Información del artículo
El yodo es un micronutriente imprescindible para la síntesis de hormonas tiroideas, por lo que las necesidades nutricionales de yodo aumentan durante el embarazo y la lactancia.
Los estudios epidemiológicos realizados hasta la fecha en nuestro país ponen de manifiesto un grado leve-moderado de déficit nutricional de yodo, que incide especialmente en la población infantil y en las gestantes. En nuestro medio, la única forma de garantizar un aporte continuo y regular de yodo durante toda la gestación y el período de lactancia, que permita cubrir los requerimientos de la madre y del feto en todo momento, pasa por la utilización de comprimidos de yoduro potásico, administrados profilácticamente desde la etapa preconcepcional y hasta el final de la lactancia.
Palabras clave:
Déficit de yodo
Gestación
Suplementación con yodo
Iodine is an essential micronutrient for thyroid hormone synthesis. Consequently, nutritional iodine requirements increase during pregnancy and breast feeding.
The epidemiologic studies performed to date in Spain have shown mild-moderate nutritional iodine deficiency, especially in infants and pregnant women.
In our environment, the only way to guarantee continuous and regular iodine intake throughout pregnancy and breast feeding sufficient to meet all maternal and fetal requirements is the use of potassium iodide pills, administered as a prophylactic method from preconception to the end of lactation.
Key words:
Iodine deficiency
Pregnancy
Iodine supplementation
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Bibliografía
[1.]
G.N. Burrow, D.A. Fisher, P. Reed Larsen.
Maternal and fetal thyroid function.
N Engl J Med, 331 (1994), pp. 1072-1078
[2.]
D. Glinoer, P. De Nayer, P. Bourdoux, M. Lemone, C. Robin, A. Van Steirteghem, et al.
Regulation of maternal thyroid during pregnancy.
J Clin Endocrinol Metab, 71 (1990), pp. 276-287
[3.]
D. Glinoer.
The regulation of thyroid function in pregnancy: Pathways of endocrine adaptation from physiology to pathology.
Endocr Rev, 18 (1997), pp. 404-433
[4.]
F. Delange.
Iodine deficiency as a cause of brain damage.
Postgrad Med J, 77 (2001), pp. 217-220
[5.]
G. Morreale de Escobar, M.J. Obregón, F. Escobar del Rey.
Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia?.
J Clin Endocrinol Metab, 85 (2000), pp. 3975-3987
[6.]
V. Pop, J.L. Kuipens, A.L. Van Baar, G. Verkerk, M.M. Van Son, J.J. De Vijlder, et al.
Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy.
Clin Endocrinol (Oxf), 50 (1999), pp. 149-155
[7.]
G. Morreale de Escobar, F. Escobar del Rey.
Hormonas tiroideas durante el desarrollo fetal: comienzo de la función tiroidea y transferencia maternofetal.
Tratado de endocrinología pediátrica, pp. 152-185
[8.]
G. Morreale de Escobar.
Yodo y embarazo.
Yodo y salud en el siglo XXI, pp. 105-144
[9.]
D. Glinoer.
Pregnancy and iodine.
Thyroid, 11 (2001), pp. 471-481
[10.]
I. Velasco López.
Anomalías prenatales asociadas a la deficiencia de yodo.
Prog Diag Trat Prenat, 17 (2005), pp. 123-128
[11.]
G. Morreale de Escobar.
Yodo y embarazo.
Prog Diag Trat Prenat, 17 (2005), pp. 129-146
[12.]
I. Domínguez, S. Reviriego, G. Rojo-Martínez, M.J. Valdés, R. Carrasco, I. Coronas, et al.
Déficit de yodo y función tiroidea en una población de mujeres embarazadas sanas.
Med Clin (Barc), 122 (2004), pp. 449-453
[13.]
D. Glinoer.
Feto-maternal repercussions of iodine deficiency during pregnancy. An Update.
Ann Endocrinol, 64 (2003), pp. 37-44
[14.]
D. Glinoer.
Maternal and fetal impact of chronic iodine deficiency.
