(7):804‐12. - PubMed
Nohr 1993 {published data only}
    1. Nøhr SB, Laurberg P, Børlum KG, Pedersen KM, Johannesen PL, Damm P, et al. Iodine deficiency in pregnancy in Denmark. Regional variations and frequency of individual iodine supplementation. Acta Obstetricia et Gynecologica Scandinavica 1993;72(5):350‐3. - PubMed
O'Donnell 2002 {published data only}
    1. O'Donnell KJ, Rakeman MA, Zhi‐Hong D, Xue‐Yi C, Mei ZY, DeLong N, et al. Effects of iodine supplementation during pregnancy on child growth and development at school age. Developmental Medicine & Child Neurology 2002;44(2):76‐81. - PubMed
Oltarzewski 2003 {published data only}
    1. Oltarzewski M, Szymborski J. Neonatal hypothyroid screening in monitoring of iodine deficiency and iodine supplementation in Poland. Journal of Endocrinological Investigation 2003;2:27‐31. - PubMed
Qian 2005 {published data only}
    1. Qian M, Wang D, Watkins WE, Gebski V, Yan YQ, Li M, 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(1):32‐42. - PubMed
Rebagliato 2013 {published data only}
    1. Rebagliato M, Murcia M, Alvarez‐Pedrerol M, Espada M, Fernandez‐Somoano A, Lertxundi N, et al. Iodine supplementation during pregnancy and infant neuropsychological development: INMA mother and child cohort study. American Journal of Epidemiology 2013;177(9):944‐53. - PubMed
Reinhardt 1998 {published data only}
    1. Reinhardt W, Kohl S, Hollmann D, Klapp G, Benker G, Reinwein D, et al. Efficacy and safety of iodine in the postpartum period in an area of mild iodine deficiency. European Journal of Medical Research 1998;3(4):203‐10. - PubMed
Romano 1991 {published data only}
    1. Romano R, Jannini EA, Pepe M, Grimaldi A, Olivieri M, Spennati P, et al. The effects of iodoprophylaxis on thyroid size during pregnancy. American Journal of Obstetrics and Gynecology 1991;164:482‐5. - PubMed
Saadat 2004 {published data only}
    1. Saadat N, Robabeh SOS, Fereidoun A. Impact of iodized oil injection during pregnancy on thyroid function test of offsprings. Medical Journal of the Islamic Republic of Iran 2004;17(4):1382.
Sack 2003 {published data only}
    1. Sack J, Goldstein A, Charpak N, Rozin A, Ruiz‐Pelaez JG, Figueroa de Calume Z, et al. Postpartum maternal hyperthyrotropinemia in an area in which iodine supplementation is required. Thyroid 2003;13(10):959‐64. - PubMed
Salarkia 2004 {published data only}
    1. Salarkia N, Mirmiran P, Azizi F. Timing of the effect of iodine supplementation on intelligence quotients of schoolchildren. International Journal of Endocrinology and Metabolism 2004;2004(2):95‐102.
Santiago 2013 {published data only}
    1. Santiago P, Velasco I, Muela JA, Sánchez B, Martínez J, Rodriguez A, et al. Infant neurocognitive development is independent of the use of iodised salt or iodine supplements given during pregnancy. British Journal of Nutrition 2013;110(5):831‐40. - PubMed
Smyth 1997 {published data only}
    1. Smyth PP, Hetherton AM, Smith DF, Radcliff M, O'Herlihy C. Maternal iodine status and thyroid volume during pregnancy: correlation with neonatal iodine intake. Journal of Clinical Endocrinology and Metabolism 1997;82(9):2840‐3. - PubMed
Smyth 2005 {published data only}
    1. Smyth PP, Wijeyaratne CN, Kaluarachi WN, Smith DF, Premawardhana LD, Parkes AB, et al. Sequential studies on thyroid antibodies during pregnancy. Thyroid 2005;15(5):474‐7. - PubMed
Troshina 2010 {published data only}
    1. Troshina EA, Abdulkhabirova FM, Sekinaeva AV, Il'in AV, Arbuzova MI, Petrova VN, et al. Prevention of iodine deficiency diseases in pregnant and lactating women. Klinicheskaia Meditsina 2010;88(5):26‐31. - PubMed
Urban 2000 {published data only}
    1. Urban G, Wnek M, Bazowska G. Iodine supplementation during pregnancy and its influence on the newborn. Ginekologia Polska 2000;71(8):690‐4. - PubMed
Velasco 2009 {published data only}
    1. Velasco I, Carreira M, Santiago P, Muela JA, Garcia‐Fuentes E, Sanchez‐Munoz B, et al. Effect of iodine prophylaxis during pregnancy on neurocognitive development of children during the first two years of life. Journal of Clinical Endocrinology and Metabolism 2009;94(3):234‐41. - PubMed
Vermiglio 2004 {published data only}
    1. Vermiglio F, Lo Presti VP, Moleti M, Sidoti M, Tortorella G, Scaffidi G, et al. Attention deficit and hyperactivity disorders in the offspring of mothers exposed to mild‐moderate iodine deficiency: a possible novel iodine deficiency disorder in developed countries. Journal of Clinical Endocrinology and Metabolism 2004;89(12):6054‐60. - PubMed
Versloot 1997 {published data only}
    1. Versloot PM, Schröder‐van der Elst JP, Heide D, Boogerd L. Effects of marginal iodine deficiency during pregnancy: iodide uptake by the maternal and fetal thyroid. American Journal of Physiology 1997;273(6 Pt 1):E1121‐6. - PubMed
Vitnerova 2000 {published data only}
    1. Vitnerova N, Miskova I, Kotesovec F. Treatment of iodine deficiency in pregnant women in the Teplice District. Casopís Lékaru Ceských 2000;139(17):533‐6. - PubMed
Vitti 1992 {published data only}
    1. Vitti P, Aghini‐Lombardi F, Antonangeli L, Rago T, Chiovato L, Pinchera A, et al. Mild iodine deficiency in fetal/neonatal life and neuropsychological performances. Acta Medica Austriaca 1992;19 Suppl 1:57‐9. - PubMed
Yan 2005 {published data only}
    1. Yan YQ, Chen ZP, Yang XM, Liu H, Zhang JX, Zhong W, et al. Attention to the hiding iodine deficiency in pregnant and lactating women after universal salt iodization: a multi‐community study in China. Journal of Endocrinological Investigation 2005;28(6):547‐53. - PubMed
Zhu 1995 {published data only}
    1. Zhu Q, Huang Z, Lei DWY, Liu L, Zhang H. The effect of iodine deficiency in pregnant women on the physical development of their infants. Acta Nutrimenta Sinica 1995;17(4):391‐5.
Zimmermann 2005 {published data only}
    1. Zimmermann MB, Aeberli I, Torresani T, Bürgi H. Increasing the iodine concentration in the Swiss iodized salt program markedly improved iodine status in pregnant women and children: a 5‐y prospective national study. American Journal of Clinical Nutrition 2005;82(2):388‐92. - PubMed

