Assessing the impact of drinking water iodine concentrations on the iodine intake of Chinese pregnant women living in areas with restricted iodized salt supply

Purpose The supply of non-iodized salt and the water improvement project have been conducted to reduce the iodine concentration in drinking water in areas with elevated water iodine. We aimed to assess the impact of water iodine concentration (WIC) on the iodine intake of pregnant women in areas with restricted iodized salt supply, and determine the cutoff values of WIC in areas with non-iodized salt supply. Methods Overall, 534 pregnant women who attended routine antenatal outpatient visits in Zibo Maternal and Child Health Hospital in Gaoqing County were recruited. The 24-h urine iodine excretion (UIE) in 534 samples and the iodine concentration in 534 drinking water samples were estimated. Urinary iodine excretion, daily iodine intake, and daily iodine intake from drinking water (WII) were calculated. The relationship between WIC and daily iodine take was analyzed. Results The median WIC, spot urine iodine concentration (UIC), and 24-h UIE were 17 (6, 226) mu g/L, 145 (88, 267) mu g/L, and 190 (110, 390) mu g/day, respectively. A significant positive correlation was found between WIC and UIE (R-2 = 0.265,p < 0.001) and UIC (R-2 = 0.261,p < 0.001). The contribution rate of WII to total iodine intake increased from 3.0% in the group with WIC of < 10 mu g/L to 45.7% in the group with WIC of 50-99 mu g/L. Conclusion The iodine content in drinking water is the major iodine source in pregnant women living in high-water iodine areas where iodized salt supply is restricted. The contribution rate of daily iodine intake from drinking water increases with the increase in water iodine concentration.