Introduction In order to address population-level mild iodine deficiency in Australia, a mandatory iodine fortification programme of salt used in bread was introduced in late 2009.Methods A before–after study was conducted to assess changes in median urinary iodine concentration (MUIC) measurements, according to supplement use, in convenience samples of pregnant women attending a public antenatal clinic in a regional area of New South Wales, Australia in 2008 (n = 139), 2011 (n = 147) and 2012 (n = 114). Knowledge and practices related to iodine nutrition were investigated in 2012, using self-administered questionnaires.Results The mild iodine deficiency confirmed pre-fortification (MUIC (IQR) = 87.5 (62–123.5; n = 110)) has steadily improved to 145.5 μg/L (91–252) in 2011 (n = 106) and 166 (97–237) in 2012 (n = 95) (sufficiency ≥ 150 μg/L). However, only women taking supplements containing iodine had MUIC indicative of sufficiency in both years surveyed post fortification (2011: 178 μg/L vs. 109 μg/L, P \u3c 0.001; 2012: 202 μg/L vs. 124 μg/L, P \u3c 0.05). Despite bread being the vehicle for iodine fortification, dairy foods remained major contributors to total iodine intake (58%). Overall knowledge regarding health implications of iodine deficiency was poor.Conclusions Iodine status of women has improved since the introduction of mandatory iodine fortification; however supplementation is indicated during pregnancy.
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