Urinary Iodine Concentration and Thyroid Hormone Metabolism in Pregnant Women and Neurodevelopment in Their Children: A Longitudinal Canadian Birth Cohort

<b>Background/Objectives</b>: Iodine is essential for thyroid hormone (TH) synthesis, and THs in pregnant women are critical for fetal brain development. It is unclear whether urinary iodine concentrations (UICs) are associated with thyroid parameters in pregnant women and neurodevelopment in their 3-4-year-old children. <b>Methods</b>: In the Canadian Maternal-Infant Research on Environmental Chemicals (MIREC) cohort, we categorized UIC adjusted for urinary creatinine (UIC/Cr) in the first two trimesters as <150, 150-500, or ≥500 µg/g. We used multivariable regression to quantify associations between UIC/Cr and thyroid parameters in maternal plasma (<i>n</i> = 1501), including thyroid stimulating hormone (TSH), total T4 (tT4), free T4 (fT4), thyroglobulin (Tg) and Tg antibodies (TgAb), and thyroid peroxidase antibodies (TPOAb). We defined positive thyroid autoantibodies as TgAb ≥ 4.11 or TPOAb ≥ 5.61 IU/mL. We also examined the associations between UIC/Cr with the Wechsler Preschool and Primary Scale of Intelligence (<i>n</i> = 503), Behavior Assessment System for Children (<i>n</i> = 751), and the Social Responsiveness Scale (<i>n</i> = 498). <b>Results:</b> Twenty-two percent of women had UIC/Cr < 150 and 17% ≥ 500 µg/g. UIC/Cr was not associated with TSH, tT4, or fT4. After excluding women with positive thyroid autoantibodies, those with UIC/Cr < 150 µg/g had higher tT4 compared to those with 150-500 µg/g. Compared to women with UIC/Cr 150-500 µg/g, those with UIC/Cr < 150 had higher Tg and, those with UIC/Cr ≥ 500 had less frequent positive thyroid autoantibodies. Neurodevelopmental outcomes were not associated with maternal Tg, nor did they differ for maternal UIC/Cr < 150 and ≥500 compared to 150-500 µg/g. <b>Conclusions:</b> In this cohort, Tg and tT4 were higher in women with UIC/Cr < 150 µg/g compared to those with UIC/Cr 150-500 µg/g. Urinary iodine in pregnant women was not associated with neurodevelopment in their 3-4-year-old children.