Beyond Salt Iodization: Sustained Population Sufficiency and Recurrence of Iodine Deficiency in Pregnant Women in Iran
Authors' conclusion
Although Iran has maintained iodine sufficiency in the general population during the last three decades, mild iodine deficiency has reappeared among pregnant women due to incomplete usage of iodide folic acid supplementation. Strengthened monitoring, stricter quality assurance in salt production, improved adherence to iodine supplementation in pregnant women, and targeted provincial interventions are needed to sustain IDD elimination.
Study context
- Population
- Schoolchildren aged 8–10 years and pregnant women from all 31 provinces of Iran; sixth National Monitoring Survey (2022–2023)
- Participants
- 11,221 vs 2,929
- Exposure
- Schoolchildren vs Pregnant women
- Schoolchildrenn = 11,221
- Pregnant womenn = 2,929
- Outcome
- Iodine status: urinary iodine concentration (UIC), Sandell-Kolthoff method
Methodological detailsnational monitoring survey, multistage cluster sampling (children), all 31 provinces
- National monitoring survey
- Multistage cluster sampling (children)
- All 31 provinces
Main finding
As reported in the abstract
UIC
| Group | Value | Urinary iodine concentration (UIC) ≥100 µg/L | UIC 50-100 µg/L | UIC <50 µg/L | UIC <150 µg/L | UIC <100 µg/L |
|---|---|---|---|---|---|---|
| Schoolchildren | median 133 (IQR 88–183) µg/L | 67.7% | 22.8% | 9.5% | ||
| Pregnant women | median 128 (IQR 84–187) µg/L | 61.2% | 34.4% |
Value
Schoolchildrenmedian 133 (IQR 88–183) µg/L
Pregnant womenmedian 128 (IQR 84–187) µg/L
Urinary iodine concentration (UIC) ≥100 µg/L
Schoolchildren67.7%
Pregnant women— not stated in the abstract
UIC 50-100 µg/L
Schoolchildren22.8%
Pregnant women— not stated in the abstract
UIC <50 µg/L
Schoolchildren9.5%
Pregnant women— not stated in the abstract
UIC <150 µg/L
Schoolchildren— not stated in the abstract
Pregnant women61.2%
UIC <100 µg/L
Schoolchildren— not stated in the abstract
Pregnant women34.4%
Observational data: associations, not effects.
Further findings
- Pregnant women using iodide + folic acid supplement
- 73.7%
- Pregnant women using iodide + folic acid supplement — Provincial variation
- 38-84%
Salt iodine content
- Household salt median iodine content
- 32 ppm
- Household samples <20 ppm
- 30.6%
- Household salt stored properly
- 54%
- Production-level salt median iodine content
- 33.8 ppm
Original publication
Beyond Salt Iodization: Sustained Population Sufficiency and Recurrence of Iodine Deficiency in Pregnant Women in Iran. Thyroid. Published 6 February 2026. doi:10.
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