{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:05:50Z","timestamp":1782968750319,"version":"3.54.5"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004271","name":"Sapienza University of Rome","doi-asserted-by":"publisher","award":["RM1201725B998E3F"],"award-info":[{"award-number":["RM1201725B998E3F"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004271","name":"Sapienza University of Rome","doi-asserted-by":"publisher","award":["1288760\/21"],"award-info":[{"award-number":["1288760\/21"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003770","name":"Bank of Italy","doi-asserted-by":"publisher","award":["RM1201725B998E3F"],"award-info":[{"award-number":["RM1201725B998E3F"]}],"id":[{"id":"10.13039\/501100003770","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003770","name":"Bank of Italy","doi-asserted-by":"publisher","award":["1288760\/21"],"award-info":[{"award-number":["1288760\/21"]}],"id":[{"id":"10.13039\/501100003770","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Adequate iodine intake is of crucial importance in pregnancy to meet the thyroid hormone needs of both mother and fetus. In the present study, undertaken as a part of the surveillance actions following the introduction in Italy of a national salt iodination program in 2005, the iodine intake was investigated in 123 pregnant women and 49 control women living in the same area of central Italy. All the participants were screened for urinary iodine concentration (UIC), serum level of thyrotropin, free-thyroxine, free-triiodothyronine, and thyroid volume. Moreover, they were provided with a questionnaire on the use of iodine-containing salt or supplements. Control women had a median UIC of 102 \u00b5g\/L, consistent with an iodine sufficiency, while in pregnant women the median UIC value was 108 \u00b5g\/L, lower than the endorsed UIC of 150 \u00b5g\/L. In addition, pregnant women showed a significantly increased median thyroid volume compared to controls. Interestingly, the median UIC did not differ between pregnant women not using iodine-containing salt or supplements and those regularly consuming iodized salt alone, while pregnant women with a daily intake of iodine-containing supplements had an adequate median UIC (168 \u00b5g\/L). In conclusion, the data reported here showed that pregnant women and their fetuses are still exposed to the detrimental effects of iodine deficiency and that the consumption of iodine-containing supplements should be recommended in pregnancy.<\/jats:p>","DOI":"10.3390\/nu15194182","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T01:51:14Z","timestamp":1695865874000},"page":"4182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Iodized Salt May Not Be Sufficient to Guarantee an Adequate Iodine Intake in Pregnant Women"],"prefix":"10.3390","volume":"15","author":[{"given":"Vincenzo","family":"Spina","sequence":"first","affiliation":[{"name":"Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8999-1386","authenticated-orcid":false,"given":"Enke","family":"Baldini","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Cardarelli","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo","family":"Oliva","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, \u201cS. 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Camillo De Lellis\u201d Hospital, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1943-4952","authenticated-orcid":false,"given":"Eleonora","family":"Lori","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Renzi","sequence":"additional","affiliation":[{"name":"Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Feroci","sequence":"additional","affiliation":[{"name":"Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Mastrodonato","sequence":"additional","affiliation":[{"name":"Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Ciferri","sequence":"additional","affiliation":[{"name":"Mother and Infant Department Unit, ASL-Rieti, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Virili","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, \u201cSapienza\u201d University of Rome, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-1649","authenticated-orcid":false,"given":"Marco","family":"Centanni","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, \u201cSapienza\u201d University of Rome, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-2550","authenticated-orcid":false,"given":"Cristina","family":"Fabiani","sequence":"additional","affiliation":[{"name":"Mother and Infant Department, \u201cSandro Pertini\u201d Hospital, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Rago","sequence":"additional","affiliation":[{"name":"Mother and Infant Department, \u201cSandro Pertini\u201d Hospital, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Carlo","family":"Schiavi","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, \u201cSandro Pertini\u201d Hospital, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Palazzetti","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, \u201cSandro Pertini\u201d Hospital, 00157 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"D\u2019Armiento","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and