Download PDF
CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd
DOI: 10.1055/a-2505-1944
GebFra Science
Statement

Key Messages of the Iodine Deficiency Working Group (AKJ): Maternal Hypothyroxinemia Due to Iodine Deficiency and Endocrine Disruptors as Risks for Child Neurocognitive Development

Article in several languages: English | deutsch
Rolf Grossklaus 
1   Mitglied des Wissenschaftlichen Beirats des Arbeitskreises Jodmangel e.V. (AKJ), Frankfurt/Main, Germany
2   ehemals Abteilung Lebensmittelsicherheit, Bundesinstitut für Risikobewertung, Berlin, Germany
,
Klaus-Peter Liesenkötter
1   Mitglied des Wissenschaftlichen Beirats des Arbeitskreises Jodmangel e.V. (AKJ), Frankfurt/Main, Germany
3   Endokrinologikum Berlin, Zentrum für Hormon- und Stoffwechselerkrankungen, Berlin, Germany
,
Klaus Doubek
1   Mitglied des Wissenschaftlichen Beirats des Arbeitskreises Jodmangel e.V. (AKJ), Frankfurt/Main, Germany
4   Berufsverband der Frauenärzte München, München, Germany
,
Henry Völzke
1   Mitglied des Wissenschaftlichen Beirats des Arbeitskreises Jodmangel e.V. (AKJ), Frankfurt/Main, Germany
5   Institut für Gemeinschaftsmedizin, SHIP/Klinisch-Epidemiologische Forschung, Universitätsmedizin Greifswald, Greifswald, Germany (Ringgold ID: RIN60634)
,
Roland Gaertner
1   Mitglied des Wissenschaftlichen Beirats des Arbeitskreises Jodmangel e.V. (AKJ), Frankfurt/Main, Germany
6   Medizinische Klinik IV der Universität München, München, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Iodine deficiency with the resultant maternal hypothyroxinemia and the effects of endocrine disruptors can, individually or together, have a negative effect on embryonic and fetal brain development.

This is the conclusion of a recent review by the authors which examined and critically discussed a total of 279 publications from the past 30 years on the effects of mild to moderate iodine deficiency, reduced maternal thyroxine levels, and the influence of endocrine disruptors on child brain development during pregnancy.

Adequate iodine intake is important for all women of childbearing age to prevent negative psychological and social consequences for their children. An additional threat to the thyroid hormone system is the ubiquitous exposure to endocrine disruptors, which can increase the impact of maternal iodine deficiency on the neurocognitive development of their offspring. Ensuring an adequate iodine intake is therefore not only crucial for healthy fetal and neonatal development in general, but could also prevent the potential effects of endocrine disruptors.

Due to the current deficient iodine status of women of childbearing age and of children and adolescents in Germany and most European countries, urgent measures are needed to improve the iodine intake of the population.

Therefore, in the opinion of the AKJ, young women of childbearing age should be instructed to take iodine supplements continuously for at least 3 months before conception and during pregnancy. In addition, detailed strategies for detecting and reducing exposure to endocrine disruptors in accordance with the “precautionary principle” should be urgently developed.

Keywords

iodine deficiency - pregnancy - hypothyroxinemia - neurocognitive development - endocrine disruptors


Publication History

Received: 08 October 2024

Accepted after revision: 07 December 2024

Article published online:
26 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References/Literatur

  • 1 Eastman CJ, Zimmermann MB. The iodine deficiency disorders. In: Feingold KR, Anawalt B, Boyce A. et al. , ed. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. Accessed February 06, 2018 at: https://www.ncbi.nlm.nih.gov/books/NBK285556/
    Search in Google Scholar
  • 2 Grossklaus R, Liesenkötter K-P, Doubek K. et al. Iodine Deficiency, Maternal Hypothyroxinemia and Endocrine Disrupters Affecting Fetal Brain Development: A Scoping Review. Nutrients 2023; 15: 2249
    CrossrefPubMedSearch in Google Scholar
  • 3 American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. Reducing Prenatal Exposure to Toxic Environmental Agents: ACOG Committee Opinion, Number 832. Obstet Gynecol 2021; 138: e40-e54
    CrossrefPubMedSearch in Google Scholar
  • 4 Yilmaz B, Terekeci H, Sandal S. et al. Endocrine disrupting chemicals: exposure, effects on human health, mechanism of action, models for testing and strategies for prevention. Rev Endocr Metab Disord 2020; 21: 127-147
    CrossrefPubMedSearch in Google Scholar
  • 5 Ghassabian A, Trasande L. Disruption in Thyroid Signaling Pathway: A Mechanism for the Effect of Endocrine-Disrupting Chemicals on Child Neurodevelopment. Front Endocrinol (Lausanne) 2018; 9: 204
    CrossrefPubMedSearch in Google Scholar
  • 6 Köhrle J, Frädrich C. Thyroid hormone system disrupting chemicals. Best Pract Res Clin Endocrinol Metab 2021; 35: 101562
    CrossrefPubMedSearch in Google Scholar
  • 7 Demeneix BA. Evidence for Prenatal Exposure to Thyroid Disruptors and Adverse Effects on Brain Development. Eur Thyroid J 2019; 8: 283-292
    CrossrefPubMedSearch in Google Scholar
  • 8 Mughal BB, Fini JB, Demeneix BA. Thyroid-disrupting chemicals and brain development: an update. Endocr Connect 2018; 7: R160-R186
    CrossrefPubMedSearch in Google Scholar
  • 9 Yan Y, Guo F, Liu K. et al. The effect of endocrine-disrupting chemicals on placental development. Front Endocrinol (Lausanne) 2023; 14: 1059854
    CrossrefPubMedSearch in Google Scholar
  • 10 Gómez-Roig D, Pascal R, Cahuana MJ. et al. Environmental Exposure during Pregnancy: Influence on Prenatal Development and Early Life: A Comprehensive Review. Fetal Diagn Ther 2021; 48: 245-257
