scholarly journals Mild-to-moderate iodine deficiency is associated with lower birthweight and increased risk of preterm delivery in a large Norwegian pregnancy cohort

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Marianne H. Abel ◽  
Ida H. Caspersen ◽  
Verena Sengpiel ◽  
Bo Jacobsson ◽  
Per M. Magnus ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Iodine Deficiency ◽  
Iodine Intake ◽  
Z Score ◽  
Gestational Length ◽  
Foetal Growth ◽  
Increased Risk ◽  
Gestational Week ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

AbstractIodine is essential in foetal development through being an integral part of the thyroid hormones. Severe iodine deficiency is associated with foetal growth restriction and preterm delivery. Less is known about the potential impact of mild-to-moderate iodine deficiency on these outcomes.The aim of this study was to investigate whether maternal iodine intake in pregnancy was associated with birth weight (BW) z-score (i.e. BW adjusted for gestational length and sex) and preterm delivery (before week 37).The study population included 77,995 singleton pregnancies from The Norwegian Mother and Child Cohort Study recruited in gestational week 15 in the period 2002–2008. Habitual iodine intake was calculated from a validated food frequency questionnaire covering the first half of pregnancy. Use of supplements was reported in questionnaires. Urinary iodine concentration (UIC) was measured in gestational week 18 in a subsample of n = 2795 women. Median iodine intake from food was 121 μg/day and median UIC was 69 μg/L. Median UIC < 150 μg/L is considered insufficient in pregnant women. Median birthweight was 3610 g and 5.0% were born before gestational week 37. Associations were modelled flexibly by use of restricted cubic splines, and adjusted for age, parity, pre-pregnancy BMI, education, smoking in pregnancy, energy intake, and fibre intake.In non-users of iodine-containing supplements (n = 48,958), a low habitual iodine intake from food (lower than about 150 μg/day) was associated with a lower mean BW z-score (p < 0.001). Compared to an intake of 150 μg/day (reference), mean z-score was 0.04 SD lower at 100 μg/day and 0.12 SD lower at 75 μg/day. Results were similar when using UIC as the exposure (n = 2795, p = 0.017). Any use of iodine containing supplements in pregnancy was associated with 0.03 (95% CI: 0.01, 0.04) SD increase in BW z-score compared to no use (n = 77,949, p < 0.001).A low habitual iodine intake from food (lower than about 100 μg/day) was associated with increased risk of preterm delivery (p = 0.003). Compared to an intake of 100 μg/day (reference), 75 μg/day was associated with 10% increased risk, and 50 μg/day with 28% increased risk. Use of an iodine-containing supplement was not associated with the risk of preterm delivery (OR: 0.97 (95%CI: 0.91, 1.04, p = 0.42)).Inadequate iodine intake is prevalent in women of childbearing age in otherwise well-nourished populations. Our results indicate that mild-to-moderate iodine deficiency in pregnancy is associated with restricted foetal growth and increased risk of preterm delivery.

Iodine in pregnancy and breastfeeding

2015 ◽  
Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Iodine Deficiency ◽  
Attention Deficit Disorder ◽  
Fetal Brain ◽  
Iodine Intake ◽  
Food Sources ◽  
Increased Risk ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

Iodine is a key component of thyroid hormones. Development of the fetal brain and nervous system are dependent on thyroid hormones supplied by the mother via the placenta, increasing the maternal demand for iodine throughout pregnancy. Women with adequate iodine intake before conception (~150 #amp;#x03BC;g/day) can adapt to the increased demand for thyroid hormones during pregnancy, because the thyroid gland adjusts its hormonal output; but this depends on sufficient availability of dietary iodine and the integrity of the thyroid gland. Iodine deficiency causes congenital hypothyroidism, and in severe form, the irreversible brain damage associated with cretinism. Moderate iodine deficiency in pregnancy is associated with lower learning capacity, reduced IQ, hearing impairment, and increased risk of attention deficit disorder. Pregnant women should take a daily multivitamin that contains 150 #amp;#x00B5;g of iodine, unless they regularly consume concentrated food sources of iodine.

scholarly journals Insufficient iodine nutrition status and the risk of pre-eclampsia: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025573 ◽  
Author(s):  
Charles Bitamazire Businge ◽  
Namhla Madini ◽  
Benjamin Longo-Mbenza ◽  
A P Kengne
Keyword(s):  
Iodine Deficiency ◽  
Meta Analysis ◽  
Iodine Intake ◽  
Nutrition Status ◽  
Iodine Nutrition ◽  
Populations At Risk ◽  
Increased Risk ◽  
Geographical Regions ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