References to studies awaiting assessment

Belykh 2014 {published data only}
    1. Belykh N, Mamenko M, Kovalenko N, Minyaylo N, Plugatarenko N. Effectiveness of iodine prophylaxis in pregnant, lactating mothers and infants in mild iodine deficiency region. European Thyroid Journal 2014;3(Suppl 1):117‐8, Abstract no: P29.
Hronek 2001 {published data only}
    1. Hronek M, Miturova K, Kudlackova Z, Beranova E. Importance of iodine intake during pregnancy ‐ iodine supplementation and its risks. Ceská Gynekologie 2001;66(3):199‐202. - PubMed

References to ongoing studies

Caron 2006 {published data only}
    1. NCT00379535. Phase III : preventing lack of iodine during pregnancy. Effect of supplying woman with potassium iodine to the neuro‐cognitive children development until two years. clinicaltrials.gov/show/NCT00379535 Date first received: 21 September 2006.
Nyström 2015a {published data only}
    1. NCT02378246. Iodine status in Swedish pregnant women ‐ effect of iodine supplementation in the thyroid function of mother and infant. clinicaltrials.gov/show/NCT02378246 Date first received: 19 January 2015.
Nyström 2015b {published data only}
    1. NCT02378233. Iodine status in Swedish lactating women ‐ effect of iodine supplementation in the thyroid function of mother and infant. clinicaltrials.gov/show/NCT02378233 Date first received: 19 January 2015.
Teng 2013 {published data only}
    1. ChiCTR‐TRC‐13003805. Screening and intervention for iodine deficiency, iron deficiency and subclinical thyroid insufficiency in women planning pregnancy and in early pregnant women. chictr.org/en/ChiCTR‐TRC‐13003805 Date first received: 19 August 2013.
Torres 2010 {published data only}
    1. NCT01301768. Group education to improve the iodine nutrition in pregnancy: cluster randomized trial. clinicaltrials.gov/show/NCT01301768 Date first received: 31 May 2010.
    1. Prieto G, Torres MT, Frances L, Falguera G, Vila L, Manresa JM, et al. Nutritional status of iodine in pregnant women in Catalonia (Spain): Study on hygiene‐dietetic habits and iodine in urine. BMC Pregnancy and Childbirth 2011;11:17. - PMC - PubMed

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