    CrossrefPubMedSearch in Google Scholar
  • 11 Hamers T, Kortenkamp A, Scholze M. et al. Transthyretin-Binding Activity of Complex Mixtures Representing the Composition of Thyroid-Hormone Disrupting Contaminants in House Dust and Human Serum. Environ Health Perspect 2020; 128: 17015
    CrossrefPubMedSearch in Google Scholar
  • 12 Lisco G, De Tullio, AGiagulli VA. et al. Interference on iodine uptake and human thyroid function by perchlorate-contaminated water and food. Nutrients 2020; 12: 1669
    CrossrefPubMedSearch in Google Scholar
  • 13 Ghassabian A, Pierotti L, Basterrechea M. et al. Association of Exposure to Ambient Air Pollution With Thyroid Function During Pregnancy. JAMA Netw Open 2019; 2: e1912902
    CrossrefPubMedSearch in Google Scholar
  • 14 Lanphear BP. The impact of toxins on the developing brain. Annu Rev Public Health 2015; 36: 211-230
    CrossrefPubMedSearch in Google Scholar
  • 15 Boas M, Feldt-Rasmussen U, Main KM. Thyroid effects of endocrine disrupting chemicals. Mol Cell Endocrinol 2012; 355: 240-248
    CrossrefPubMedSearch in Google Scholar
  • 16 Jugan ML, Levi Y, Blondeau JP. Endocrine disruptors and thyroid hormone physiology. Biochem Pharmacol 2010; 79: 939-947
    CrossrefPubMedSearch in Google Scholar
  • 17 Hartoft-Nielsen ML, Boas M, Bliddal S. et al. Do Thyroid Disrupting Chemicals Influence Foetal Development during Pregnancy?. J Thyroid Res 2011; 2011: 342189
    CrossrefPubMedSearch in Google Scholar
  • 18 Noyes PD, Friedman KP, Browne P. et al. Evaluating Chemicals for Thyroid Disruption: Opportunities and Challenges with in Vitro Testing and Adverse Outcome Pathway Approaches. Environ Health Perspect 2019; 127: 95001
    CrossrefPubMedSearch in Google Scholar
  • 19 Calsolaro V, Pasqualetti G, Niccolai F. et al. Thyroid Disrupting Chemicals. Int J Mol Sci 2017; 18: 2583
    CrossrefPubMedSearch in Google Scholar
  • 20 Duntas LH, Stathatos N. Toxic chemicals and thyroid function: hard facts and lateral thinking. Rev Endocr Metab Disord 2015; 16: 311-318
    CrossrefPubMedSearch in Google Scholar
  • 21 Gilbert ME, Rovet J, Chen Z. et al. Developmental thyroid hormone disruption: prevalence, environmental contaminants and neurodevelopmental consequences. Neurotoxicology 2012; 33: 842-852
    CrossrefPubMedSearch in Google Scholar
  • 22 Cediel-Ulloa A, Lupu DL, Johansson Y. et al. Impact of endocrine disrupting chemicals on neurodevelopment: the need for better testing strategies for endocrine disruption-induced developmental neurotoxicity. Expert Rev Endocrinol Metab 2022; 17: 131-141
    CrossrefPubMedSearch in Google Scholar
  • 23 Hetzel BS. The development of a global program for the elimination of brain damage due to iodine deficiency. Asia Pac J Clin Nutr 2012; 21: 164-170
    PubMedSearch in Google Scholar
  • 24 Monahan M, Boelaert K, Jolly K. et al. Costs and benefits of iodine supplementation for pregnant women in a mildly to moderately iodine-deficient population: a modelling analysis. Lancet Diabetes Endocrinol 2015; 3: 715-722
    CrossrefPubMedSearch in Google Scholar
  • 25 Großklaus R. Nutzen und Risiken der Jodprophylaxe. Einfluss von Jodsalz auf Schilddrüsenkrankheiten und die Gesundheit des Menschen. Präv Gesundheitsf 2007; 2: 158-166
    PubMedSearch in Google Scholar
  • 26 Demeneix B, Slama R. Endocrine Disruptors: From Scientific Evidence to Human Health Protection. In Report Commissioned by the PETI Committee of the European Parliament; Policy Department for Citizen’s Rights and Constitutional Affairs. 2019 Accessed October 09, 2021 at: http://www.europarl.europa.eu/RegData/etudes/STUD/2019/608866/IPOL_STU(2019)608866_EN.pdf
    PubMedSearch in Google Scholar
  • 27 Trasande L, Zoeller RT, Hass U. et al. Burden of disease and costs of exposure to endocrine disrupting chemicals in the European Union: an updated analysis. Andrology 2016; 4: 565-572
    CrossrefPubMedSearch in Google Scholar
  • 28 Costa LG, Cole TB, Dao K. et al. Developmental impact of air pollution on brain function. Neurochem Int 2019; 131: 104580
    CrossrefPubMedSearch in Google Scholar
  • 29 Rivas I, Basagaña X, Cirach M. et al. Association between Early Life Exposure to Air Pollution and Working Memory and Attention. Environ Health Perspect 2019; 127: 57002
    CrossrefPubMedSearch in Google Scholar
  • 30 D’Angiulli A. Severe Urban Outdoor Air Pollution and Children’s Structural and Functional Brain Development, From Evidence to Precautionary Strategic Action. Front Public Health 2018; 6: 95
    CrossrefPubMedSearch in Google Scholar
  • 31 Suades-González E, Gascon M, Guxens M. et al. Air Pollution and Neuropsychological Development: A Review of the Latest Evidence. Endocrinology 2015; 156: 3473-3482
    CrossrefPubMedSearch in Google Scholar
  • 32 Padmanabhan V, Song W, Puttabyatappa M. Praegnatio Perturbatio-Impact of Endocrine-Disrupting Chemicals. Endocr Rev 2021; 42: 295-353
    CrossrefPubMedSearch in Google Scholar
  • 33 Inoue K, Yan Q, Arah OA. et al. Air Pollution and Adverse Pregnancy and Birth Outcomes: Mediation Analysis Using Metabolomic Profiles. Curr Environ Health Rep 2020; 7: 231-242
    CrossrefPubMedSearch in Google Scholar
  • 34 Pergialiotis V, Kotrogianni P, Christopoulos-Timogiannakis E. et al. Bisphenol A and adverse pregnancy outcomes: a systematic review of the literature. J Matern Fetal Neonatal Med 2018; 31: 3320-3327
    CrossrefPubMedSearch in Google Scholar
  • 35 Janssen BG, Saenen ND, Roels HA. et al. Fetal Thyroid Function, Birth Weight, and in Utero Exposure to Fine Particle Air Pollution: A Birth Cohort Study. Environ Health Perspect 2017; 125: 699-705
