Universal Iodine Supplementation Recommended During Pregnancy

Giving all pregnant women iodine supplements, even in mildly iodine deficient countries, could result in huge cost savings for health care systems and society in general, according to a new study.

Researchers at the University of Birmingham (United Kingdom) and the National University of Singapore (NUS; Singapore) systematically searched MEDLINE, Embase, EconLit, and other sources for economic studies that linked IQ and income to investigate the cost-effectiveness of iodine supplementation for pregnant women in a mildly to moderately iodine-deficient population. In all, 1,361 published articles were reviewed, and clinical data relating to iodine deficiency in pregnant women and the effect on IQ in their children were extracted.

A decision tree was developed to compare the treatment strategies of iodine supplementation in tablet form, compared to no iodine supplementation for pregnant women in the UK. Modeling analyses were then done from both a health service perspective and societal perspective, presented in terms of cost per IQ point gained in the offspring. Data-supported assumptions were used in a conservative approach, which limited the benefits of iodine supplementation and overestimated its potential harms.

The results estimated the lifetime value of an additional IQ point at GBP 3,297 for the offspring cohort. Iodine supplementation presented a cost saving from both a health service perspective (GBP 199 per pregnant woman), and societal perspective (GBP 4,476 per pregnant woman), based on a net gain of 1.22 IQ points. The estimates were derived from projected increased lifetime earnings and lower public sector costs. According to the researchers, the findings have implications for 1.88 billion people in the 32 countries with iodine deficiency. The study was published on August 9, 2015, in the Lancet Diabetes & Endocrinology.

“Iodine deficiency in pregnancy remains the leading cause of preventable retardation worldwide. Even mild iodine deficiency during pregnancy is associated with children with lower IQs,” said study coauthor Professor of Public Health Kate Jolly, PhD, of the University of Birmingham. “It's time for all women living in iodine deficient countries without universal supplementation of iodine, who are pregnant, breastfeeding, or planning a pregnancy to be advised to take a daily supplement containing iodine.”

Iodine is not produced naturally in the body and must be consumed by eating dairy and seafood, or by supplementation. Severe iodine deficiency during pregnancy can cause substantial mental impairment and delayed development in children, resulting in a lower IQ and consequently lower educational attainment and earning potential. International health organizations such as the World Health Organization (WHO; Geneva, Switzerland) the European Food Safety Authority (EFSA; Parma, Italy) recommend that pregnant and breastfeeding women take daily iodine supplements.

Related Links:
University of Birmingham
National University of Singapore
World Health Organization