Clin Obstet Gynecol, 40 (1997), pp. 102-116
[15.]
V.J. Pop, E. Brouwers, H.L. Vader, T. Vulsma, A.L. Van Baar, J.J. De Vijlder.
Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study.
Clin Endocrinol, 59 (2003), pp. 282-288
[16.]
P.O.D. Pharoah.
Iodine-supplementation trials.
Am J Clin Nutr, 57 (1993), pp. S276-S279
[17.]
WHO/UNICEF/ICCIDD. Assessment of Iodine Deficiency Disorders and Monitoring their elimination. WHO/NHD/01.1. Geneva: WHO; 1999.
[18.]
J.E. Haddow, G.E. Palomaki, W.C. Allan, et al.
Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child.
N Engl J Med, 341 (1999), pp. 549-555
[19.]
R.D. Utiger.
Maternal hypothiroidism and fetal development.
N Engl J Med, 341 (1999), pp. 601-602
[20.]
Cost-effectiveness of prenatal screening for postpartum thyroiditis NHS EED Abstract 20011780 [citado 28 Ene 2003]. Disponible en: http://nhscrd.york.ac.uk/online/nhseed/20011780.htm
[21.]
V.J. Pop, A.L. Van Baar, T. Vulsma.
Should all pregnant women be screened for hypothyroidism?.
Lancet, 354 (1999), pp. 1224-1225
[22.]
R.T. Zoeller.
Transplacental thyroxine and fetal brain development.
J Clin Invest, 111 (2003), pp. 954-957
[23.]
E. Ausó, R. Lavado-Autric, E. Cuevas, F. Escobar del Rey, G. Morreale de Escobar, P. Berbel.
A moderate and transient deficiency of maternal thyroid function at the beginning og fetal neocorticogenesis alters neuronal migration.
Endocrinology, 145 (2004), pp. 4037-4047
[24.]
J.R. Martínez-Galán, P. Pedraza, M. Santacana, F. Escobar del Rey, G. Morreale de Escobar, et al.
Early effects of iodine deficiency on radial glial cells of the hippocampus of the rat fetus. A model of neurological cretinism.
J Clin Invest, 99 (1997), pp. 2701-2709
[25.]
X.Z. Sun, S. Takahashi, C. Cui, R. Zhang, H. Sakata-Haga, K. Sawada, et al.
Normal and abnormal migration in the developing cerebral cortex.
J Med Invest, 49 (2002), pp. 97-110
[26.]
V.J. Pop, E. Brouwers, H.L. Vader, T. Vulsma, A.L. Van Baar, J.J. De Vijlder.
Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study.
Clin Endocrinol, 59 (2003), pp. 282-288
[27.]
F. Vermiglio, V.P. Lo Presti, M. Moleti, G. Tortorella, G. Scaffiddi, M.G. Castagna, et al.
Attention deficit and hyperactivity disorders in the offspring of mothers exposed to mild-moderate iodine deficiency: a possible novel iodine deficiency disorder in developed countries.
J Clin Endocrinol Metab, 89 (2004), pp. 6054-6060
[28.]
L. Kooistra, S. Crawford, A.L. van Baar, E.P. Brouwers, V.J. Pop.
Neonatal effects of maternal hypothiroxinemia during early pregnancy.
Paediatrics, 117 (2006), pp. 161-167
[29.]
E.C. Wasco, E. Martínez, K.S. Grant, E.A. St Germain, D.L. St Germain, V.A. Galton.
Determinants of iodothyronine deiodinase activity in rodents uterus.
Endocrinology, 144 (2003), pp. 4253-4261
[30.]
R.H. Mortimer, J.P. Galligan, G.R. Cannell, R.S. Addison, M.S. Roberts.
Maternal to fetal thyroxine transmission in the human term placenta is limited by inner ring deiodination.
J Clin Endocrinol Metab, 81 (1996), pp. 2247-2249
[31.]