    CrossrefPubMedSearch in Google Scholar
  • 36 Zhao X, Peng S, Xiang Y. et al. Correlation between Prenatal Exposure to Polybrominated Diphenyl Ethers (PBDEs) and Infant Birth Outcomes: A Meta-Analysis and an Experimental Study. Int J Environ Res Public Health 2017; 14: 268
    CrossrefPubMedSearch in Google Scholar
  • 37 Li M, Eastman CJ. The changing epidemiology of iodine deficiency. Nat Rev Endocrinol 2012; 8: 434-440
    CrossrefPubMedSearch in Google Scholar
  • 38 Velasco I, Bath SC, Rayman MP. Iodine as Essential Nutrient during the First 1000 Days of Life. Nutrients 2018; 10: 290
    CrossrefPubMedSearch in Google Scholar
  • 39 Bath C. The effect of iodine deficiency during pregnancy on child development. Proc Nutr Soc 2019; 78: 150-160
    CrossrefPubMedSearch in Google Scholar
  • 40 Min H, Dong J, Wang Y. et al. Maternal Hypothyroxinemia-Induced Neurodevelopmental Impairments in the Progeny. Mol Neurobiol 2016; 53: 1613-1624
    CrossrefPubMedSearch in Google Scholar
  • 41 de Escobar GM, Obregón MJ, del Rey FE. Iodine deficiency and brain development in the first half of pregnancy. Public Health Nutr 2007; 10: 1554-1570
    CrossrefPubMedSearch in Google Scholar
  • 42 Chen Y, Xue F. The impact of gestational hypothyroxinemia on the cognitive and motor development of offspring. J Matern Fetal Neonatal Med 2020; 33: 1940-1945
    CrossrefPubMedSearch in Google Scholar
  • 43 Dosiou C, Medici M. Isolated maternal hypothyroxinemia during pregnancy: knowns and unknowns. Eur J Endocrinol 2017; 176: R21-R38
    CrossrefPubMedSearch in Google Scholar
  • 44 Henrichs J, Ghassabian A, Peeters RP. et al. Maternal hypothyroxinemia and effects on cognitive functioning in childhood: how and why?. Clin Endocrinol (Oxf) 2013; 79: 152-162
    CrossrefPubMedSearch in Google Scholar
  • 45 Moleti M, Trimarchi F, Vermiglio F. Doubts and Concerns about Isolated Maternal Hypothyroxinemia. J Thyroid Res 2011; 2011: 463029
    CrossrefPubMedSearch in Google Scholar
  • 46 Glinoer D. The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab 2004; 18: 133-152
    CrossrefPubMedSearch in Google Scholar
  • 47 Mégier C, Dumery G, Luton D. Iodine and Thyroid Maternal and Fetal Metabolism during Pregnancy. Metabolites 2023; 13: 633
    CrossrefPubMedSearch in Google Scholar
  • 48 EFSA NDA Panel (EFSA Panel on Panel on Dietetic Products Nutrition and Allergies). Scientific Opinion on Dietary Reference Values for iodine. EFSA Journal 2014; 12: 3660
    CrossrefPubMedSearch in Google Scholar
  • 49 Korevaar TIM, Medici M, Visser TJ. et al. Thyroid disease in pregnancy: new insights in diagnosis and clinical management. Nat Rev Endocrinol 2017; 13: 610-622
    CrossrefPubMedSearch in Google Scholar
  • 50 Williams GR. Neurodevelopmental and neurophysiological actions of thyroid hormone. J Neuroendocrinol 2008; 20: 784-794
    CrossrefPubMedSearch in Google Scholar
  • 51 World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. 3. Geneva: World Health Organization; 2007. Accessed December 04, 2012 at: https://apps.who.int/iris/handle/10665/43781
    Search in Google Scholar
  • 52 The Iodine Global Network. Global scorecard of iodine nutrition in 2020 in the general population based on school-age children (SAC). Ottawa, Canada: IGN; 2020. Accessed October 20, 2020 at: https://www.ign.org/cm_data/Global-Scorecard-2020-3-June-2020.pdf
    Search in Google Scholar
  • 53 Hey I, Thamm M. Monitoring der Jod- und Natriumversorgung bei Kindern und Jugendlichen im Rahmen der Studie des Robert Koch-Instituts zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS Welle 2). Abschlussbericht. Berlin: Robert Koch-Institut; 2019. Accessed May 14, 2020 at: https://service.ble.de/ptdb/index2.php?detail_id=47144&site_key=145&zeilenzahl_zaehler=592&NextRow=330
    Search in Google Scholar
  • 54 Bundesinstitut für Risikobewertung (BfR). Jodversorgung in Deutschland wieder rückläufig – Tipps für eine gute Jodversorgung. Fragen und Antworten zur Jodversorgung und zur Jodmangelvorsorge. FAQ des BfR vom 20. Februar 2020 (aktualisiert 9. Februar 2021). Accessed October 20, 2023 at: https://www.bfr.bund.de/cm/343/jodversorgung-in-deutschland-wieder-ruecklaeufig-tipps-fuer-eine-gute-jodversorgung.pdf
    PubMed
  • 55 The Iodine Global Network. Global Scorecard of Iodine Nutrition in 2017 in the general population and in pregnant women (PW). Zurich, Switzerland: IGN; Accessed June 09, 2017 at: https://www.ign.org/cm_data/IGN_Global_Scorecard_AllPop_and_PW_May2017.pdf
  • 56 Katko M, Gazso AA, Hircsu I. et al. Thyroglobulin level at week 16 of pregnancy is superior to urinary iodine concentration in revealing preconceptual and first trimester iodine supply. Matern Child Nutr 2018; 14: e12470
    CrossrefPubMedSearch in Google Scholar
  • 57 Candido AC, Morais NS, Dutra LV. et al. Insufficient iodine intake in pregnant women in different regions of the world: a systematic review. Arch Endocrinol Metab 2019; 63: 306-311
    CrossrefPubMedSearch in Google Scholar
  • 58 Baldini E, Virili C, D’Armiento E. et al. Iodine Status in Schoolchildren and Pregnant Women of Lazio, a Central Region of Italy. Nutrients 2019; 11: 1647
    CrossrefPubMedSearch in Google Scholar
  • 59 Medici M, Ghassabian A, Visser W. et al. Women with high early pregnancy urinary iodine levels have an increased risk of hyperthyroid newborns: the population-based Generation R Study. Clin Endocrinol (Oxf) 2014; 80: 598-606
    CrossrefPubMedSearch in Google Scholar
  • 60 Vandevijvere S, Amsalkhir S, Mourri AB. et al. Iodine deficiency among Belgian pregnant women not fully corrected by iodine-containing multivitamins: a national cross-sectional survey. Br J Nutr 2013; 109: 2276-2284
