Association of iodine‐related knowledge, attitudes and behaviours with urinary iodine excretion in pregnant women with mild iodine deficiency

Pregnant women and infants are risk populations of iodine deficiency disorders (IDD). Therefore, this study was designed to explore the status of IDD among pregnant women through the analysis of urinary iodine excretion (UIE). A total of 94 pregnant women from Chautara Hospital Sindhupalchowk were included to analyze UIE through Sandell-Kolthoff Reaction. Although the general clinical status of women was satisfactory, the urinary iodine excretion revealed that still, 18.0 percent of pregnant women in Sindhupalchowk had insufficient iodine intake. This indicates that pregnant women are still at risk of iodine deficiency disorder, and they should be in the priority population for the IDD prevention program.

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A cross-sectional study on iodine status among pregnant and non-pregnant women of Tripura: a North-Eastern state of India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20190359 ◽

2019 ◽

Vol 7 (2) ◽

pp. 486

Author(s):

Nilratan Majumder ◽

Balaram Sutradhar ◽

Saradindu Riang ◽

Shib Sekhar Datta

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Cross Sectional Study ◽

Iodine Intake ◽

Urinary Iodine Excretion ◽

Metabolic Demand ◽

Cross Sectional ◽

Iodine Status ◽

Iodine Excretion

Background: Due to excess metabolic demand of iodine in pregnancy, pregnant women and lactating mother and their neonates are most vulnerable of iodine deficiency disorder. Urinary iodine excretion is a good marker of recent dietary iodine intake. Thus, present study was conducted to assess the iodine status and median urinary iodine excretion (UIE μg/lit) among pregnant and non-pregnant women of Tripura.Methods: Tribal and Bengali pregnant and non-pregnant women from Bokafa and Jolaibari Block of South Tripura district were included in the study. Urinary iodine excretion was done using simple micro plate method. Salt iodine was estimated using iodometric titration. All the tests were performed at CNRT Lab, ICMR, India.Results: Total number of subjects included in this study was 1071. Total number of urine samples collected from pregnant and non-pregnant women was 538 and 533 respectively. Median value of UIE in pregnant and non-pregnant women of Tripura was 155.0µg/L and 130.0µg/L. In pregnant women percentage prevalence of severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-149µg/L) was found in 4.1%, 15.1% and 29.6% subjects. In case of non-pregnant women severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-99µg/L) was found in 0.6%, 9.6%, 27.8% subjects respectively. The overall prevalence of iodine deficiency was found in 48.8% pregnant women, compared to 38.0% non-pregnant subjects.Conclusions: Efforts towards universal salt iodization need to be stepped-up in Sub-Himalayan region (NE part of India) and pregnant and lactating mothers may be targeted with alternate iodine supplements (Colloidal Iodine).

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Iodine status and thyroid parameters of pregnant women living in an iodine sufficient area

Archive of Food and Nutritional Science ◽

10.29328/journal.afns.1001026 ◽

2021 ◽

Vol 5 (1) ◽

pp. 001-006

Author(s):

