0.80) and early vs. late treatment for severe cases (d = 0.91) made a difference in the child’s mental development. Tillotson et al. [78] found no difference between affected children and controls (d = 0.45). Rovet et al. [76,77] used a number of different comparison groups, including siblings and children with non-delayed skeletal maturity as a proxy for iodine sufficiency during fetal development. Children were followed up over many years. The effects sizes for different ages and different tests ranged widely from 0.00 to 4.00. No average effect size was calculated for these different AG-490MedChemExpress AG-490 studies because it would not appropriately capture their varied outcomes. Figure 4. Forest plot for effect size (Standard mean difference SMD and 95 confidence interval) of iodine on mental development of children, cohort prospective studies stratified by newborn iodine status. The studies were homogeneous (Q = 3.44, df = 3, p > 0.05). The fixed effects model was therefore more appropriate. Estimated effect size of 0.1 in Oken’s study not included as details for computation not reported.Choudhury Gordon [74]Choudhury Gordon [74]Galan et al. [47]Murcia et al. [48]Total (fixed effects)Total (random effects)-0.0.0 0.5 1.0 Standardized Mean Difference (SMD)1.4. Discussion The findings by intervention designs, whether randomized or non-randomized, showed a consistently better outcome for children of mothers who were supplemented with iodine before or during pregnancy compared to placebo or no supplementation. The average effect size for the two randomized controlled studies was d = 0.68 and for the eight non-randomized studies was d = 0.46.Nutrients 2013,The mean effect size for supplementation studies was therefore 0.49 which translates into 7.4 IQ points assuming a SD of 15. This mean effect size included a total of 16 effect sizes across 10 studies. The findings from observation studies showed a consistently positive association between status of mother or infant and mental development. Observation studies where children’s mental development was compared on the basis of their mother’s iodine status showed a mean effect size of 0.52 which translates into 7.8 IQ points. Observational studies where children’s outcome was compared based on their own iodine status showed a mean effect size of 0.54 which translates into 8.1 IQ points. Several studies allowed us to examine the importance of the timing of supplementation. The findings overall showed that comparisons between early pregnancy and control groups produced a large average effect size of 0.51 while comparisons between late pregnancy and control groups produced a small average effect size of 0.17. This result was similar to two studies which included comparisons between children supplemented in early VER-52296 web infancy vs. controls where differences were non-significant [57,63]. The effect size of 0.49 reported for supplementation studies was lower than reported in two other meta-analyses which combined intervention and observation designs [24,26], but only slightly lower than Verhoef et al. who reported an effect size of 0.56 for intervention studies [25]. Effects sizes for the other two observational designs were also similar at 0.52 and 0.54. This was slightly lower than Verhoef and coworkers’ pooled effect size of 0.67 for observational studies [25]. Higher effect sizes were reported for the two randomized design studies included the current review. However, the study by Pretell et al. from Peru [50] did n.0.80) and early vs. late treatment for severe cases (d = 0.91) made a difference in the child’s mental development. Tillotson et al. [78] found no difference between affected children and controls (d = 0.45). Rovet et al. [76,77] used a number of different comparison groups, including siblings and children with non-delayed skeletal maturity as a proxy for iodine sufficiency during fetal development. Children were followed up over many years. The effects sizes for different ages and different tests ranged widely from 0.00 to 4.00. No average effect size was calculated for these different studies because it would not appropriately capture their varied outcomes. Figure 4. Forest plot for effect size (Standard mean difference SMD and 95 confidence interval) of iodine on mental development of children, cohort prospective studies stratified by newborn iodine status. The studies were homogeneous (Q = 3.44, df = 3, p > 0.05). The fixed effects model was therefore more appropriate. Estimated effect size of 0.1 in Oken’s study not included as details for computation not reported.Choudhury Gordon [74]Choudhury Gordon [74]Galan et al. [47]Murcia et al. [48]Total (fixed effects)Total (random effects)-0.0.0 0.5 1.0 Standardized Mean Difference (SMD)1.4. Discussion The findings by intervention designs, whether randomized or non-randomized, showed a consistently better outcome for children of mothers who were supplemented with iodine before or during pregnancy compared to placebo or no supplementation. The average effect size for the two randomized controlled studies was d = 0.68 and for the eight non-randomized studies was d = 0.46.Nutrients 2013,The mean effect size for supplementation studies was therefore 0.49 which translates into 7.4 IQ points assuming a SD of 15. This mean effect size included a total of 16 effect sizes across 10 studies. The findings from observation studies showed a consistently positive association between status of mother or infant and mental development. Observation studies where children’s mental development was compared on the basis of their mother’s iodine status showed a mean effect size of 0.52 which translates into 7.8 IQ points. Observational studies where children’s outcome was compared based on their own iodine status showed a mean effect size of 0.54 which translates into 8.1 IQ points. Several studies allowed us to examine the importance of the timing of supplementation. The findings overall showed that comparisons between early pregnancy and control groups produced a large average effect size of 0.51 while comparisons between late pregnancy and control groups produced a small average effect size of 0.17. This result was similar to two studies which included comparisons between children supplemented in early infancy vs. controls where differences were non-significant [57,63]. The effect size of 0.49 reported for supplementation studies was lower than reported in two other meta-analyses which combined intervention and observation designs [24,26], but only slightly lower than Verhoef et al. who reported an effect size of 0.56 for intervention studies [25]. Effects sizes for the other two observational designs were also similar at 0.52 and 0.54. This was slightly lower than Verhoef and coworkers’ pooled effect size of 0.67 for observational studies [25]. Higher effect sizes were reported for the two randomized design studies included the current review. However, the study by Pretell et al. from Peru [50] did n.