IntroductionPre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. Although subclinical hypothyroidism (SCH) in pregnancy is one of the established risk factors for pre-eclampsia, the link between iodine deficiency, the main cause of hypothyroidism and pre-eclampsia remains uncertain. About two billion people live in areas with iodine insufficiency. The increased renal blood flow during pregnancy leading to increased renal iodine clearance together with the increased placental transfer of iodine to the fetus leads to further iodine deficiency in pregnancy. Iodine is one of the most potent exogenous antioxidants whose deficiency is associated with oxidant imbalance and endothelial dysfunction, one of the mechanisms associated with increased risk of pre-eclampsia.Methods and analysisA systematic search of published literature will be conducted for case–control studies that directly determined the iodine nutrition status of women with pre-eclampsia and appropriate normotensive controls. A similar search will be conducted for cohort studies in which the incidence of pre-eclampsia among pregnant women with adequate and inadequate iodine nutrition status was reported. Databases including MEDLINE, EMBASE, Google Scholar, SCOPUS and Africa Wide Information will be searched up to 31 December 2018. Screening of identified articles and data extraction will be conducted independently by two investigators. Risk of bias of the included studies will be assessed using a Newcastle-Ottawa Scale. Appropriate meta-analytic techniques will be used to pool prevalence and incidence rates, odds and relative risk of pre-eclampsia from studies with similar features, overall and by geographical regions. Heterogeneity of the estimates across studies will be assessed and quantified and publication bias investigated. This protocol is reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols (PRISMA-P) 2015 guidelines.Ethics and disseminationSince the proposed study will use published data, there is no requirement for ethical approval. This review seeks to identify the risk of pre-eclampsia associated with insufficient iodine nutrition in pregnancy. This will help to ascertain whether insufficient iodine intake may be an independent risk factor for pre-eclampsia. This will advise policy makers on the possibility of maximising iodine nutrition in pregnancy and reproductive age as one of the remedies for prevention of pre-eclampsia among populations at risk of inadequate iodine intake. This review is part of the thesis that will be submitted for the award of a PhD in Medicine to the Faculty of Health Sciences of the University of Cape Town. In addition the results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018099427.

Assessment of iodine intake in mildly iodine-deficient pregnant women by a new automated kinetic urinary iodine determination method

2005 ◽  
Vol 43 (3) ◽  
Author(s):  
Mustafa Gültepe ◽  
Ömer Özcan ◽  
Osman Metin İpçioglu
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Second Trimester ◽  
Third Trimester ◽  
Iodine Excretion ◽  
Iodine Deficiency In Pregnancy ◽  
Iodine Determination ◽  
In Pregnancy

AbstractMaternal iodine deficiency can compromise the thyroid status of the mother, fetus and newborn child. Therefore, it is important to assess the iodine excretion level of groups of pregnant women. In this study we aimed to determine iodine intake in pregnancy using a recently reported automated kinetic method for urinary iodine determination. Urinary iodine measurements of 123 pregnant women (18 first, 28 second and 77 third trimester) were carried out using a new automated kinetic assay based on the Sandell-Kolthoff reaction at 37°C and its kinetic measurement at 340nm in a random-access automated analyzer after ammonium persulfate digestion at 95°C in a water bath with ±0.1°C precision. Statistical analyses were carried out using SPSS software. Whole group, first trimester, second trimester and third trimester urinary iodine concentrations (mean±SD) in pregnant women were 1.13±0.81, 1.08±0.71, 0.86±0.58 and 1.27±0.87μmol/L, respectively. The urinary iodine concentration significantly increased with gestational age (p<0.05). We found that our study group was mildly iodine-deficient according to WHO criteria. Furthermore, the pregnant women were found to be mildly iodine-deficient in the first and third trimesters and moderately so in the second trimester. The only statistical difference was between second and third trimester values (p<0.05). Even though the increased iodine deficiency in the second trimester is not useful for early detection of iodine deficiency in pregnancy, the severity of this deficiency in the second trimester may lead to important effects on thyroid metabolism for both mother and fetus. Our study suggests that the iodine excretion of pregnant women living in iodine-deficient areas could be assessed using this fast and automated method.

scholarly journals Iodine nutrition status in Africa: potentially high prevalence of iodine deficiency in pregnancy even in countries classified as iodine sufficient

