Infant Iodine and Selenium Status in Relation to Maternal Status and Diet During Pregnancy and Lactation

Mia Stråvik, Klara Gustin, Malin Barman, Helena Skröder, Anna Sandin, Agnes E Wold, Ann-Sofie Sandberg, Maria Kippler, Marie Vahter, Mia Stråvik, Klara Gustin, Malin Barman, Helena Skröder, Anna Sandin, Agnes E Wold, Ann-Sofie Sandberg, Maria Kippler, Marie Vahter

Abstract

Iodine and selenium are essential trace elements. Recent studies indicate that pregnant and lactating women often have insufficient intake of iodine and selenium, but the impact on fetal and infant status is unclear. Here, we assessed iodine and selenium status of infants in relation to maternal intake and status of these trace elements in the birth cohort NICE, conducted in northern Sweden (n = 604). Iodine was measured in urine (UIC) in gestational week 29, and in breast milk and infant urine 4 months postpartum, while selenium was measured in maternal plasma and erythrocytes in gestational week 29, and in breast milk and infant erythrocytes 4 months postpartum, in both cases using ICP-MS. Maternal intake was assessed with semi-quantitative food frequency questionnaires in gestational week 34 and at 4 months postpartum. The median intake of iodine and selenium during pregnancy (98 and 40 μg/d, respectively) and lactation (108 and 39 μg/d, respectively) was below recommended intakes, reflected in insufficient status (median UIC of 113 μg/L, median plasma selenium of 65 μg/L). Also, breast milk concentrations (median iodine 77 μg/L, median selenium 9 μg/L) were unlikely to meet infant requirements. Median UIC of the infants was 114 μg/L and median erythrocyte selenium 96 μg/kg, both similar to the maternal concentrations. Infant UIC correlated strongly with breast milk levels (rho = 0.64, p < 0.001). Their erythrocyte selenium correlated with maternal erythrocyte selenium in pregnancy (rho = 0.38, p < 0.001), but not with breast milk selenium, suggesting formation of prenatal reserves. Our results indicate that the transport of iodine and selenium to the fetus and infant is prioritized. Still, it is uncertain whether most infants had sufficient intakes. Further, the results might indicate an involvement of iodine in asthma development during the first year of life, which is essential to follow up. The low maternal and infant dietary intake of both iodine and selenium, especially when the mothers did not use supplements or iodized table salt, suggest a need for a general screening of women and young children.

Keywords: allergy; biomarkers; breast milk; dietary intake; infant; iodine; pregnancy; selenium.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Stråvik, Gustin, Barman, Skröder, Sandin, Wold, Sandberg, Kippler and Vahter.

Figures

Figure 1
Figure 1
Flow chart of inclusion of pregnancies, number of available samples for measurements of iodine and selenium, and prevalence of allergic disease at 12 months of age.
Figure 2
Figure 2
Estimated maternal intake of iodine and selenium from dietary sources during gestational week 34 (GW34) and during lactation at 4 months postpartum (4M). Intake from supplements is not included. The vertical dashed line represents the recommended daily intake for pregnant and lactating women as given by the Nordic Council of Ministers (41).
Figure 3
Figure 3
Correlation matrix of iodine (A) and selenium (B) concentrations in erythrocytes (Ery), plasma (P), urine (U), and breast milk (BM) and estimated intake from diet in gestational week 34 (GW34) and 4 months postpartum (4M) among all included mothers and their breastfed infants. Significant correlations are denoted with asterisks as follows: p < 0.001 =***, p < 0.01 =** and p < 0.05 =*.
Figure 4
Figure 4
Heatmaps displaying Spearman correlations between (A) iodine concentrations in urine (UIC) and breast milk (BM-I), and maternal food intake (B) selenium concentrations in erythrocytes (Ery-Se), plasma (P-Se) and breast milk (BM-Se), and maternal food intake. Food intake was assessed to reflect maternal intake in gestational week 30–34 and at 3–4 months postpartum. Associations between infants' iodine and selenium concentrations and maternal food intake was investigated solely for breastfed infants (i.e., with available breast milk samples). Significant correlations are denoted with asterisks as follows: p < 0.001 =***, p < 0.01 =** and p < 0.05 =*.

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