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Nutrition during the early life cycle

Prevalence of insufficient iodine intake in pregnancy worldwide: a systematic review and meta-analysis



Iodine deficiency in pregnant women is related to impaired foetal growth and development. The objective of this study was to estimate the prevalence of insufficient iodine intake in pregnant women from different regions of the world.


Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and Google Scholar grey literature were searched until 10 April 2021. Two reviewers independently conducted article selection, data extraction, and assessment of the risk of bias. Meta-analyses with random effects, subgroup analyses, and meta-regressions were performed.


In total, 4639 observational articles were found, with 61 eligible for inclusion. The population consisted of 163,021 pregnant women adults and adolescents, and the overall prevalence of insufficient iodine intake was 53% (95% confidence interval [CI]: 47–60; I2 = 99.8%). Pregnant women who live in insufficient iodine status country had a higher prevalence (86%; 95% CI: 78–93; I² =97.0%) of inadequate iodine nutritional status than to those living in country considered sufficient (51%; 95% IC: 45–57; I² = 99.8%).


Despite the progress in iodine fortification policies and periodic monitoring of the iodine nutritional status of the population worldwide, salt iodination alone may not be sufficient to provide adequate iodine status to pregnant women. Thus, other actions may be necessary to improve the nutritional clinical care of pregnant group.

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Fig. 1: Flow chart of the literature search, selection criteria and inclusion of studies (Adapted from PRISMA).
Fig. 2: Risk of bias in the included studies (The Joanna Briggs Institute Critical Appraisal checklist for prevalence studies).
Fig. 3: Prevalence of insufficient iodine intake in pregnancy in worldwide.
Fig. 4: Funnel graph on the publication bias.


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We would like to thank the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)—Financing Code 001. Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), case 408295/2017-1.

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(1) ESOP, ICCL, VSSG and NP contributed significantly to the work’s conception, design, data collection (as applicable), or data interpretation and analysis; (2) EAFN and SCCF participated in the writing or critical revision of the article in a manner sufficient to establish ownership of the intellectual content; and (3) ESOP, ICCL, EAFN, SCCF, VSSG and NP read and approved the version of the manuscript being submitted.

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Correspondence to Nathalia Pizato.

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Patriota, E.S.O., Lima, I.C.C., Nilson, E.A.F. et al. Prevalence of insufficient iodine intake in pregnancy worldwide: a systematic review and meta-analysis. Eur J Clin Nutr (2021).

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