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Letters |

Iodine Supplements During and After Pregnancy

Sarah C. Bath, PhD, RD; Kate B. Jolly, MBChB, MSc, PhD; Margaret P. Rayman, DPhil, RNutr
JAMA. 2013;309(13):1345-1346. doi:10.1001/jama.2013.2237.
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To the Editor: Dr Stagnaro-Green and colleagues1 argued that a randomized controlled trial (RCT) of iodine in pregnancy would be unethical because many international bodies recommend additional iodine intake, largely for the prevention of cognition-related adverse effects in offspring. We dispute their assertion that such a trial is necessarily unethical.

While in regions of severe iodine deficiency, the benefit of iodine supplementation during pregnancy is indisputable, in regions of mild-to-moderate deficiency, the evidence for benefit is only suggestive.2 Previous RCTs of iodine in pregnancy in such regions lacked cognitive outcomes and only 2 small intervention studies, neither of which was randomized or placebo-controlled, afforded evidence of improvements in child cognition.2

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April 3, 2013
Marisa Rebagliato, MD, MPH; Jesus Vioque, MD, MPH; Juan José Arrizabalaga, MD
JAMA. 2013;309(13):1345-1346. doi:10.1001/jama.2013.2246.
April 3, 2013
Alex Stagnaro-Green, MD, MHPE; Scott Sullivan, MD; Elizabeth N. Pearce, MD, MSc
JAMA. 2013;309(13):1345-1346. doi:10.1001/jama.2013.2252.
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