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Maria Lopes-Pereira Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Hospital de Braga, Braga, Portugal

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Anna Quialheiro Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Patrício Costa Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Susana Roque Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Nadine Correia Santos Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
ACMP5 – Associação Centro de Medicina P5 (P5), School of Medicine, University of Minho, Braga, Portugal

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Margarida Correia-Neves Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Ana Goios Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Ivone Carvalho Newborn Screening, Metabolism & Genetics Unit, National Institute of Health Dr Ricardo Jorge, Porto, Portugal

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Tim I M Korevaar Academic Center for Thyroid Diseases, Erasmus MC, Rotterdam, the Netherlands
Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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Laura Vilarinho Newborn Screening, Metabolism & Genetics Unit, National Institute of Health Dr Ricardo Jorge, Porto, Portugal

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Joana Almeida Palha Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Clinical Academic Center-Braga (2CA-B), Braga, Portugal

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Introduction Iodine is an essential nutrient required for the biosynthesis of thyroid hormone. Thyroid hormone regulates growth and metabolism and is essential for proper fetal brain- and nervous system development ( 1 ). During pregnancy

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Berta Soldevila Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Badalona, Spain

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Inés Velasco Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Department of Obstetrics & Gynecology, Germans Trias i Pujol University Hospital, Badalona, Spain

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Carla Muñoz Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain

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Yesika Díaz Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Health Department, Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain

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Laia Egea-Cortés Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Health Department, Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain

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Laura Ferrer-Escopiñan Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain

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Alejandra Pérez-Montes de Oca Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain

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Raquel Martínez-Mondejar Department of Obstetrics & Gynecology, Germans Trias i Pujol University Hospital, Badalona, Spain

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Jordi Casabona Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Health Department, Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain

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Manel Puig-Domingo Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Badalona, Spain

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thyroid function ( 5 ), including changes in hormonal metabolism and iodine absorption, inducing a dynamic regulation of the hypothalamic–pituitary–thyroid axis throughout pregnancy. For this reason, the measurement of thyroid function in healthy pregnant

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Emna Jelloul Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Georgiana Sitoris Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Flora Veltri Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Pierre Kleynen Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Serge Rozenberg Departement of Gynecology and Obstetrics, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Kris G Poppe Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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including a larger number of women (by the use of individual-participant data meta-analysis), the inclusion of women with different backgrounds (and thus different iodine status and BMI levels), and adjustments made for other variables (hCG and iron reserve

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Georgiana Sitoris Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Flora Veltri Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Pierre Kleynen Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Malika Ichiche Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Serge Rozenberg Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Kris G Poppe Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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), nutritional factors (iodine and iron), high estradiol levels (ovarian stimulation), high hCG levels (twin pregnancies, during gestational weeks 9–13) and, finally, the variability in the TSH assays ( 1 , 2 , 3 , 4 , 5 , 6 ). In a number of studies, the

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Victor J M Pop Department of Medical Psychology, Tilburg University, The Netherlands

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Johannes G Krabbe Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, The Netherlands

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Maarten Broeren Department of Clinical Chemistry, Maxima Medical Centre, Veldhoven, The Netherlands

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Wilmar Wiersinga Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands

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Margaret P Rayman Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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resulting in different strategies between the American and European Thyroid Associations ( 4 ). It is thus all the more surprising that – apart from the effect of iodine intake on IH – there are very few reports on possible other determinants of IH during

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Laura Croce Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Fausta Beneventi Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Federica Ripepi Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy

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Irene De Maggio Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Alberto Malovini Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Informatics and Systems Engineering for Clinical Research, Pavia (PV), Italy

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Camilla Bellingeri Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Francesca Coperchini Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy

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Marsida Teliti Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Mario Rotondi Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Arsenio Spinillo Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Flavia Magri Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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, accounting for up to 20% of cases of chronic autoimmune thyroiditis ( 7 ), but also laboratory interferences ( 8 , 9 ) and the presence of TSH genetic variants ( 10 ) can explain this phenomenon. Not only moderate–severe iodine deficiency but also iodine

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Jan Jiskra 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Jiří Horáček 4th Department of Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Czech Republic

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Sylvie Špitálníková Department of Nuclear Medicine, District Hospital, Havlíčkův Brod, Czech Republic

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Jan Paleček 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Zdeňka Límanová 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Jan Krátký 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Drahomíra Springer Department of Clinical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Kristýna Žabková 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Hana Vítková 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Introduction While the prevalence of thyroid nodules during pregnancy in areas with mild to moderate iodine deficiency varies between 3 and 21% ( 1 , 2 ) and increases with increasing parity ( 3 ), data from areas with sufficient iodine

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Stine Linding Andersen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Niels Henrik Bruun Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark

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Peter Astrup Christensen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Simon Lykkeboe Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Aase Handberg Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Annebirthe Bo Hansen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Maja Hjelm Lundgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Louise Knøsgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Nanna Maria Uldall Torp Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Allan Carlé Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Jesper Karmisholt Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Inge Bülow Pedersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Peter Vestergaard Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark

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Stig Andersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark

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of severe and untreated maternal hypothyroidism are evident from the historical description of cretinism in children born to mothers with hypothyroidism caused by severe iodine deficiency and are further supported by experimental findings ( 6

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Chae Won Chung Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea

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Kyungsik Kim Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

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Sue K Park Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea

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Dal Lae Ju Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea

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Young Joo Park Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea

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Choong Ho Shin Department of Pediatrics, Seoul National University Children’s Hospital and Seoul National University College of Medicine, Seoul, Korea

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Jong Kwan Jun Department of Obstetrics and Gynecology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea

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June-Key Chung Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea

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Yoon Ju Song Department of Food Science and Nutrition, The Catholic University of Korea, Bucheon, Korea

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Young Ah Lee Department of Pediatrics, Seoul National University Children’s Hospital and Seoul National University College of Medicine, Seoul, Korea

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Gi Jeong Cheon Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea

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Sun Wook Cho Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea

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.80/5.60/6.40/4.60/5.10). Urine iodine concentration (UIC) was measured by the 7900 ICP-MS apparatus (Agilent Technologies,USA). Thyroid parenchymal heterogeneity was examined by two experienced endocrinologists. Total caloric and iodine intakes were estimated by a nutritionist

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Zohar Steinberg Ben-Zeev Pediatric Department A, Ha’Emek Medical Center, Afula, Israel

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Marina Peniakov Neonatal Intensive Care Unit, Ha’Emek Medical Center, Afula, Israel

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Clari Felszer Neonatal Intensive Care Unit, Ha’Emek Medical Center, Afula, Israel

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Scott A Weiner Neonatal Intensive Care Unit, Ha’Emek Medical Center, Afula, Israel

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Avishay Lahad Pediatric Department A, Ha’Emek Medical Center, Afula, Israel

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Shlomo Almashanu The National Newborn Screening Program, Ministry of Health, Tel Hashomer, Ramat Gan, Israel

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Yardena Tenenbaum Rakover Consulting Medicine in Pediatric Endocrinology, Clalit Health Services, Afula, Israel
The Rappaport Faculty of Medicine, Technion, Institute of Technology, Haifa, Israel

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/or thyroglobulin (Tg)) were positive, non-autoimmune hypothyroidism when thyroid antibodies were negative, CH, hypothyroidism post-surgery or post-radioactive iodine therapy, goiter, Graves’ disease, multinodular goiter and SCH. SCH was defined when TSH was above 2

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