2020 ◽  
pp. 1-6
Author(s):  
Charles Bitamazire Businge ◽  
Benjamin Longo-Mbenza ◽  
Andre Pascal Kengne
Keyword(s):  
Iodine Deficiency ◽  
Iodine Intake ◽  
Nutrition Status ◽  
Urinary Iodine Concentration ◽  
School Age ◽  
African Countries ◽  
Iodine Nutrition ◽  
High Prevalence ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

Abstract Objective: To assess the burden of iodine deficiency in pregnancy in Africa using estimated pregnancy median urinary iodine concentration (pMUIC). Design: pMUIC for each African country was estimated using a regression equation derived by correlating the school-age children (SAC) median UIC (mUIC) and pMUIC from countries around the globe, and the SAC mUIC data for African countries obtained from the Iodine Global Network (IGN) 2017 and 2019 Score cards. Setting: Iodine deficiency was endemic in many African countries before the introduction of iodine fortification, mainly through universal salt iodisation programmes about 25 years ago. There is a scarcity of data on the level of iodine nutrition in pregnancy in Africa. Women living in settings with pMUIC below 150 µg/l are at risk of iodine deficiency-related pregnancy complications. Participants: Fifty of the fifty-five African countries that had data on iodine nutrition status. Results: A cut-off school age mUIC ≤ 175 µg/l is correlated with insufficient iodine intake in pregnancy (pregnancy mUIC ≤ 150 μg/l). Twenty-two African countries had SAC mUIC < 175 μg/l, which correlated with insufficient iodine intake during pregnancy (pMUIC < 150 μg/l). However, nine of these twenty-two countries had adequate iodine intake based on SAC mUIC. Conclusions: There is likely a high prevalence of insufficient iodine intake in pregnancy, including in some African countries classified as having adequate iodine intake in the general population. A SAC mUIC ≤ 175 µg/l predicts insufficient iodine intake among pregnant women in these settings.

Mild iodine deficiency in pregnancy in Europe and its consequences for cognitive and psychomotor development of children: A review

2013 ◽  
Vol 27 (3) ◽  
pp. 174-183 ◽  
Author(s):  
Caroline Trumpff ◽  
Jean De Schepper ◽  
Jean Tafforeau ◽  
Herman Van Oyen ◽  
Johan Vanderfaeillie ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Psychomotor Development ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

scholarly journals Mitochondrial Disease (MELAS Syndrome) Discovered at the Start of Pregnancy in a Patient with Advanced CKD: A Clinical and Ethical Challenge

2019 ◽  
Vol 8 (3) ◽  
pp. 303
Author(s):  
Domenico Santoro ◽  
Gianluca Di Bella ◽  
Antonio Toscano ◽  
Olimpia Musumeci ◽  
Michele Buemi ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Preterm Delivery ◽  
Mitochondrial Disease ◽  
Unplanned Pregnancy ◽  
Ethical Challenge ◽  
Dependent Diabetes Mellitus ◽  
Melas Syndrome ◽  
Increased Risk ◽  
Stage 4 ◽  
In Pregnancy

Pregnancy is a challenge in the life of a woman with chronic kidney disease (CKD), but also represents an occasion for physicians to make or reconsider diagnosis of kidney disease. Counselling is particularly challenging in cases in which a genetic disease with a heterogeneous and unpredictable phenotype is discovered in pregnancy. The case reported regards a young woman with Stage-4 CKD, in which “Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes” (MELAS syndrome), was diagnosed during an unplanned pregnancy. A 31-year-old Caucasian woman, being followed for Stage-4 CKD, sought her nephrologist’s advice at the start of an unplanned pregnancy. Her most recent data included serum creatinine 2–2.2 mg/dL, Blood urea nitrogen (BUN) 50 mg/dL, creatinine clearance 20–25 mL/min, proteinuria at about 2 g/day, and mild hypertension which was well controlled by angiotensin-converting enzyme inhibitors (ACEi); her body mass index (BMI) was 21 kg/m2 (height 152 cm, weight 47.5 kg). Her medical history was characterized by non-insulin-dependent diabetes mellitus (at the age of 25), Hashimoto’s thyroiditis, and focal segmental glomerulosclerosis. The patient’s mother was diabetic and had mild CKD. Mild hearing impairment and cardiac hypertrophy were also detected, thus leading to suspect a mitochondrial disease (i.e., MELAS syndrome), subsequently confirmed by genetic analysis. The presence of advanced CKD, hypertension, and proteinuria is associated with a high, but difficult to quantify, risk of preterm delivery and progression of kidney damage in the mother; MELAS syndrome is per se associated with an increased risk of preeclampsia. Preterm delivery, associated with neurological impairment and low nephron number can worsen the prognosis of MELAS in an unpredictable way. This case underlines the importance of pregnancy as an occasion to detect CKD and reconsider diagnosis. It also suggests that mitochondrial disorders should be considered in the differential diagnosis of kidney impairment in patients who display an array of other signs and symptoms, mainly type-2 diabetes, kidney disease, and vascular problems, and highlights the difficulties encountered in counselling and the need for further studies on CKD in pregnancy.