    CrossrefPubMedSearch in Google Scholar
  • 61 Andersen SL, Sørensen LK, Krejbjerg A. et al. Iodine deficiency in Danish pregnant women. Dan Med J 2013; 60: A4657
    PubMedSearch in Google Scholar
  • 62 Global Fortification Data Exchange. Global Fortification Coverage Data. 2021 Accessed March 17, 2025 at: https://www.gfdx.org
    PubMedSearch in Google Scholar
  • 63 Nyström HF, Brantsæter AL, Erlund I. et al. Iodine status in the Nordic countries – past and present. Food Nutr Res 2016; 60: 31969
    CrossrefPubMedSearch in Google Scholar
  • 64 Miles EA, Vahlberg T, Calder PC. et al. Iodine status in pregnant women and infants in Finland. Eur J Nutr 2022; 61: 2919-2927
    CrossrefPubMedSearch in Google Scholar
  • 65 Nazeri P, Mirmiran P, Shiva N. et al. Iodine nutrition status in lactating mothers residing in countries with mandatory and voluntary iodine fortification programs: an updated systematic review. Thyroid 2015; 25: 611-620
    CrossrefPubMedSearch in Google Scholar
  • 66 Manousou S, Andersson M, Eggertsen R. et al. Iodine deficiency in pregnant women in Sweden: a national cross-sectional study. Eur J Nutr 2020; 59: 2535-2545
    CrossrefPubMedSearch in Google Scholar
  • 67 Lindorfer H, Krebs M, Kautzky-Willer A. et al. Iodine deficiency in pregnant women in Austria. Eur J Clin Nutr 2015; 69: 349-354
    CrossrefPubMedSearch in Google Scholar
  • 68 Johner SA, Thamm M, Schmitz R. et al. Examination of iodine status in the German population: an example for methodological pitfalls of the current approach of iodine status assessment. Eur J Nutr 2016; 55: 1275-1282
    CrossrefPubMedSearch in Google Scholar
  • 69 Dold S, Zimmermann MB, Jukic T. et al. Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: A cross-sectional multicenter study. J Nutr 2018; 148: 587-598
    CrossrefPubMedSearch in Google Scholar
  • 70 Ittermann T, Albrecht D, Arohonka P. et al. Standardized Map of Iodine Status in Europe. Thyroid 2020; 30: 1346-1354
    CrossrefPubMedSearch in Google Scholar
  • 71 Eastman CJ, Ma G, Li M. Optimal Assessment and Quantification of Iodine Nutrition in Pregnancy and Lactation: Laboratory and Clinical Methods, Controversies and Future Directions. Nutrients 2019; 11: 2378
    CrossrefPubMedSearch in Google Scholar
  • 72 Trumpff C, De Schepper J, Tafforeau J. et al. Mild iodine deficiency in pregnancy in Europe and its consequences for cognitive and psychomotor development of children: a review. J Trace Elem Med Biol 2013; 27: 174-183
    CrossrefPubMedSearch in Google Scholar
  • 73 Zimmermann M, Delange F. Iodine supplementation of pregnant women in Europe: a review and recommendations. Eur J Clin Nutr 2004; 58: 979-984
    CrossrefPubMedSearch in Google Scholar
  • 74 Chan S, Boelaert K. Optimal management of hypothyroidism, hypothyroxinemia and euthyroid TPO antibody positivity preconception and in pregnancy. Clin Endocrinol (Oxf) 2015; 82: 313-326
    CrossrefPubMedSearch in Google Scholar
  • 75 Dhillon-Smith RK, Boelaert K. Preconception Counseling and Care for Pregnant Women with Thyroid Disease. Endocrinol Metab Clin North Am 2022; 51: 417-436
    CrossrefPubMedSearch in Google Scholar
  • 76 Miranda A, Sousa N. Maternal hormonal milieu influence on fetal brain development. Brain Behav 2018; 8: e00920
    CrossrefPubMedSearch in Google Scholar
  • 77 Costeira MJ, Oliveira P, Santos NC. et al. Psychomotor development of children from an iodine-deficient region. J Pediatr 2011; 159: 447-453
    CrossrefPubMedSearch in Google Scholar
  • 78 Kawahori K, Hashimoto K, Yuan X. et al. Mild Maternal Hypothyroxinemia During Pregnancy Induces Persistent DNA Hypermethylation in the Hippocampal Brain-Derived Neurotrophic Factor Gene in Mouse Offspring. Thyroid 2018; 28: 395-406
    CrossrefPubMedSearch in Google Scholar
  • 79 Ghassabian A, El Marroun H, Peeters RP. et al. Downstream effects of maternal hypothyroxinemia in early pregnancy: nonverbal IQ and brain morphology in school-age children. J Clin Endocrinol Metab 2014; 99: 2383-2390
    CrossrefPubMedSearch in Google Scholar
  • 80 Suárez-Rodríguez M, Azcona-San Julián C, Alzina de Aguilar V. Hypothyroxinemia during pregnancy: the effect on neurodevelopment in the child. Int J Dev Neurosci 2012; 30: 435-438
    CrossrefPubMedSearch in Google Scholar
  • 81 Kasatkina EP, Samsonova LN, Ivakhnenko VN. et al. Gestational hypothyroxinemia and cognitive function in offspring. Neurosci Behav Physiol 2006; 36: 619-624
    CrossrefPubMedSearch in Google Scholar
  • 82 Moog NK, Entringer S, Heim C. et al. Influence of maternal thyroid hormones during gestation on fetal brain development. Neuroscience 2017; 342: 68-100
    CrossrefPubMedSearch in Google Scholar
  • 83 Korevaar TI, Muetzel R, Medici M. et al. Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study. Lancet Diabetes Endocrinol 2016; 4: 35-43
    CrossrefPubMedSearch in Google Scholar
  • 84 Préau L, Fini JB, Morvan-Dubois G. et al. Thyroid hormone signaling during early neurogenesis and its significance as a vulnerable window for endocrine disruption. Biochim Biophys Acta 2015; 1849: 112-121
    CrossrefPubMedSearch in Google Scholar
  • 85 Abel MH, Korevaar TIM, Erlund I. et al. Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women. Thyroid 2018; 28: 1359-1371
    CrossrefPubMedSearch in Google Scholar
  • 86 Alcaide Martin A, Mayerl S. Local Thyroid Hormone Action in Brain Development. Int J Mol Sci 2023; 24: 12352
    CrossrefPubMedSearch in Google Scholar
