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Iodine intake in a population of pregnant women: INMA mother and child cohort study, Spain
  1. M Murcia1,2,
  2. M Rebagliato1,3,
  3. M Espada4,
  4. J Vioque1,5,
  5. L Santa Marina1,6,
  6. M Alvarez-Pedrerol1,7,
  7. M-J Lopez-Espinosa1,2,8,
  8. G León5,
  9. C Íñiguez1,2,
  10. M Basterrechea1,6,
  11. M Guxens1,7,
  12. A Lertxundi1,6,
  13. A Perales9,
  14. F Ballester1,2,
  15. J Sunyer1,7
  16. on behalf of the INMA Study Group
  1. 1CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  2. 2Centre for Public Health Research (CSISP), Conselleria de Sanidad, Valencia, Spain
  3. 3Rey Juan Carlos University, Madrid, Spain
  4. 4Clinical Chemistry Unity, Public Health Laboratory of Bilbao, Bilbao, Spain
  5. 5Department of Public Health, Miguel Hernández University, San Juan de Alicante, Spain
  6. 6Subdirección de Salud Pública de Gipuzkoa, San Sebastián, Spain
  7. 7Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM), Barcelona, Spain
  8. 8Laboratory of Medical Investigations, San Cecilio University Hospital, University of Granada, Granada, Spain
  9. 9Department of Obstetrics and Gynaecology, La Fe University Hospital, Valencia, Spain
  1. Correspondence to Mario Murcia Hinarejos, Unit of Environment and Health, Centre for Public Health Research (CSISP), Avda Catalunya 21, 46020 Valencia, Spain; murcia_mar{at}


Background Monitoring iodine status during pregnancy is essential to prevent iodine-related disorders. The objectives of this study are to estimate iodine intake and excretion, to assess their association and to evaluate the compliance of the recommendations in a multicentre cohort of pregnant women.

Methods Cross-sectional data on maternal iodine nutritional status, compiled between weeks 8 and 22 of gestation in three Spanish areas (Valencia, Gipuzkoa and Sabadell), were analysed. Information on iodine intake from diet, salt and supplements was estimated through questionnaires. Spot urine samples were analysed for urinary iodine concentration (UIC). Tobit regression analysis was used to assess the association between iodine intake and UIC.

Results 1522 women were included in the study. Median UIC was 134 (IQR 80–218) μg/l in Valencia, 168 (IQR 108–272) μg/l in Gipuzkoa and 94 (IQR 57–151) μg/l in Sabadell. 48.9% of Valencian women consumed iodine supplements, 93.3% in Gipuzkoa and 11.0% in Sabadell. Prevalence of iodised salt consumption was 50.5% in the whole sample. UIC was associated with intake of supplements, iodised salt, dietary iodine and water. UIC levels were lower than expected according to the estimated iodine intake.

Conclusion Median UIC reflected iodine deficiency according to WHO reference levels, except in Gipuzkoa where supplements are widely consumed. It is necessary to strengthen iodised salt consumption since it is already far from the objective proposed of coverage of 90% of households. More data would be valuable to assess the correspondence between iodine intake and excretion during pregnancy.

  • Pregnancy
  • iodine
  • biological markers
  • diet
  • dietary supplements
  • nutrition

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  • Funding The INMA network has been set up thanks to the Instituto de Salud Carlos III (G03/176). This study was supported by Ministerio Sanidad y Consumo (FIS 03/1615, FIS 04/1509, FIS 04/1436, FIS 05/1079, FIS 06/1213, FIS 06/0867), Ministerio Educación y Ciencia (SAF2002-03508), Generalitat de Catalunya-CIRIT 1999SGR 00241, Departamento de Sanidad, Gobierno Vasco 2005111093 and Diputación Foral de Gipuzkoa 06/004.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the The Institut Municipal d'Investigació Mèdica (Barcelona), Hospital La Fe (Valencia) and Hospital Donostia (Gipuzkoa).

  • Provenance and peer review Not commissioned; externally peer reviewed.