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Iodine supplements in pregnancy ‘would save NHS cash’

Daily dose would boost children's IQ scores and cause health improvements, study suggests

Mark Gould

Tuesday, 11 August 2015

Recommending iodine supplements to all pregnant women could save the NHS money, say researchers.

A study* in The Lancet Diabetes & Endocrinology by researchers from the University of Birmingham concluded that if all pregnant women took a daily dose, it could boost children's IQ scores, causing health improvements. A previous UK study of around 1,000 pregnant women, published in 2013, found that around two-thirds could be classed as mildly to moderately deficient in iodine. Lower levels of iodine during pregnancy were subsequently linked with slightly poorer IQ and reading scores when the children were eight years old. In the latest study, researchers calculated the potential impact of all women taking iodine supplements before conception, during pregnancy, and while they were breastfeeding.

They based the study on the assumption that around 67% of women do not get enough iodine from their diet, which is used by the body to make thyroid hormones.

Their estimates suggest that universal iodine supplements in pregnancy could boost children's IQ scores by an average of 1.22 points.

They then took evidence over 1,300 other published studies that had looked at economic benefits linked to IQ score. The lifetime value of an additional IQ point based on earnings was estimated to be £3,297 for the offspring who received supplementary iodine. They calculated that iodine supplements would save the NHS £199 per pregnant woman. They also calculated, using previous research, that on average, the financial benefit for every pregnant woman taking the supplement would amount to £4,476 in higher earnings and lower education costs for her child.

Iodine is important for healthy brain development and there is some evidence that the UK population may not be getting enough. But Public Health England (PHE) said a varied diet should offer enough iodine.

"The longstanding government advice is that everyone including pregnant women should be able to get all the iodine they need from a varied and balanced diet," said Dr Louis Levy, head of nutrition science, diet and obesity, at PHE.

The latest study's author, Professor Kate Jolly from the University of Birmingham, said that ideally women who are deficient in iodine should be targeted. But there was no easy way of knowing who they are.

She added that the UK was behind other countries, such as Australia, which already recommend supplements in pregnancy, and a change in guidance was warranted.

"The next step is we need a large scale look at the iodine status of pregnant women," she said.

No study has looked directly at the impact of giving iodine supplementation in populations that are only mildly to moderately deficient. And because of ethical and cost concerns this is unlikely to happen, the researchers pointed out.

Last year the government's Scientific Advisory Committee on Nutrition called for more research into iodine levels in certain groups including "girls of reproductive age, pregnant and lactating women".

UK guidelines recommend that adults need around 0.14mg of iodine a day, while the World Health Organisation advises that pregnant women should have 0.25mg a day.

* Mark Monahan, et al. Costs and benefits of iodine supplementation for pregnant women in a mildly to moderately iodine-deficient population: a modelling analysis. The Lancet Diabetes & Endocrinology. Published online: August 2015. DOI: 10.1016/S2213-8587(15)00212-0

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