scholarly journals Moderate Iodine Deficiency Is Common in Pregnancy but Does Not Alter Maternal and Neonatal Thyroid Function Tests

2020 ◽  
Vol 11 ◽  
Author(s):  
Tal Schiller ◽  
Arnon Agmon ◽  
Viviana Ostrovsky ◽  
Gabi Shefer ◽  
Hilla Knobler ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Content ◽  
First Trimester ◽  
Thyroid Function Tests ◽  
Neonatal Thyroid Function ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (&lt;150 µg/L). Widespread desalinated water usage and no national fortification plan are possible causes. Studies assessing relationships between iodine status and maternal and neonatal thyroid function provided varying results. Our aims were to determine whether iodine deficiency was associated with altered maternal or neonatal thyroid function and the factors leading to iodine deficiency.MethodsA cross-sectional study including 100 healthy women without prior thyroid disease, in their first trimester of a singleton pregnancy were recruited from an HMO clinic in central Israel. The women were followed from their first trimester. All women completed a 24-h dietary recall and life habits questionnaires. We tested for UIC, maternal and neonatal thyroid function, maternal autoantibodies, and neonatal outcomes.ResultsMedian UIC in our cohort was 49 µg/L [25%–75% interquartile range (IQR) 16-91.5 µg/L], with 84% below adequacy range. No correlation was found between iodine deficiency and maternal or neonatal thyroid function which remained within normal ranges. Antibody status did not differ, but thyroglobulin levels were significantly higher in iodine insufficient subjects. UIC was higher in women consuming an iodine containing supplement. There was no association between UIC and dietary iodine content or water source.ConclusionsModerate iodine deficiency is common in our healthy pregnant women population. Our data imply that moderate iodine deficiency in pregnancy seem sufficient to maintain normal maternal and neonatal thyroid function.

scholarly journals Cervical Length and Androgens in Pregnant Women With Polycystic Ovary Syndrome: Has Metformin Any Effect?

2016 ◽  
Vol 101 (6) ◽  
pp. 2325-2331 ◽  
Author(s):  
Tone Shetelig Løvvik ◽  
Solhild Stridsklev ◽  
Sven M. Carlsen ◽  
Øyvind Salvesen ◽  
Eszter Vanky
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Preterm Delivery ◽  
Polycystic Ovary ◽  
First Trimester ◽  
Cervical Length ◽  
Cervical Ripening ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Gestational Week ◽  
Androgen Levels

Abstract Context: Women with polycystic ovary syndrome (PCOS) have increased risk of preterm delivery. Shortening of the cervix is a sign of preterm delivery. Objective: This study aimed to investigate potential effect of metformin on cervical length and whether androgen levels correlate with cervical length in PCOS pregnancies. Design and Setting: This was a sub-study of a randomized, placebo-controlled, multicenter study (The PregMet study) performed at 11 secondary or tertiary centers from 2005 to 2009. Participants: Two-hundred sixty-one pregnancies of 245 women with PCOS, age 18–42 years participated. Interventions: Participants were randomly assigned to metformin or placebo from first trimester to delivery. Outcome Measurements: We compared cervical length and androgen levels in metformin and placebo groups at gestational weeks 19 and 32. We also explored whether cervical length correlated with androgen levels. Results: We found no difference in cervical length between the metformin and the placebo groups at gestational week 19 and 32. Dehydroepiandrosterone (DHEAS) tended to be higher in the metformin group. There were no correlations between androgens and cervical length at week 19. At gestational week 32, androstenedione (P = .02) and DHEAS (P = .03) showed a trend toward negative correlation to cervical length. High androstenedione level correlated with shortening of cervical length from week 19 to 32 when adjusted for confounders (P = .003). T (P = .03), DHEAS (P = .02), and free testosterone index (P = .03) showed a similar trend. Conclusion: Metformin in pregnancy did not affect cervical length in women with PCOS. High maternal androgen levels correlated with cervical shortening from the second to the third trimester of pregnancy, as a sign of cervical ripening.

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