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Effect of iodine supplementation in pregnant women on child neurodevelopment: a randomised, double-blind, placebo-controlled trial.
Gowachirapant, Sueppong; Jaiswal, Nidhi; Melse-Boonstra, Alida; Galetti, Valeria; Stinca, Sara; Mackenzie, Ian; Thomas, Susan; Thomas, Tinku; Winichagoon, Pattanee; Srinivasan, Krishnamachari; Zimmermann, Michael B.
Afiliação
  • Gowachirapant S; Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand; Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands.
  • Jaiswal N; Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands; St John's Research Institute, Bangalore, India.
  • Melse-Boonstra A; Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands.
  • Galetti V; Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland.
  • Stinca S; Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland.
  • Mackenzie I; Hearing Impairment Research Group, Liverpool School of Tropical Medicine, Liverpool, UK.
  • Thomas S; St John's Research Institute, Bangalore, India.
  • Thomas T; St John's Research Institute, Bangalore, India.
  • Winichagoon P; Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand.
  • Srinivasan K; St John's Research Institute, Bangalore, India.
  • Zimmermann MB; Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland. Electronic address: michael.zimmermann@hest.ethz.ch.
Lancet Diabetes Endocrinol ; 5(11): 853-863, 2017 11.
Article em En | MEDLINE | ID: mdl-29030199
BACKGROUND: Iodine deficiency during pregnancy might be associated with reduced intelligence quotient (IQ) score in offspring. We assessed the effect of iodine supplementation in mildly iodine-deficient pregnant women on neurodevelopment of their offspring in areas where schoolchildren were iodine sufficient. METHODS: In this randomised, placebo-controlled trial, pregnant women in Bangalore, India, and Bangkok, Thailand, were randomly assigned (1:1) to receive 200 µg iodine orally once a day or placebo until delivery. Randomisation was done with a computer-generated sequence and stratified by site. Co-primary outcomes were verbal and performance IQ scores on the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) and the global executive composite score from the Behaviour Rating Inventory of Executive Function-Preschool Version (BRIEF-P) in the children at age 5-6 years. The trial was double-blinded; some unmasking took place at age 2 years for an interim analysis, but participants and nearly all investigators remained masked to group assignment until age 5-6 years. Analysis was by intention to treat using mixed-effects models. This trial is registered with ClinicalTrials.gov, number NCT00791466. FINDINGS: Between Nov 18, 2008, and March 12, 2011, 832 women entered the trial at a mean gestational age of 10·7 weeks (SD 2·7); median urinary iodine concentration was 131 µg/L (IQR 81-213). Mean compliance with supplementation was 87%, assessed by monthly tablet counts. 313 children (iodine group, n=159; placebo group, n=154) were analysed for verbal and performance IQ with WPPSI-III and 315 (iodine group, n=159; placebo group, n=156) for overall executive function with BRIEF-P. Mean WPPSI-III scores for verbal IQ were 89·5 (SD 9·8) in the iodine group and 90·2 (9·8) in the placebo group (difference -0·7, 95% CI -2·9 to 1·5; p=0·77), and for performance IQ were 97·5 (12·5) in the iodine group and 99·1 (13·4) in the placebo group (difference -1·6, -4·5 to 1·3; p=0·44). The mean BRIEF-P global executive composite score was 90·6 (26·2) in the iodine group and 91·5 (27·0) in the placebo group (difference -0·9, -6·8 to 5·0; p=0·74). The frequency of adverse events did not differ between groups during gestation or at delivery: 24 women in the iodine group and 28 in the placebo group reported adverse events (iodine group: abortion, n=20; blighted ovum, and n=2; intrauterine death, n=2; placebo group: abortion, n=22; blighted ovum, n=1; intrauterine death, n=2; early neonatal death, n=1; and neonatal death, n=2). INTERPRETATION: Daily iodine supplementation in mildly iodine-deficient pregnant women had no effect on child neurodevelopment at age 5-6 years. FUNDING: Swiss National Science Foundation, Nestlé Foundation, Wageningen University and Research, and ETH Zurich.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações na Gravidez / Deficiências do Desenvolvimento / Suplementos Nutricionais / Iodo Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies Limite: Adult / Child / Child, preschool / Female / Humans / Infant / Male / Pregnancy Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações na Gravidez / Deficiências do Desenvolvimento / Suplementos Nutricionais / Iodo Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies Limite: Adult / Child / Child, preschool / Female / Humans / Infant / Male / Pregnancy Idioma: En Ano de publicação: 2017 Tipo de documento: Article