and Medical Specialties, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Cantisani","sequence":"additional","affiliation":[{"name":"Department of Radiological and Oncological Sciences and Pathological Anatomy, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"},{"name":"Teleradiology Complex Unit, ASL-Rieti, 02100 Rieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0427-6648","authenticated-orcid":false,"given":"Salvatore","family":"Sorrenti","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-0759","authenticated-orcid":false,"given":"Salvatore","family":"Ulisse","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sorrenti, S., Baldini, E., Pironi, D., Lauro, A., D\u2019Orazi, V., Tartaglia, F., Tripodi, D., Lori, E., Gagliardi, F., and Pratic\u00f2, M. (2021). Iodine: Its role in thyroid hormone biosynthesis and beyond. Nutrients, 13.","DOI":"10.3390\/nu13124469"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1097\/GRF.0000000000000428","article-title":"Iodine deficiency and supplementation in pregnancy","volume":"62","author":"Chittimoju","year":"2019","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1089\/thy.2005.15.54","article-title":"Thyroid function inside and outside of pregnancy: What do we know and what don\u2019t we know?","volume":"15","author":"Smallridge","year":"2005","journal-title":"Thyroid"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1210\/jc.2011-2803","article-title":"Management of thyroid dysfunction during pregnancy and postpartum: An Endocrine Society clinical practice guideline","volume":"97","author":"Abalovich","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","unstructured":"World Health Organization, United Nations Children\u2019s Fund, and International Council for the Control of Iodine Deficiency Disorders (2007). Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"347S","DOI":"10.1093\/advances\/nmy020","article-title":"Iodine in Human Milk: A Systematic Review","volume":"9","author":"Dror","year":"2018","journal-title":"Adv. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/S0140-6736(83)90636-0","article-title":"Iodine deficiency disorders (IDD) and their eradication","volume":"2","author":"Hetzel","year":"1983","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/S0140-6736(08)61005-3","article-title":"Iodine-deficiency disorders","volume":"372","author":"Zimmermann","year":"2008","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S0140-6736(71)91040-3","article-title":"Neurological damage to the fetus resulting from severe iodine deficiency during pregnancy","volume":"1","author":"Pharoah","year":"1971","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1136\/pmj.77.906.217","article-title":"Iodine deficiency as a cause of brain damage","volume":"77","author":"Delange","year":"2001","journal-title":"Postgrad. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1007\/s12035-018-1270-y","article-title":"Hypothyroidism and cognitive disorders during development and adulthood: Implications in the central nervous system","volume":"56","author":"Salazar","year":"2019","journal-title":"Mol. Neurobiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1056\/NEJM199908193410801","article-title":"Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child","volume":"341","author":"Haddow","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S2213-8587(19)30153-6","article-title":"Maternal thyroid function during pregnancy and child brain morphology: A time window-specific analysis of a prospective cohort","volume":"7","author":"Jansen","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/S2213-8587(15)00263-6","article-title":"Iodine deficiency in pregnant women in Europe","volume":"3","author":"Zimmermann","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1079\/PHN2002366","article-title":"Urinary iodine excretion in pregnant women residing in areas with adequate iodine intake","volume":"6","author":"Azizi","year":"2003","journal-title":"Public Health Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/BF03347244","article-title":"Attention to the hiding iodine deficiency in pregnant and lactating women after universal salt iodination: A multi-community study in China","volume":"28","author":"Yan","year":"2005","journal-title":"J. Endocrinol. Investig."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.nut.2008.01.015","article-title":"Iodine deficiency in pregnant women residing in an area with adequate iodine intake","volume":"24","author":"Marchioni","year":"2008","journal-title":"Nutrition"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"The Public Health Committee of the America Thyroid Association (2006). Iodine supplementation for pregnancy and lactation\u2014United States and Canada: Recommendations of the American Thyroid Association. Thyroid, 16, 949\u2013951.","DOI":"10.1089\/thy.2006.16.949"},{"key":"ref_19","unstructured":"Iodine Global Network (2021). Global Scorecard of Iodine Nutrition in 2020 in the General Population Based on Schoolage Children, IGN. Available online: https:\/\/www.ign.org\/scorecard.htm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1007\/s40618-020-01402-6","article-title":"Global iodine nutrition 2020: Italy is an iodine sufficient country","volume":"43","author":"Olivieri","year":"2020","journal-title":"J. Endocrinol. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1093\/ajcn\/nqz206","article-title":"The iodine nutritional status in the Italian population: Data from the Italian National Observatory for Monitoring Iodine Prophylaxis (OSNAMI) (period 2015\u20132019)","volume":"110","author":"Olivieri","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.nut.2015.12.033","article-title":"Consumption of iodized salt may not represent a reliable indicator of iodine adequacy: Evidence from a cross-sectional study on schoolchildren living in an urban area of central Italy","volume":"32","author":"Coccaro","year":"2016","journal-title":"Nutrition"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.nut.2017.11.007","article-title":"Iodine deficiency in pregnancy: Still a health issue for the women of Cassino city, Italy","volume":"50","author":"Tuccilli","year":"2018","journal-title":"Nutrition"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Baldini, E., Virili, C., D\u2019Armiento, E., Centanni, M., and Ulisse, S. (2019). Iodine status in schoolchildren and pregnant women of Lazio, a central region of Italy. Nutrients, 11.","DOI":"10.3390\/nu11071647"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1210\/jc.2007-0141","article-title":"Management of thyroid dysfunction during pregnancy and post-partum: An Endocrine Society clinical practice guideline","volume":"92","author":"Abalovich","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1210\/jc.2015-3519","article-title":"The urine iodine to creatinine as an optimal index of iodine during pregnancy in an iodine adequate area in China","volume":"101","author":"Li","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/S0002-9378(11)80004-9","article-title":"The effects of iodoprophylaxis on thyroid size during pregnancy","volume":"164","author":"Romano","year":"1991","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/j.1365-2265.1994.tb02560.x","article-title":"Thyroid function and thyroid size in normal pregnant women living in an iodine replete area","volume":"41","author":"Berghout","year":"1994","journal-title":"Clin. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/jn\/nxy015","article-title":"Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: A cross-sectional multicenter study","volume":"148","author":"Dold","year":"2018","journal-title":"J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1017\/S1368980007360965","article-title":"The impact of iodized salt or iodine supplements on iodine status during pregnancy, lactation and infancy","volume":"10","author":"Zimmermann","year":"2007","journal-title":"Public Health Nutr."},{"key":"ref_31","first-page":"87","article-title":"Aggiornamento sulla nutrizione iodica in Italia: I risultati della seconda sorveglianza dell\u2019Osservatorio per il Monitoraggio della Iodoprofilassi in Italia-OSNAMI (2015\u20132019)","volume":"23","author":"Rotondi","year":"2022","journal-title":"L\u2019Endocrinologo"},{"key":"ref_32","unstructured":"Food and Nutrition Board, Institute of Medicine (2001). Dietary Reference Intakes, National Academy Press."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Wang, Z., Zhu, W., Mo, Z., Wang, Y., Mao, G., Wang, X., and Lou, X. (2017). An increase in consuming adequately iodized salt may not be enough to rectify iodine deficiency in pregnancy in an iodine-sufficient area of China. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14020206"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"432","DOI":"10.3389\/fendo.2018.00432","article-title":"Gestational TSH and FT4 reference intervals in chinese women: A systematic review and meta-analysis","volume":"9","author":"Gao","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1080\/09513590.2017.1320375","article-title":"Serum thyroid hormone levels among chinese pregnant women","volume":"33","author":"Yu","year":"2017","journal-title":"Gynecol. Endocrinol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/00045632211063142","article-title":"Establishment of trimester-specific reference intervals for thyroid stimulating hormone and free thyroxine during pregnancy in southwest China by indirect method","volume":"59","author":"Guo","year":"2022","journal-title":"Ann. Clin. Biochem."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1080\/10408363.2022.2050182","article-title":"Evaluating thyroid function in pregnant women","volume":"59","author":"Geno","year":"2022","journal-title":"Crit. Rev. Clin. Lab. Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/19\/4182\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:00:02Z","timestamp":1760130002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/19\/4182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,27]]},"references-count":37,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["nu15194182"],"URL":"https:\/\/doi.org\/10.3390\/nu15194182","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,27]]}}}