Delshad Hossein ◽

Mirmiran Parvin ◽

Mehran Ladan ◽

Tohidi Maryam ◽

Azizi Fereidoun

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Thyroid Volume ◽

Urinary Iodine Excretion ◽

Third Trimester ◽

Group I ◽

Iodine Excretion ◽

The Mean ◽

Group Ii

During the last few decades painstaking efforts have been made to eliminate iodine deficiency throughout the world. Todays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life. Objective: The aim of this study was to obtain longitudinal data on urinary iodine excretion and the changes of maternal thyroid parameters in two groups of healthy women with mild-to-moderate iodine deficiency and iodine sufficiency residing in an iodine replete area of Tehran capital city of IR Iran, for more than one decade. Research designs and methods: The present study is part of a cohort study, investigating the relative influences of iodine intake on thyroid size and function of mothers and their infants during and after pregnancy. A total of 500 pregnant women enrolled from two mother-child health care centers and was divided into group I, with median urinary iodine excretion (MUIE) < 150 µg/L, and group II with MUIE ≥ 150 µg/L. Sonographic thyroid volume measurement, urinary iodine excretion and thyroid function tests were measured sequentially in all pregnant women during the three trimesters (T) of pregnancy. Results: The mean ± SD age of the participants was 25.1 ± 5.1 years. The MUIE in group I and II in the first, second and third trimester were 123 and 250 µg/L, 127 and 166 µg/L, 120 and 150 µg/L, respectively. The MUIE in the third trimester of pregnancy in group I did not differ significantly from the values in the first and second trimesters (p = 0.67), but it did decline significantly in group II (p < 0.001). The median thyroid volume of subjects, in the first, second and third trimesters were 7.8, 8.2 and 8.1 ml in group I and 7.5, 8.0 and 8.4 ml in group II, respectively. No difference in thyroid volume was found between two groups in each of the three trimesters of pregnancy (p > 0.05). The mean (± SD) TSH concentration of subjects in first, second and third trimester was 2.3(± 2.6), 2.1(± 1.8), 2.3(± 1.7) mIU/L in group I and 2.1(± 3.1), 2.1(± 1.8) and 2.0(± 1.3) mIU/L in group II, respectively. The trend of TSH rising in group I was 26.7% and in group II it was 13.3%. The mean TSH value in three trimesters did not differ significantly in either groups (p > 0.05). The mean (± SD) total T4 concentrations of subjects in first, second and third trimesters were 13.2(± 3.4), 13.8(± 3.3), 13.0(± 2.9) µg/dl in group I and 13.1(± 3.2), 13.7(± 2.9), 13.4(± 3.2) µg/dl in group II, respectively. The mean total T4 value in three trimesters did not differ significantly in either groups (p > 0.05). There was no correlation between the thyroid volume and three observed parameters (UIE, total T4 and TSH) during the pregnancy in either groups. Conclusion: Even in areas with well-established universal salt iodization program, pregnancy could be a risk of having iodine deficiency and systematic dietary fortification needs to be implemented in this vulnerable group.

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Maternal iodine status and neonatal thyroid-stimulating hormone concentration: a community survey in Songkhla, southern Thailand

Public Health Nutrition ◽

10.1017/s1368980009005205 ◽

2009 ◽

Vol 12 (12) ◽

pp. 2279-2284 ◽

Cited By ~ 17

Author(s):

Somchit Jaruratanasirikul ◽

Pasuree Sangsupawanich ◽

Ounjai Koranantakul ◽

Prasin Chanvitan ◽

Prasit Ruaengrairatanaroj ◽

...

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Intake ◽

Thyroid Stimulating Hormone ◽

Iodized Salt ◽

Urinary Iodine Excretion ◽

Southern Thailand ◽

Iodine Excretion ◽

Stimulating Hormone

AbstractObjectiveTo determine iodine intake and urinary iodine excretion (UIE) in a group of pregnant Thai women and the concentration of thyroid-stimulating hormone (TSH) in their neonates.DesignA prospective cohort study.SettingThree districts of Songkhla, southern Thailand.SubjectsTwo hundred and thirty-six pregnant women.ResultsA quarter of the participants lacked knowledge of iodine and the prevention of iodine deficiency, although 70 % used iodized salt. Those who did not use iodized salt stated that they had no knowledge about iodine (57 %) and no iodized salt was sold in their village (36 %). The median iodine intake in the three districts was 205–240 μg/d, with 53–74 % of pregnant women having iodine intake <250 μg/d. The median UIE in the three districts was 51–106 μg/l, with 24–35 % having UIE < 50 μg/l. The mean neonatal TSH was 2·40 (sd1·56) mU/l, with 8·9 % of neonates having TSH > 5 mU/l.ConclusionsThe studied women and their fetuses were at risk of mild iodine deficiency. About a quarter of the participants lacked knowledge of the importance of iodine. Education regarding the importance of iodine supplements and the promotion of iodized salt should be added to national health-care policies in order to prevent iodine-deficiency disorders, diseases that are subclinical but have long-term sequelae.