F. Santini, L. Chiovatto, P. Ghirri, P. Lapi, C. Mammoli, L. Montanelli, et al.
Serum iodothyronines in the human fetus and the newborn: Evidence for an important role of placenta in fetal thyroid hormone homeostasis.
J Clin Endocrinol Metab, 84 (1999), pp. 493-498
[32.]
L. Antonangeli, D. Maccherini, R. Cavaliere, C. Di Gulio, B. Reinhardt, A. Pinchera, et al.
Comparison of two different doses of iodide in the prevention of gestational goiter in marginal iodine deficiency: a longitudinal study.
Eur J Endocrinol, 147 (2002), pp. 29-34
[33.]
F. Delange.
Optimal iodine nutrition during pregnancy, lactation and the neonatal period.
Int J Endocrinol Metab, 2 (2004), pp. 1-12
[34.]
M. Zimmermann, F. Delange.
Iodine supplementation of pregnant women in Europe: a review and recommendations.
Eur J Clin Nutr, 58 (2004), pp. 979-984
[35.]
R.D. Utiger.
Iodine nutrition: More is better.
N Engl J Med, 354 (2006), pp. 2819-2821
[36.]
I. Rodríguez, R. Luna, M. Ríos, E. Fluiters, C. Páramo, R.V. García-Mayor.
Déficit de yodo en gestantes y mujeres en edad fértil pertenecientes a un área con consumo normal de yodo.
Med Clin (Barc), 118 (2002), pp. 217-218
[37.]
P. Vitti, F. Delange, A. Pinchera, M. Zimmermann, J.T. Dunn.
Europe is iodine deficient.
Lancet, 361 (2003), pp. 1226
[38.]
Proceso Asistencial Integrado de Embarazo, parto y puerperio, 2005. Disponible en http://www.csalud.junta-andalucia.es
[39.]
G. Morreale de Escobar.
El yodo durante la gestación, lactancia y primera infancia: Cantidades mínimas y máximas: de microgramos a gramos.
Prog Diag Trat Prenat, 17 (2005), pp. 111-117
[40.]
Manifiesto sobre la erradicación de la deficiencia de yodo en España. Málaga 2004. Prog Diag Trat Prenat. 2005:109-1.
[41.]
P. Santiago Fernández, R. Torres Barahona, J.A. Muela Martínez, G. Rojo Martínez, E. García Fuentes, M.J. Garriga, et al.
Intelligence quotient and iodine intake: a cross-sectional study in children.
J Clin Endocrinol Metab, 89 (2004), pp. 3851-3857
[42.]
Mahomed K, Gülmezoglu AM. Maternal iodine supplements in areas of deficiency. The Cochrane Database of Systematic Reviews 1997, Issue 4.
[43.]
S. Chan, N. Gittoes, j. Franklyn, M. Kilby.
Iodine intake in pregnancy.
Lancet, 358 (2001), pp. 583-584
[44.]
F. Delange.
ICCIDD. Risk and benefits of iodine supplementation.
Lancet, 351 (1998), pp. 9107
[45.]
J.A. Pennington.
A review of iodine toxicity reports.
J Am Diet Assoc, 90 (1990), pp. 1571-1581
[46.]
J. Arena Ansotegui, J.I. Emparanza Knör.
Los antisépticos yodados no son inocuos.
An Esp Pediatr, 53 (2000), pp. 25-29
[47.]
L. Vila.
La deficiencia de yodo en España: un problema pendiente que urge resolver.
Endocrinol Nutr, 49 (2002), pp. 1-4
[48.]
Consenso para la prevención y control de los trastornos causados por deficiencia de yodo en España. Endocrinología. 1993;40:305.
[49.]
B. Vaidya, S. Anthony, M. Bilous, B. Shields, J. Drury, S. Hutchinson, et al.
Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding?.
J Clin Endocrin Metab, (2006),
[50.]
G. Morreale de Escobar, M.J. Obregón, F. Escobar del Rey.
Role of thyroid hormone during early brain development.
Eur J Endocrinol, 151 (2004), pp. 25-37
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