  • 87 Korevaar TI, Nieboer D, Bisschop PH. et al. Risk factors and a clinical prediction model for low maternal thyroid function during early pregnancy: two population-based prospective cohort studies. Clin Endocrinol (Oxf) 2016; 85: 902-909
    CrossrefPubMedSearch in Google Scholar
  • 88 Berbel P, Mestre JL, Santamaría A. 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: 511-519
    CrossrefPubMedSearch in Google Scholar
  • 89 Mohan V, Sinha RA, Pathak A. et al. Maternal thyroid hormone deficiency affects the fetal neocorticogenesis by reducing the proliferating pool, rate of neurogenesis and indirect neurogenesis. Exp Neurol 2012; 237: 477-488
    CrossrefPubMedSearch in Google Scholar
  • 90 Julvez J, Alvarez-Pedrerol M, Rebagliato M. et al. Thyroxine levels during pregnancy in healthy women and early child neurodevelopment. Epidemiology 2013; 24: 150-157
    CrossrefPubMedSearch in Google Scholar
  • 91 Elahi S, Nagra SA. Low maternal iodine intake and early pregnancy hypothyroxinemia: Possible repercussions for children. Indian J Endocrinol Metab 2014; 18: 526-530
    CrossrefPubMedSearch in Google Scholar
  • 92 Alexander EK, Pearce EN, Brent GA. et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid 2017; 27: 315-389
    CrossrefPubMedSearch in Google Scholar
  • 93 Lazarus J, Brown RS, Daumerie C. et al. 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J 2014; 3: 76-94
    CrossrefPubMedSearch in Google Scholar
  • 94 Thompson W, Russell G, Baragwanath G. et al. Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis. Clin Endocrinol (Oxf) 2018; 88: 575-584
    CrossrefPubMedSearch in Google Scholar
  • 95 Pop VJ, Kuijpens JL, van Baar AL. et al. Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clin Endocrinol (Oxf) 1999; 50: 149-155
    CrossrefPubMedSearch in Google Scholar
  • 96 Pop VJ, Brouwers EP, Vader HL. et al. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol (Oxf) 2003; 59: 282-288
    CrossrefPubMedSearch in Google Scholar
  • 97 Li Y, Shan Z, Teng W. et al. Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25–30 months. Clin Endocrinol (Oxf) 2010; 72: 825-829
    CrossrefPubMedSearch in Google Scholar
  • 98 Henrichs J, Bongers-Schokking JJ, Schenk JJ. et al. Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J Clin Endocrinol Metab 2010; 95: 4227-4234
    CrossrefPubMedSearch in Google Scholar
  • 99 Williams F, Watson J, Ogston S. Scottish Preterm Thyroid Group. et al. Mild maternal thyroid dysfunction at delivery of infants born ≤ 34 weeks and neurodevelopmental outcome at 5.5 years. J Clin Endocrinol Metab 2012; 97: 1977-1985
    CrossrefPubMedSearch in Google Scholar
  • 100 Craig WY, Allan WC, Kloza EM. et al. Mid-gestational maternal free thyroxine concentration and offspring neurocognitive development at age two years. J Clin Endocrinol Metab 2012; 97: E22-E28
    CrossrefPubMedSearch in Google Scholar
  • 101 Päkkilä F, Männistö T, Hartikainen AL. et al. Maternal and Child’s Thyroid Function and Child’s Intellect and Scholastic Performance. Thyroid 2015; 25: 1363-1374
    CrossrefPubMedSearch in Google Scholar
  • 102 Grau G, Aguayo A, Vela A. et al. Normal intellectual development in children born from women with hypothyroxinemia during their pregnancy. J Trace Elem Med Biol 2015; 31: 18-24
    CrossrefPubMedSearch in Google Scholar
  • 103 Kampouri M, Margetaki K, Koutra K. et al. Maternal mild thyroid dysfunction and offspring cognitive and motor development from infancy to childhood: the Rhea mother-child cohort study in Crete, Greece. J Epidemiol Community Health 2021; 75: 29-35
    CrossrefPubMedSearch in Google Scholar
  • 104 Andersen SL, Andersen S, Liew Z. et al. Maternal Thyroid Function in Early Pregnancy and Neuropsychological Performance of the Child at 5 Years of Age. J Clin Endocrinol Metab 2018; 103: 660-670
    CrossrefPubMedSearch in Google Scholar
  • 105 Chevrier J, Harley KG, Kogut K. et al. Maternal Thyroid Function during the Second Half of Pregnancy and Child Neurodevelopment at 6, 12, 24, and 60 Months of Age. J Thyroid Res 2011; 2011: 426427
    CrossrefPubMedSearch in Google Scholar
  • 106 Chen H, Oliver BG, Pant A. et al. Particulate Matter, an Intrauterine Toxin Affecting Foetal Development and Beyond. Antioxidants (Basel) 2021; 10: 732
    CrossrefPubMedSearch in Google Scholar
  • 107 Johnson NM, Hoffmann AR, Behlen JC. et al. Air pollution and Children’s health-a review of adverse effects associated with prenatal exposure from fine to ultrafine particulate matter. Environ Health Prev Med 2021; 26: 72
    CrossrefPubMedSearch in Google Scholar
  • 108 Costa LG, Cole TB, Dao K. et al. Effects of air pollution on the nervous system and its possible role in neurodevelopmental and neurodegenerative disorders. Pharmacol Ther 2020; 210: 107523
    CrossrefPubMedSearch in Google Scholar
  • 109 Ozaki K, Kato D, Ikegami A. et al. Maternal immune activation induces sustained changes in fetal microglia motility. Sci Rep 2020; 10: 21378
    CrossrefPubMedSearch in Google Scholar
  • 110 Street ME, Bernasconi S. Endocrine-Disrupting Chemicals in Human Fetal Growth. Int J Mol Sci 2020; 21: 1430
    CrossrefPubMedSearch in Google Scholar
  • 111 Genc S, Zadeoglulari Z, Fuss SH. et al. The adverse effects of air pollution on the nervous system. J Toxicol 2012; 2012: 782462
    CrossrefPubMedSearch in Google Scholar
  • 112 Bose S, Ross KR, Rosa MJ. et al. Prenatal particulate air pollution exposure and sleep disruption in preschoolers: Windows of susceptibility. Environ Int 2019; 124: 329-335
    CrossrefPubMedSearch in Google Scholar