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Iodized salt prophylaxis of endemic goiter: an experience in Toscana (Italy)

Acta Endocrinologica ◽

10.1530/acta.0.1290497 ◽

1993 ◽

Vol 129 (6) ◽

pp. 497-500 ◽

Cited By ~ 16

Author(s):

F Aghini-Lombardi ◽

A Pinchera ◽

L Antonangeli ◽

T Rago ◽

GF Fenzi ◽

...

Keyword(s):

Iodine Deficiency ◽

Endemic Goiter ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodized Salt ◽

Urinary Iodine Excretion ◽

Goiter Prevalence ◽

Iodine Excretion ◽

Health Organization ◽

Legislative Measures

It is well established that iodine supplementation is effective in correcting iodine deficiency and reducing goiter prevalence. In Italy, legislation has allowed the production of iodized salt since 1972, but its consumption is on a voluntary basis. In the present study, the efficacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretion and thyroid size, scored according to Pan American Health Organization recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whole schoolchildren population residing in a restricted area of the Tuscan Appennines. Moreover, in 1991, thyroid volume was determined by ultrasonography. In 1981, mean urinary iodine excretion was 47.1±22.4 mg/kg creatinine (0.412 μmol/l) and goiter prevalence was 60%, indicating a moderate iodine deficiency. Eighty of the families subsequently used iodized salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7±73 mg/kg creatinine (1.24 μmol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophylaxis in correcting iodine deficiency and abating endemic goiter in schoolchildren, and suggest that implementation of measures that make compulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and trading of iodized salt.

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Iodine deficiency in pregnant women living in the South East of the UK: the influence of diet and nutritional supplements on iodine status

British Journal Of Nutrition ◽

10.1017/s0007114513004030 ◽

2014 ◽

Vol 111 (9) ◽

pp. 1622-1631 ◽

Cited By ~ 60

Author(s):

Sarah C. Bath ◽

Alan Walter ◽

Andrew Taylor ◽

John Wright ◽

Margaret P. Rayman

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

World Health ◽

The South ◽

Childbearing Age ◽

Iodine Status ◽

Supplement Use ◽

Iodine Excretion ◽

The Uk

Iodine is a key component of the thyroid hormones which are crucial for brain development. Adequate intake of iodine in pregnancy is important as in utero deficiency may have lifelong consequences for the offspring. Data on the iodine status of UK pregnant women are sparse, and there are no such data for pregnant women in the South East of the UK. A total of 100 pregnant women were recruited to a cross-sectional study carried out at the Royal Surrey County Hospital, Guildford, at their first-trimester visit for an ultrasound scan. The participants provided a spot-urine sample (for the measurement of urinary iodine concentration (UIC) and creatinine concentration) and 24 h iodine excretion was estimated from the urinary iodine:creatinine ratio. Women completed a general questionnaire and a FFQ. The median UIC (85·3 μg/l) indicated that the group was iodine deficient by World Health Organisation criteria. The median values of the iodine:creatinine ratio (122·9 μg/g) and of the estimated 24 h iodine excretion (151·2 μg/d) were also suggestive of iodine deficiency. UIC was significantly higher in women taking an iodine-containing prenatal supplement (n 42) than in those not taking such a supplement (P< 0·001). In the adjusted analyses, milk intake, maternal age and iodine-containing prenatal supplement use were positively associated with the estimated 24 h urinary iodine excretion. Our finding of iodine deficiency in these women gives cause for concern. We suggest that women of childbearing age and pregnant women should be given advice on how to improve their iodine status through dietary means. A national survey of iodine status in UK pregnant women is required.

