Prenatal and Postpartum Maternal Iodide Intake from Diet and Supplements, Urinary Iodine and Thyroid Hormone Concentrations in a Region of the United Kingdom with Mild-to-Moderate Iodine Deficiency

Iodine is essential for normal thyroid function, supporting healthy fetal and child development. Io-dine requirements increase in pregnancy, but many women in regions without salt iodisation have insufficient intakes. We explored associations between iodide intake and urinary iodine concentra-tion (UIC), urinary iodine:creatinine ratio (I:Cr), thyroid stimulating hormone, thyroglobulin, free triiodothyronine, free thyroxine and palpable goiter in a region of mild-to-moderate iodine insufficiency. 246 pregnant women aged 18-40 in Bradford, UK, joined the Health and Iodine in Babies (Hiba) study. They provided detailed information on diet and supplement use, urine and serum samples and were assessed for goiter, at around 12, 26 and 36 weeks gestation, and 6, 18 and 30 weeks postpartum. Dietary iodide intake from food and drink was estimated using six 24-hour re-calls. During pregnancy, median (IQR) dietary iodide intake was 101µg/day (54, 142), with 42% from dairy and 9% white fish. Including supplements, intake was 143µg/day (94, 196), with 49% < UK reference nutrient intake (140µg/day). Women with Pakistani heritage had 129µg/day (87, 190) median total intake. Total intake during pregnancy was associated with 4% (95% CI: 1%, 7%) high-er UIC, 5% (3%, 7%) higher I:Cr, 4% (2%, 6%) lower thyroglobulin and 21% (9%, 32%) lower odds of palpable goiter per 50µg/day. This cohort consumed less iodide in pregnancy than UK and World Health Organization dietary recommendations. UIC, I:Cr and thyroglobulin were associated with intake. Higher intake was associated with fewer goiters. Because dairy was the dominant source of iodide, women following plant-based or low-dairy diets may be at particular risk of iodine insufficiency.