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Iodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658–8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465–6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539–5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb ( P  non-linear  &lt; 0.05). Iodine deficiency during the first trimester is a  risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405

Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study