  • 113 Vandenberg LN, Colborn T, Hayes TB. et al. Hormones and endocrine-disrupting chemicals: low-dose effects and nonmonotonic dose responses. Endocr Rev 2012; 33: 378-455
    CrossrefPubMedSearch in Google Scholar
  • 114 Dutta S, Haggerty DK, Rappolee DA. et al. Phthalate Exposure and Long-Term Epigenomic Consequences: A Review. Front Genet 2020; 11: 405
    CrossrefPubMedSearch in Google Scholar
  • 115 Xin F, Susiarjo M, Bartolomei MS. Multigenerational and transgenerational effects of endocrine disrupting chemicals: A role for altered epigenetic regulation?. Semin Cell Dev Biol 2015; 43: 66-75
    CrossrefPubMedSearch in Google Scholar
  • 116 Daniel S, Balalian AA, Insel BJ. et al. Prenatal and early childhood exposure to phthalates and childhood behavior at age 7 years. Environ Int 2020; 143: 105894
    CrossrefPubMedSearch in Google Scholar
  • 117 Neven KY, Cox B, Cosemans C. et al. Lower iodine storage in the placenta is associated with gestational diabetes mellitus. BMC Med 2021; 19: 47
    CrossrefPubMedSearch in Google Scholar
  • 118 Neven KY, Wang C, Janssen BG. et al. Ambient air pollution exposure during the late gestational period is linked with lower placental iodine load in a Belgian birth cohort. Environ Int 2021; 147: 106334
    CrossrefPubMedSearch in Google Scholar
  • 119 Neven KY, Cox B, Vrijens K. et al. Determinants of placental iodine concentrations in a mild-to-moderate iodine-deficient population: an ENVIRONAGE cohort study. J Transl Med 2020; 18: 426
    CrossrefPubMedSearch in Google Scholar
  • 120 Jacobson JL, Jacobson SW. Intellectual impairment in children exposed to polychlorinated biphenyls in utero. N Engl J Med 1996; 335: 783-789
    CrossrefPubMedSearch in Google Scholar
  • 121 Bouchard MF, Chevrier J, Harley KG. et al. Prenatal exposure to organophosphate pesticides and IQ in 7-year-old children. Environ Health Perspect 2011; 119: 1189-1195
    CrossrefPubMedSearch in Google Scholar
  • 122 Eskenazi B, Kogut K, Huen K. et al. Organophosphate pesticide exposure, PON1, and neurodevelopment in school-age children from the CHAMACOS study. Environ Res 2014; 134: 149-157
    CrossrefPubMedSearch in Google Scholar
  • 123 Yamazaki K, Araki A, Nakajima S. et al. Association between prenatal exposure to organochlorine pesticides and the mental and psychomotor development of infants at ages 6 and 18 months: The Hokkaido Study on Environment and Children’s Health. Neurotoxicology 2018; 69: 201-208
    CrossrefPubMedSearch in Google Scholar
  • 124 Wang S, Hu C, Lu A. et al. Association between prenatal exposure to persistent organic pollutants and neurodevelopment in early life: A mother-child cohort (Shanghai, China). Ecotoxicol Environ Saf 2021; 208: 111479
    CrossrefPubMedSearch in Google Scholar
  • 125 Jeddy Z, Kordas K, Allen K. et al. Prenatal exposure to organochlorine pesticides and early childhood communication development in British girls. Neurotoxicology 2018; 69: 121-129
    CrossrefPubMedSearch in Google Scholar
  • 126 Vermeir G, Covaci A, Van Larebeke N. et al. Neurobehavioural and cognitive effects of prenatal exposure to organochlorine compounds in three year old children. BMC Pediatr 2021; 21: 99
    CrossrefPubMedSearch in Google Scholar
  • 127 Sagiv SK, Thurston SW, Bellinger DC. et al. Prenatal organochlorine exposure and behaviors associated with attention deficit hyperactivity disorder in school-aged children. Am J Epidemiol 2010; 171: 593-601
    CrossrefPubMedSearch in Google Scholar
  • 128 Taylor PN, Okosieme OE, Murphy R. et al. Maternal perchlorate levels in women with borderline thyroid function during pregnancy and the cognitive development of their offspring: data from the Controlled Antenatal Thyroid Study. J Clin Endocrinol Metab 2014; 99: 4291-4298
    CrossrefPubMedSearch in Google Scholar
  • 129 Moore BF, Shapiro AL, Wilkening G. et al. Prenatal Exposure to Tobacco and Offspring Neurocognitive Development in the Healthy Start Study. J Pediatr 2020; 218: 28-34.e2
    CrossrefPubMedSearch in Google Scholar
  • 130 Zhang Q, Chen XZ, Huang X. et al. The association between prenatal exposure to phthalates and cognition and neurobehavior of children-evidence from birth cohorts. Neurotoxicology 2019; 73: 199-212
    CrossrefPubMedSearch in Google Scholar
  • 131 Engel SM, Miodovnik A, Canfield RL. et al. Prenatal phthalate exposure is associated with childhood behavior and executive functioning. Environ Health Perspect 2010; 118: 565-571
    CrossrefPubMedSearch in Google Scholar
  • 132 van den Dries MA, Guxens M, Spaan S. et al. Phthalate and Bisphenol Exposure during Pregnancy and Offspring Nonverbal IQ. Environ Health Perspect 2020; 128: 77009
    CrossrefPubMedSearch in Google Scholar
  • 133 Olesen TS, Bleses D, Andersen HR. et al. Prenatal phthalate exposure and language development in toddlers from the Odense Child Cohort. Neurotoxicol Teratol 2018; 65: 34-41
    CrossrefPubMedSearch in Google Scholar
  • 134 Ramhøj L, Frädrich C, Svingen T. et al. Testing for heterotopia formation in rats after developmental exposure to selected in vitro inhibitors of thyroperoxidase. Environ Pollut 2021; 283: 117135
    CrossrefPubMedSearch in Google Scholar
  • 135 O’Shaughnessy KL, Kosian PA, Ford JL. et al. Developmental Thyroid Hormone Insufficiency Induces a Cortical Brain Malformation and Learning Impairments: A Cross-Fostering Study. Toxicol Sci 2018; 163: 101-115
    CrossrefPubMedSearch in Google Scholar
  • 136 Crofton KM, Gilbert M, Friedman KP. et al. Adverse outcome pathway on inhibition of thyroperoxidase and subsequent adverse neurodevelopmental outcomes in mammals. In: OECD Series on Adverse Outcome Pathways, No. 13. Paris: OECD Publishing; 2019.
