Public health policy to redress iodine insufficiency in pregnant women may widen sociodemographic disparities.

Public health nutrition

PubMedID: 23777645

Mallard SR, Houghton LA. Public health policy to redress iodine insufficiency in pregnant women may widen sociodemographic disparities. Public Health Nutr. 2013;1-9.
OBJECTIVE: To evaluate the impact of a mandatory bread fortification programme on estimated iodine intakes of childbearing women and to describe the extent to which uptake of a maternal iodine supplement recommendation is associated with sociodemographic characteristics. DESIGN: A postpartum survey was conducted using a self-administered questionnaire. Details on pre- and post-conceptional supplement use, bread intake, iodized salt use and maternal sociodemographic and obstetric characteristics were obtained. SETTING: Eleven maternity wards and hospitals located across New Zealand. SUBJECTS: Seven hundred and twenty-three postpartum New Zealand women. RESULTS: Mean iodine intake from fortified bread was 37 µg/d prior to conception. Younger women, women with higher parity, single women and those with unplanned pregnancies were less likely to meet the pregnancy Estimated Average Requirement (EAR) for iodine (all P = 0·022). Although not statistically significant for all months of pregnancy, women with less education and income were less likely to meet the EAR (P = 0·11 and P = 0·2 for all months, respectively) and indigenous Maori women and Pacific women were less likely than New Zealand Europeans to meet the EAR (P = 0·17 and P = 0·051 for all months, respectively). During pregnancy, iodine-containing supplement uptake at the recommended level (150 µg/d) was non-uniform across sociodemographic subgroups, with the most disadvantaged women benefiting the least from this public health policy. CONCLUSIONS: The disparities in supplement uptake noted here highlight the need for prioritizing further efforts towards universal salt iodization, such as the mandatory fortification of additional processed foods with iodized salt.