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Accepted manuscript

Serum Iodine Concentration as a Biomarker for Individual Iodine Nutrition and Thyroid Function in Pregnant Women: A Cross-Sectional Study in Hubei Province

Published online by Cambridge University Press:  24 June 2026

Mingjuan Xu ,
Xin Dai ,
Zhen Wang ,
Chong Guo ,
Biyun Zhang  and
Huailan Guo Open the ORCID record for Huailan Guo [Opens in a new window]
Mingjuan Xu
Affiliation:
School of Public Health, Hubei University of Medicine, Shiyan, 442000, China
Xin Dai
Affiliation:
Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
Zhen Wang
Affiliation:
National medicine Dongfeng Maojian hospital, Shiyan, 442000, China
Chong Guo
Affiliation:
Department of Obstetrics and Gynecology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China
Biyun Zhang*
Affiliation:
Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
Huailan Guo*
Affiliation:
School of Public Health, Hubei University of Medicine, Shiyan, 442000, China Research Center of Environment and Health of South-to-North Water Diversion Area, Hubei University of Medicine, Shiyan, 442000, China
*
*Corresponding authors: guohuailan@hbmu.edu.cn (H. Guo), zhbiyun.hbcdc@outlook.com (B. Zhang)
*Corresponding authors: guohuailan@hbmu.edu.cn (H. Guo), zhbiyun.hbcdc@outlook.com (B. Zhang)
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Abstract

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Objective:

The physiological demands of pregnancy substantially alter iodine metabolism and thyroid function. This critical period heightens the requirement for iodine, making deficiency a significant risk factor for both maternal and fetal thyroid dysfunction. This study aimed to evaluate the iodine nutritional status of pregnant women in Hubei Province, explore the relationship between serum iodine concentration (SIC) and thyroid function, and determine the prevalence of thyroid disorders.

Design:

The eligible participants underwent a face-to-face interview and completed questionnaire surveys to collect baseline information and dietary intake data. Serum thyroid hormones, thyroid antibodies, SIC, and urine iodine concentration (UIC) were measured. The 95% reference intervals of SIC were established and ROC analysis was applied to compare the predictive ability of SIC and UIC for thyroid dysfunction.

Setting:

Hubei Province, China.

Participants:

1197 eligible pregnant women were included in this study.

Results:

This study revealed a thyroid dysfunction prevalence of 28.40%, with hypothyroxinemia being the most prevalent thyroid function abnormality, accounting for 79.7% of all thyroid dysfunction cases. Significant differences in hypothyroxinemia prevalence were noted across pregnancy trimesters (P < 0.001), with the highest prevalence in the first trimester and the lowest in the third. In the first trimester, SIC was negatively correlated with TSH (r = –0.195, P < 0.001) and positively correlated with FT3 (r = 0.294, P < 0.001). Additionally, SIC demonstrated a positive correlation with FT4 in each trimester (all P < 0.001). Finally, the SIC reference intervals for pregnant women in the first, second, and third trimesters were 50.08∼118.61 µg/L, 59.16∼127.44 µg/L, and 53.61∼118.67 µg/L, respectively.

Conclusions:

SIC can serve as a reliable indicator for evaluating individual iodine nutritional status and predicting thyroid dysfunction.

Keywords

Pregnant womenIodine nutritionSerum iodineUrinary iodineThyroid function

Information

Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 32
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society

Footnotes

†

These authors contributed equally to this work.