    CrossrefSearch in Google Scholar
  • 137 Gibson EA, Siegel EL, Eniola F. et al. Effects of Polybrominated Diphenyl Ethers on Child Cognitive, Behavioral, and Motor Development. Int J Environ Res Public Health 2018; 15: 1636
    CrossrefPubMedSearch in Google Scholar
  • 138 Lam J, Lanphear BP, Bellinger D. et al. Developmental PBDE Exposure and IQ/ADHD in Childhood: A Systematic Review and Meta-analysis. Environ Health Perspect 2017; 125: 086001
    CrossrefPubMedSearch in Google Scholar
  • 139 Vuong AM, Yolton K, Xie C. et al. Childhood polybrominated diphenyl ether (PBDE) exposure and neurobehavior in children at 8 years. Environ Res 2017; 158: 677-684
    CrossrefPubMedSearch in Google Scholar
  • 140 Herbstman JB, Mall JK. Developmental Exposure to Polybrominated Diphenyl Ethers and Neurodevelopment. Curr Environ Health Rep 2014; 1: 101-112
    CrossrefPubMedSearch in Google Scholar
  • 141 Roze E, Meijer L, Bakker A. et al. Prenatal exposure to organohalogens, including brominated flame retardants, influences motor, cognitive, and behavioral performance at school age. Environ Health Perspect 2009; 117: 1953-1958
    CrossrefPubMedSearch in Google Scholar
  • 142 Wang Y, Qian H. Phthalates and Their Impacts on Human Health. Healthcare (Basel) 2021; 9: 603
    CrossrefPubMedSearch in Google Scholar
  • 143 Charatcharoenwitthaya N, Ongphiphadhanakul B, Pearce EN. et al. The association between perchlorate and thiocyanate exposure and thyroid function in first-trimester pregnant Thai women. J Clin Endocrinol Metab 2014; 99: 2365-2371
    CrossrefPubMedSearch in Google Scholar
  • 144 Berghuis SA, Soechitram SD, Hitzert MM. et al. Prenatal exposure to polychlorinated biphenyls and their hydroxylated metabolites is associated with motor development of three-month-old infants. Neurotoxicology 2013; 38: 124-130
    CrossrefPubMedSearch in Google Scholar
  • 145 Crofton KM, Zoeller RT. Mode of action: neurotoxicity induced by thyroid hormone disruption during development--hearing loss resulting from exposure to PHAHs. Crit Rev Toxicol 2005; 35: 757-769
    CrossrefPubMedSearch in Google Scholar
  • 146 Paul KB, Hedge JM, Bansal R. et al. Developmental triclosan exposure decreases maternal, fetal, and early neonatal thyroxine: a dynamic and kinetic evaluation of a putative mode-of-action. Toxicology 2012; 300: 31-45
    CrossrefPubMedSearch in Google Scholar
  • 147 Wang X, Ouyang F, Feng L. et al. Maternal Urinary Triclosan Concentration in Relation to Maternal and Neonatal Thyroid Hormone Levels: A Prospective Study. Environ Health Perspect 2017; 125: 067017
    CrossrefPubMedSearch in Google Scholar
  • 148 Johannes J, Jayarama-Naidu R, Meyer F. et al. Silychristin, a Flavonolignan Derived From the Milk Thistle, Is a Potent Inhibitor of the Thyroid Hormone Transporter MCT8. Endocrinology 2016; 157: 1694-1701
    CrossrefPubMedSearch in Google Scholar
  • 149 Ruel MVM, Bos AF, Soechitram SD. et al. Prenatal exposure to organohalogen compounds and Children’s mental and motor development at 18 and 30 months of age. Neurotoxicology 2019; 72: 6-14
    CrossrefPubMedSearch in Google Scholar
  • 150 Santoro A, Chianese R, Troisi J. et al. Neuro-toxic and Reproductive Effects of BPA. Curr Neuropharmacol 2019; 17: 1109-1132
    CrossrefPubMedSearch in Google Scholar
  • 151 Gaberšček S, Zaletel K. Epidemiological trends of iodine-related thyroid disorders: an example from Slovenia. Arh Hig Rada Toksikol 2016; 67: 93-98
    CrossrefPubMedSearch in Google Scholar
  • 152 Román GC. Autism: transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents. J Neurol Sci 2007; 262: 15-26
    CrossrefPubMedSearch in Google Scholar
  • 153 Lewandowski TA, Peterson MK, Charnley G. Iodine supplementation and drinking-water perchlorate mitigation. Food Chem Toxicol 2015; 80: 261-270
    CrossrefPubMedSearch in Google Scholar
  • 154 Leung AM, Pearce EN, Braverman LE. Environmental perchlorate exposure: potential adverse thyroid effects. Curr Opin Endocrinol Diabetes Obes 2014; 21: 372-376
    CrossrefPubMedSearch in Google Scholar
  • 155 Ozpinar A, Kelestimur F, Songur Y. et al. Iodine status in Turkish populations and exposure to iodide uptake inhibitors. PLoS One 2014; 9: e88206
    CrossrefPubMedSearch in Google Scholar
  • 156 Suh M, Abraham L, Hixon JG. et al. The effects of perchlorate, nitrate, and thiocyanate on free thyroxine for potentially sensitive subpopulations of the 2001–2002 and 2007–2008 National Health and Nutrition Examination Surveys. J Expo Sci Environ Epidemiol 2014; 24: 579-587
    CrossrefPubMedSearch in Google Scholar
  • 157 Lumen A, Mattie DR, Fisher JW. Evaluation of perturbations in serum thyroid hormones during human pregnancy due to dietary iodide and perchlorate exposure using a biologically based dose-response model. Toxicol Sci 2013; 133: 320-341
    CrossrefPubMedSearch in Google Scholar
  • 158 Kim MJ, Park YJ. Bisphenols and Thyroid Hormone. Endocrinol Metab (Seoul) 2019; 34: 340-348
    CrossrefPubMedSearch in Google Scholar
  • 159 World Health Organization. WHO global air quality guidelines: particulate matter (‎PM2.5 and PM10)‎, ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide: executive summary. Geneva: World Health Organization; 2021. Accessed October 02, 2021 at: https://apps.who.int/iris/handle/10665/345334
    Search in Google Scholar
  • 160 World Health Organization. WHO Fact sheets Ambient (outdoor) air quality and health. 22.09.2021. Geneva, Switzerland: World Health Organization; Accessed September 30, 2021 at: https://www.who.int/en/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health
