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36 Of these, 16 studies were in children, 4 included adults, and 2 included infants; the age range was 2�C45 years. The final meta-analysis included 2214 participants (mainly children) and IQ was used as the main outcome measure. The studies were all done in areas of moderate-to-severe iodine deficiency. The IQs of non-ID groups were on average 13.5 IQ points higher Dabrafenib than those of the iodine-deficient groups. In the second meta-analysis by Qian et?al.,37 inclusion criteria were all studies conducted in China, comparing children (binedaline iodine-sufficient group and the later two groups, compared with those in iodine-deficient areas. Compared with severely iodine-deficient children, there was an increase of ��12 IQ points for children born more than 3.5 years after iodine prophylaxis was introduced. The five early intervention trials, in severely iodine-deficient populations,10�C21 were ground breaking studies done under difficult conditions in remote areas. The Papua New Guinea study had the strongest design and clearly demonstrates that iodine treatment in a population with high levels of endemic cretinism sharply reduces or eliminates incidence of the condition.10,11 The Zaire and China trials report developmental scores were 10�C20% higher in young children born to mothers treated during pregnancy or before.13�C16 The studies in Peru and Ecuador were less well controlled but also suggest modest cognitive benefits for infants and children of maternal iodine treatment.18�C21 Although the data from the Zaire trial indicate correction of ID even at mid-to-late pregnancy improves infant cognitive development,13�C15 data from the other trials suggest the full picture of neurological click here cretinism can only be prevented when iodine is given before or early in pregnancy. The six controlled studies of iodine supplementation in pregnant women in Europe22�C27 suggest that in areas of mild-to-moderate iodine deficiency, the maternal thyroid is able to adapt to meet the increased thyroid hormone requirements of pregnancy. Although supplementation was generally effective in minimising an increase in thyroid size during pregnancy, only two of the six studies reported maternal TSH was lower (within the normal reference range) with supplementation, and in none of the studies showed a clear impact of supplementation on maternal and newborn total or free thyroid hormone concentrations.