Reinforcing the iodine message for pregnant women in Australia

To the Editor: The recently released clinical practice guidelines on antenatal care,1 which have been endorsed by the National Health and Medical Research Council, recommend nutritional supplementation with 500 μg/day of folic acid, from 12 weeks before conception and for the first trimester, and 150 μg/day of iodine throughout pregnancy. This recommendation recognises that, despite the introduction in 2009 of mandatory fortification of bread with both iodine and folic acid, fortification does not meet the increased needs of pregnant and lactating women. Urinary iodine concentrations of pregnant women improved after the introduction of the iodine fortification program; however, a study in regional New South Wales found that only those women who were taking iodine-containing supplements had urinary concentrations indicating sufficiency (≥ 150 μg/L).2