Iodine Intakes of <150 µg/day or >550 µg/day are Not Recommended during Pregnancy: A Balance Study.

BACKGROUND: Adequate iodine intake during pregnancy is critical for maintaining maternal and fetal thyroid function and development. There are only limited data from iodine-balance studies to inform iodine requirements during pregnancy. OBJECTIVES: This is an iodine-balance study conducted to explore the associations among iodine intake, excretion, and retention to provide information regarding iodine requirements during pregnancy. METHODS: A 7-d iodine-balance experiment enrolled 93 healthy pregnant Chinese women from Hebei, Tanjin, and Shandong. Duplicates of all foods and beverages consumed were systematically collected and measured for iodine content. Iodine excretion was measured by collecting 24-h urine and feces samples. Simple linear regression models were used to assess relationships between total iodine intake and iodine retention, whereas mixed effect models were used to assess the relationship between daily iodine intake and iodine retention. RESULTS: The mean ± SD age of participating pregnant women was 29 ± 2 y at a median 22 (IQR: 13-30) wk of gestation. The mean 7-d iodine retention was 43.0 ± 1060 µg/7 d. A negative iodine balance was present in 56% of women whereas 44% had a positive balance. Pregnant women with iodine intakes <150 µg/d were in negative balance whereas those with intakes >550 µg/d were in positive balance. The daily iodine intake at zero balance was 343 µg/d, which was higher in women from Shandong (492 µg/d) than in those from Hebei and Tianjin (202 µg/d). CONCLUSIONS: Iodine intake at zero balance determined in pregnant women with adequate iodine nutrition is 202 µg/d, and the calculated recommended nutrient intake (RNI) is 280 µg/d. Iodine intakes of <150 µg/d and >550 µg/d are not recommended during pregnancy. This trial was registered at clinicaltrials.gov as NCT03710148.