Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women’s urinary iodine concentration in rural Malawi

A secondary outcome analysis of the iLiNS Dyad trial

Bibliographic Data

ID15097099
AuthorsSeth Adu-Afarwuah (0000-0002-2720-5474, University of Ghana, corresponding author), Charles D Arnold (0000-0001-6510-3172, University of California, Davis), Kenneth Maleta (0000-0002-2536-3938, University of Malawi), Per Ashorn (0000-0003-2311-2593, Tampere University Hospital), Ulla Ashorn (0000-0002-1720-868X), Josh M Jorgensen (0000-0001-8299-2530, University of California, Davis), Yue-Mei Fan (0000-0002-3241-6225, Tampere University Hospital), Minyanga Nkhoma (0000-0002-5002-2246, University of Malawi), Jaden Bendabenda (0000-0001-6231-1224, University of Malawi), Andrew Matchado (0000-0002-0302-5591, University of Malawi), Kathryn G Dewey (0000-0002-4185-3451, University of California, Davis)
Year2021
Volume24
Issue10
Pages3049-3057
Publication date2021-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980020003250
PMID33054890
OpenAlexW3093365318
LanguageEN
References cited41

Objectives: Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi. Design: A randomised controlled trial. Pregnant women ( n 1391) were assigned to consume 60 mg/d Fe and 400 μg/d folic acid (IFA) or 18 vitamins and minerals including 250 μg/d iodine (MMN) or 20 g/d small-quantity lipid-based nutrient supplements (SQ-LNS) with similar nutrient contents as MMN group, plus macronutrients (LNS) until childbirth. In a sub-study ( n 317), we evaluated group geometric mean urinary iodine concentration (UIC) (μg/L) at 36 weeks of gestation controlling for baseline UIC and compared median (baseline) and geometric mean (36 weeks) UIC with WHO cut-offs: UIC Setting: Mangochi District, Malawi. Participants: Women ≤20 weeks pregnant. Results: Groups had comparable background characteristics. At baseline, overall median (Q1, Q3) UIC (319 (167, 559)) suggested iodine intakes above requirements. At 36 weeks, the geometric mean (95 % CI) UIC of the IFA (197 (171, 226)), MMN (212 (185, 243)) and LNS (220 (192, 253)) groups did not differ ( P = 0·53) and reflected adequate intakes. Conclusions: In this setting, provision of supplements containing iodine at the recommended dose to pregnant women with relatively high iodine intakes at baseline, presumably from iodised salt, has no impact on the women’s UIC. Regular monitoring of the iodine status of pregnant women in such settings is advisable. Clinicaltrials.gov identifier: NCT01239693

Animal science · Dietary Reference Intake · Gestation · Gynecology · Iodine · Iodine deficiency · Iodised salt · Micronutrient · Nutrient · Obstetrics · Pregnancy · Thyroid · Chemistry · Child Nutrition and Water Access · Iron Metabolism and Disorders · Medicine · Pregnancy and preeclampsia studies · Internal Medicine · Physiology