目的 调查武汉市孕妇碘营养状况,为指导孕妇科学补碘、调整碘缺乏病防治策略提供依据。方法 2018–2022年,在武汉市13个行政区内,按东、西、南、北、中划分5个片区,每个片区抽取1个乡镇（街道）,每个乡镇（街道）抽取20名孕妇,采集其家中食用盐盐样及随机一次尿样,按照不同年份、区域、年龄段、孕期阶段、是否高龄产妇对盐碘及尿碘进行分析。结果 共纳入研究对象6495人,年龄中位数为30岁,孕周中位数为20 w。不同年份孕妇的年龄、孕周、是否高龄产妇、孕期分布比较,差异均有统计学意义(H/χ2=39.97、536.97、11.43、538.12,均P <0.05）。孕妇食用盐盐碘中位数为24.2 mg/kg。碘盐覆盖率为99.18%,合格碘盐食用率为95.41%。不同年份碘盐覆盖率、合格碘盐食用率不同（χ2=44.31、32.25,均P <0.05）,合格碘盐食用率呈逐年上升的趋势（趋势P<0.05）。尿碘中位数150.40 μg/L。不同年份、区域、孕期、盐碘四分位数分组尿碘中位数不同（H=22.59、5.061、8.252、20.488,均P <0.05）,其中2021年、2022年、中心城区、及孕早期处于碘缺乏水平。尿碘中位数有随着年份下降、随着孕周上升的趋势（趋势均P <0.05）。从行政区层面看,全市2018-2022年中有4年超过50% 的行政区未达到国际组织推荐的碘适宜标准。江岸区、硚口区、武昌区、东西湖区、黄陂区只有1年孕妇尿碘中位数达到国际组织推荐的适宜标准。结论 武汉市各行政区孕妇碘盐覆盖率与合格碘盐食用率均较高,总体碘营养处于适宜水平下限,孕早期孕妇处于碘缺乏水平,江岸区、硚口区、武昌区、东西湖区、黄陂区孕妇碘缺乏较严重,孕妇单纯依靠食用碘盐补碘不能满足碘营养需求,应强化食用富碘食物。
Abstract
Objective To understand the iodine nutrition status of pregnant women in Wuhan, and provide scientific evidence for iodine supplementation in iodine deficiency prevention and control in pregnant women. Methods Thirteen districts of Wuhan were divided into the east, west, south, north, and center, in which 20 pregnant women from every town/street were selected every year from 2018 to 2022. Salt and urine samples were collected to analyze the iodine nutrition of pregnant women. Results A total of 6,495 subjects were included in the study, with a median age of 30 years and a median gestation of 20 weeks. There were statistically significant differences in age, gestation, whether they were elderly pregnant women, and pregnancy stages from year to year (H/χ2=39.97, 536.97, 11.43, 538.12, P<0.05). The median iodine content in the salt was 24.2 mg/kg. The iodized salt coverage rate was 99.18%, and the qualified iodized salt consumption rate was 95.41%. There were differences in iodized salt coverage rates and qualified iodized salt consumption rates in different years (χ2=44.31, 32.25, P<0.05), with a trend of increasing qualified iodized salt consumption rate over the years (trend P<0.05). The median urinary iodine concentration was 150.40 μg/L. There were differences in median urinary iodine concentrations among different years, regions, pregnancy stages, and quartiles of salt iodine content (H=22.59, 5.061, 8.252, 20.488, P<0.05). In 2021 and 2022, as well as in the central urban area and early pregnancy, iodine deficiency cases were diagnosed. The median urinary iodine concentration showed a decreasing trend over the years and an increasing trend with pregnancy stages (trend P<0.05). There were more than 50% of districts not reaching the iodine adequacy recommended by international organizations in four years. Only one year had median urinary iodine concentration meeting the recommended adequacy standards set by international organizations in Jiang'an, Qiaokou, Wuchang, Dongxihu and Huangpi Districts. Conclusion The iodized salt coverage rate and the qualified iodized salt consumption rate among pregnant women in the districts of Wuhan are relatively high, but there is a risk of iodine deficiency in early pregnancy, while pregnant women in Jiang'an, Qiaokou, Wuchang, Dongxihu and Huangpi District experience more severe risk of iodine deficiency. It is necessary to strengthen the iodine nutrition status of pregnant women in urban areas.
关键词
碘盐 /
尿碘 /
孕妇
Key words
iodized salt /
urinary iodine /
pregnant women
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基金
武汉市卫生健康委科研基金（No.WG20Q02）
