碘 Iodine × 懷孕（碘營養與胎兒神經發育）

結論：Children of mothers with iodine/creatinine <150 mcg/g had higher odds of scores in lowest quartile for verbal IQ (OR 1.58, 95% CI 1.09-2.30; p=0.02), reading accuracy (OR 1.69, 95% CI 1.15-2.49; p=0.007), and reading comprehension (OR 1.54, 95% CI 1.06-2.23; p=0.02), after adjustment for 21 confounders. Establishes mild deficiency as a risk factor for offspring cognitive deficit in iodine-replete-by-policy population.

結論：Children of mothers with UIC <150 mcg/L had significantly lower scores in spelling (-10%, p=0.03), grammar (-7.6%, p=0.04), and English-literacy (-5.6%, p=0.04) at age 9 vs adequate-iodine mothers, after adjustment. Effect persisted despite resolution of iodine deficiency at population level by time of testing — suggesting in-utero deficit is not corrected by post-natal repletion.

結論：In mild-to-moderate deficiency, iodine reduced postpartum hyperthyroidism (RR 0.68, 95% CI 0.42-1.07) and elevated TgAb (RR 0.95, low-quality), with possible reduction in infant TSH (low-quality evidence). Insufficient evidence to determine effects on infant cognitive outcomes — only 1 trial (n=131) reported neurodevelopment with no clear difference. Severe-deficiency setting trials (older, mostly iodised oil) suggested reductions in cretinism. Authors conclude evidence is insufficient to draw definitive conclusions on benefits/harms of routine supplementation in pregnancy and call for adequately powered RCTs.

結論：Iodine supplementation did not improve child cognition at 5-6 years: adjusted mean difference in Full-Scale IQ -1.07 points (95% CI -3.30 to 1.16; p=0.34) vs placebo. Maternal urinary iodine increased as expected; thyroid function preserved. First and to date only adequately powered RCT of iodine supplementation for neurodevelopmental endpoint in mild-deficiency setting, finding no benefit of routine supplementation when initiated in first trimester.

結論：No significant difference between iodine and placebo on any BSID-III subscale at 18 months. Trial substantially underpowered (n=56 vs original target much larger; recruitment difficulties). Findings consistent with later larger Gowachirapant 2017 RCT but limited by sample size.

結論：Pooled effect of severe iodine deficiency on offspring mental development: -6.9 to -10.2 IQ points (across study designs), with greater deficits in severe than in mild deficiency. RCT subgroup of supplementation in moderate-to-severe deficiency showed gain of 8.7 IQ points (95% CI 1.85-15.59). For mild deficiency, observational data suggest 1-2 IQ-point deficits but RCT evidence is sparse. Substantial heterogeneity by baseline iodine status and design.

結論：Strong consensus recommendation that women in iodine-insufficient regions take 150 mcg/day iodine pre-conception through lactation, despite sparse RCT evidence at the time, on grounds of (i) consistent observational evidence of mild-deficiency harm, (ii) low risk of recommended dose, and (iii) plausibility from severe-deficiency RCTs. Reflects guideline-level supportive stance contemporaneous with mixed RCT evidence.