Maternal iodine status in a multi-ethnic UK birth cohort: associations with autism spectrum disorder

Publication authors

Kirsten Jade Cromie, Diane Erin Threapleton, Charles Jonathan Peter Snart, Elizabeth Taylor, Dan Mason, Barry Wright, Brian Kelly, Stephen Reid, Rafaq Azad, Claire Keeble, Amanda H. Waterman, Sarah Meadows, Amanda McKillion, Nisreen A. Alwan, Janet Elizabeth Cade, Nigel A. B. Simpson, Paul M. Stewart, Michael Zimmermann, John Wright, Dagmar Waiblinger, Mark Mon-Williams, Laura J. Hardie & Darren Charles Greenwood

Abstract

Background

Maternal iodine requirements increase during pregnancy to supply thyroid hormones essential for fetal brain development. Maternal iodine deficiency can lead to hypothyroxinemia, a reduced fetal supply of thyroid hormones which, in the first trimester, has been linked to an increased risk of autism spectrum disorder (ASD) in the child. No study to date has explored the direct link between maternal iodine deficiency and diagnosis of ASD in offspring.

Methods

Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6955 mothers at 26–28 weeks gestation participating in the Born in Bradford (BiB) cohort. Maternal iodine status was examined in relation to the probability of a Read (CTV3) code for autism being present in a child’s primary care records through a series of logistic regression models with restricted cubic splines.

Results

Median (inter-quartile range) UIC was 76 μg/L (46, 120) and I:Cr was 83 μg/g (59, 121) indicating a deficient population according to WHO guidelines. Ninety two children (1·3%) in our cohort had received a diagnosis of ASD by the census date. Overall, there was no evidence to support an association between I:Cr or UIC and ASD risk in children aged 8–12 years (p = 0·3).

Conclusions

There was no evidence of an increased clinical ASD risk in children born to mothers with mild-to-moderate iodine deficiency at 26 weeks gestation. Alternative functional biomarkers of exposure and a wider range of conditions may provide further insight.