    Search in Google Scholar
  • 161 Burnett R, Chen H, Szyszkowicz M. et al. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter. Proc Natl Acad Sci U S A 2018; 115: 9592-9597
    CrossrefPubMedSearch in Google Scholar
  • 162 Chen H, Oliver BG, Pant A. et al. Particulate matter, an intrauterine toxin affecting foetal development and beyond. Antioxidants (Basel) 2021; 10: 732
    CrossrefPubMedSearch in Google Scholar
  • 163 Block ML, Elder A, Auten RL. et al. The outdoor air pollution and brain health workshop. Neurotoxicology 2012; 33: 972-984
    CrossrefPubMedSearch in Google Scholar
  • 164 Loftus CT, Ni Y, Szpiro AA. et al. Exposure to ambient air pollution and early childhood behavior: A longitudinal cohort study. Environ Res 2020; 183: 109075
    CrossrefPubMedSearch in Google Scholar
  • 165 Peterson BS, Rauh VA, Bansal R. et al. Effects of prenatal exposure to air pollutants (polycyclic aromatic hydrocarbons) on the development of brain white matter, cognition, and behavior in later childhood. JAMA Psychiatry 2015; 72: 531-540
    CrossrefPubMedSearch in Google Scholar
  • 166 Lubczyńska MJ, Muetzel RL, El Marroun H. et al. Exposure to Air Pollution during Pregnancy and Childhood, and White Matter Microstructure in Preadolescents. Environ Health Perspect 2020; 128: 27005
    CrossrefPubMedSearch in Google Scholar
  • 167 Guxens M, Lubczyńska MJ, Muetzel RL. et al. Air Pollution Exposure During Fetal Life, Brain Morphology, and Cognitive Function in School-Age Children. Biol Psychiatry 2018; 84: 295-303
    CrossrefPubMedSearch in Google Scholar
  • 168 Lee SY, Pearce EN. Testing, Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy. J Clin Endocrinol Metab 2021; 106: 883-892
    CrossrefPubMedSearch in Google Scholar
  • 169 Leung AM. No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years. Clin Thyroidol 2018; 30: 100-103
    CrossrefPubMedSearch in Google Scholar
  • 170 Runkle I, de Miguel MP, Barabash A. et al. Early Levothyroxine Treatment for Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy: The St Carlos Gestational and Thyroid Protocol. Front Endocrinol (Lausanne) 2021; 12: 743057
    CrossrefPubMedSearch in Google Scholar
  • 171 Robinson SM, Crozier SR, Miles EA. et al. Preconception Maternal Iodine Status Is Positively Associated with IQ but Not with Measures of Executive Function in Childhood. J Nutr 2018; 148: 959-966
    CrossrefPubMedSearch in Google Scholar
  • 172 Dineva M, Fishpool H, Rayman MP. et al. Systematic review and meta-analysis of the effects of iodine supplementation on thyroid function and child neurodevelopment in mildly-to-moderately iodine-deficient pregnant women. Am J Clin Nutr 2020; 112: 389-412
    CrossrefPubMedSearch in Google Scholar
  • 173 Machamba AAL, Azevedo FM, Fracalossi KO. et al. Effect of iodine supplementation in pregnancy on neurocognitive development on offspring in iodine deficiency areas: a systematic review. Arch Endocrinol Metab 2021; 65: 352-367
    CrossrefPubMedSearch in Google Scholar
  • 174 Nazeri P, Shariat M, Azizi F. Effects of iodine supplementation during pregnancy on pregnant women and their offspring: a systematic review and meta-analysis of trials over the past 3 decades. Eur J Endocrinol 2021; 184: 91-106
    CrossrefPubMedSearch in Google Scholar
  • 175 Harding KB, Peña-Rosas JP, Webster AC. et al. Iodine supplementation for women during the preconception, pregnancy and postpartum period. Cochrane Database Syst Rev 2017; 3 (03) CD011761
    CrossrefPubMedSearch in Google Scholar
  • 176 Verhagen NJE, Gowachirapant S, Winichagoon P. et al. Iodine Supplementation in Mildly Iodine-Deficient Pregnant Women Does Not Improve Maternal Thyroid Function or Child Development: A Secondary Analysis of a Randomized Controlled Trial. Front Endocrinol (Lausanne) 2020; 11: 572984
    CrossrefPubMedSearch in Google Scholar
  • 177 Manousou S, Eggertsen R, Hulthén L. et al. A randomized, double-blind study of iodine supplementation during pregnancy in Sweden: pilot evaluation of maternal iodine status and thyroid function. Eur J Nutr 2021; 60: 3411-3422
    CrossrefPubMedSearch in Google Scholar
  • 178 Lopes-Pereira M, Roque S, Costa P. et al. Impact of iodine supplementation during preconception, pregnancy and lactation on maternal thyroid homeostasis and offspring psychomotor development: protocol of the IodineMinho prospective study. BMC Pregnancy Childbirth 2020; 20: 693
    CrossrefPubMedSearch in Google Scholar
  • 179 Bell MA, Ross AP, Goodman G. Assessing infant cognitive development after prenatal iodine supplementation. Am J Clin Nutr 2016; 104 (Suppl. 3) 928S-9234S
    CrossrefPubMedSearch in Google Scholar
  • 180 Troendle JF. Statistical design considerations applicable to clinical trials of iodine supplementation in pregnant women who may be mildly iodine deficient. Am J Clin Nutr 2016; 104 (Suppl. 3) 924S-927S
    CrossrefPubMedSearch in Google Scholar
  • 181 Schaffner M, Mühlberger N, Conrads-Frank A. et al. Benefits and Harms of a Prevention Program for Iodine Deficiency Disorders: Predictions of the Decision-Analytic EUthyroid Model. Thyroid 2021; 31: 494-508
    CrossrefPubMedSearch in Google Scholar
  • 182 Volzke H, Erlund I, Grunert I. et al. The Krakow Declaration on Iodine: Tasks and Responsibilities for Prevention Programs Targeting Iodine Deficiency Disorders. Eur Thyroid J 2018; 7: 201-204
    CrossrefPubMedSearch in Google Scholar