# Iodine Deficiency: Novel assessment methods and implications for reproductive health

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $668,668

## Abstract

PROJECT SUMMARY/ABSTRACT
Iodine deficiency has increased dramatically in the U.S. in recent decades leading to over 40% deficiency in
reproductive age women. Moreover, infertility and pregnancy loss are increasingly common with far reaching
physical, social, and emotional consequences. Targeted low-cost interventions are needed to address these
adverse reproductive outcomes. Iodine is a potential therapeutic for these outcomes as it is biologically
important for critical hormones involved in reproduction, placentation, and growth and development of
offspring. Severe deficiency is well known for its effect on hypothyroidism and irreversible brain damage in
offspring of deficient pregnant women. However, little is understood on the effects of deficiency on women's
fertility, fecundity, pregnancy loss, and other pregnancy complications. Research into the implications of
deficiency has proven quite challenging as it does not always present clinically and is incredibly variable day-
to-day. It is commonly recommended that 10 urine samples are needed to accurately classify iodine status of
an individual. Yet many studies fail to follow this recommendation and rely on a single spot urine which can
lead to grossly attenuated findings, hampering progress in iodine research. An accurate evidence base is
critically needed to inform policy and individual decisions on iodine fortification, supplementation, and dietary
intake, all which of which offer a potential low-cost solution to promote the health and wellbeing of women and
their offspring. We propose a novel application of biospecimen pooling to classify individual's iodine status and
overcome prior measurement challenges. We
pooling
have developed an innovative hybrid design that uses both
and random sampling to measure iodine in preconception and throughout pregnancy.The overarching
goal of this study is to investigate the role of iodine on reproductive and perinatal outcomes including rarely
studied outcomes of fecundability, fertility, very early pregnancy loss. This work will utilize the EAGeR study
(n=1228), an existing well-defined, preconception cohort of women at high risk for pregnancy loss with daily
urine collection preconception, and if they achieved pregnancy, during the first four weeks of pregnancy with
additional spot urine samples throughout, and collection of the placenta at delivery. Using novel biospecimen
pooling methods we will classify iodine status in preconception, early-, mid-, and late- pregnancy. Using a trial
emulation approach, we will investigate the effects of iodine deficiency, across critical periods of susceptibility
on reproductive and perinatal outcomes. We will also measure iodine in placenta samples; little is known about
how maternal iodine in gestation relates to placental iodine and how this interrelationship relates to pregnancy
outcomes. The successful completion of these aims with the novel characterization of iodine status from
preconception through gestatio...

## Key facts

- **NIH application ID:** 10817759
- **Project number:** 5R01HD111643-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Stefanie Nicole Hinkle
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $668,668
- **Award type:** 5
- **Project period:** 2023-04-05 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817759

## Citation

> US National Institutes of Health, RePORTER application 10817759, Iodine Deficiency: Novel assessment methods and implications for reproductive health (5R01HD111643-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10817759. Licensed CC0.

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