August 10, 2015

expert reaction to study looking at iodine supplementation in pregnancy and estimated health care cost savings

A team of researchers, writing in The Lancet Diabetes and Endocrinology, have examined the cost effectiveness of iodine supplementation compared to no supplementation in pregnant women, who are mildly to moderately iodine deficient. They report that iodine supplementation for pregnant women in the UK is potentially cost saving.

Dr Channa Jayasena, Clinical Senior Lecturer in Reproductive Endocrinology, Hammersmith Hospital, Imperial College London & Imperial College Healthcare NHS Trust, said:

“This fascinating study uses data from several international studies to propose that iodine supplementation during pregnancy may boost a child’s IQ marginally.

“This study supports organisations already advocating iodine supplementation. However as the authors correct state, it is uncertain how applicable the results would be to the UK. Furthermore, it is important to emphasise that if the results were confirmed, a 1 point IQ increase is very small when compared with other factors that make up a person’s intelligence.”

Dr Mark Vanderpump, Consultant Physician and Honorary Senior Lecturer in Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, said:

“Mild to moderate maternal iodine deficiency during pregnancy, at levels seen in UK women, is associated with impaired child cognition.

“No completed randomised clinical trials have assessed the effects of maternal iodine supplementation on child cognition in mildly-to-moderately iodine-deficient regions. The ideal clinical trial might not be possible due to ethical concerns regarding a placebo group.

“This paper has performed an economic analysis which argues in favour of iodine supplementation for pregnant and lactating women in the UK. It has been estimated that tablet supplements would be cost saving from health service (saving £199 per woman) and societal perspectives (saving £4476 per woman), with a net gain of 1-22 IQ points in the child.

“The optimum long-term approach to UK iodine nutrition remains uncertain. A national plan to monitor urinary iodine concentrations in pregnant women should be prioritised with the aim of considering iodine supplementation.”

* ‘Costs and benefits of iodine supplementation for pregnant women in a mildly to moderately iodine-deficient population: a modelling analysis’ by Mark Monahan et al. published in the Lancet Diabetes & Endocrinology on Monday 10 August 2015.

Declared interests

Dr Channa Jayasena: “I have received funding from the Wellcome Trust, NIHR, Medical Research Council, SFE, Academy of Medical Sciences. Member of Royal College of Physicians, London; Royal College of Pathologists of London. No financial interest.”

Dr Mark Vanderpump declares no interests.