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Goiter Prevalence and Urinary Iodine Excretion in Schoolchildren of Jordan

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.74.4.301 ◽

2004 ◽

Vol 74 (4) ◽

pp. 301-304 ◽

Cited By ~ 4

Author(s):

Kharabsheh ◽

Belbesi ◽

Qarqash ◽

Azizi

Keyword(s):

Iodine Deficiency ◽

Eastern Mediterranean ◽

Urinary Iodine ◽

Eastern Mediterranean Region ◽

Urinary Iodine Excretion ◽

Major Health Problem ◽

Salt Iodization ◽

Goiter Prevalence ◽

Iodine Excretion ◽

Monitoring Survey

Iodine deficiency disorders (IDD) are considered a major health problem in the eastern Mediterranean region. In Jordan, an IDD assessment was performed in 1993 following which, a salt iodization and consumption program was implemented and a monitoring survey performed in 2000. In schoolchildren 8 to 10 years of age (2457 in 1993 and 2601 in 2000) goiter was graded according to WHO classification. Urinary iodine was measured in 10% of the children in 1993 and in all of them in 2000. Percent of iodine consumption in households was assessed by rapid kit test in 2000. Prevalence of goiter was 37.7 and 32.1% and median urinary iodine was 40 and 154 mug/L, in 1993 and 2000, respectively. Before salt iodization, the prevalence of goiter and severity of iodine deficiency was more pronounced in rural regions and in the southern part of Jordan. In 2000, all but one governorate had a median urinary iodine (MUI) of above 100 mug/L. The percentage of urinary iodine levels < 50 mug in two governorates was > 20%. Iodine consumption rate of households was 88.3% throughout the country, but was < 70% in three governorates. It is concluded that moderate and severe IDD existed before 1993 in Jordan. Although the iodized salt program has been successful in optimizing MUI, the program for the control of IDD needs further improvement.

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Iodine Intake and Thyroid Function in Pregnant Women in a Private Clinical Practice in Northwestern Sydney before Mandatory Fortification of Bread with Iodised Salt

Journal of Thyroid Research ◽

10.1155/2012/798963 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Norman Blumenthal ◽

Karen Byth ◽

Creswell J. Eastman

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Intake ◽

Urinary Iodine Excretion ◽

Blood Collection ◽

Antenatal Visit ◽

Urinary Iodine Concentration ◽

Cross Sectional

Aim. The primary objective of the study was to assess the iodine nutritional status, and its effect on thyroid function, of pregnant women in a private obstetrical practice in Sydney.Methods. It was a cross-sectional study undertaken between November 2007 and March 2009. Blood samples were taken from 367 women at their first antenatal visit between 7 and 11 weeks gestation for measurement of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels and spot urine samples for urinary iodine excretion were taken at the same time as blood collection.Results. The median urinary iodine concentration (UIC) for all women was 81 μg/l (interquartile range 41–169 μg/l). 71.9% of the women exhibited a UIC of <150 μg/l. 26% of the women had a UIC <50 μg/l, and 12% had a UIC <20 μg/l. The only detectable influences on UIC were daily milk intake and pregnancy supplements. There was no statistically significant association between UIC and thyroid function and no evidence for an effect of iodine intake on thyroid function.Conclusions. There is a high prevalence of mild to moderate iodine deficiency in women in Western Sydney but no evidence for a significant adverse effect on thyroid function. The 6.5% prevalence of subclinical hypothyroidism is unlikely to be due to iodine deficiency.

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Urinary iodine excretion in Belarus children

Acta Endocrinologica ◽

10.1530/eje.0.1330216 ◽

1995 ◽

Vol 133 (2) ◽

pp. 216-217 ◽

Cited By ~ 10

Author(s):

TA Mityukova ◽

LN Astakhova ◽

LD Asenchyk ◽

MM Orlov ◽

L VanMiddlesworth

Keyword(s):

Thyroid Cancer ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Intake ◽

Urine Samples ◽

Urinary Iodine Excretion ◽

University Of Tennessee ◽

Iodine Excretion

Mityukova TA, Astakhova LN, Asenchyk LD, Orlov MM, VanMiddlesworth L. Urinary iodine excretion in Belarus children. Eur J Endocrinol 1995;133:216–7. ISSN 0804–4643. Casual urine samples were collected to determine iodine excretion of 1680 Belarus children during 1990–1994. The subjects, 8–16 years old, were from nine different regions of Belarus; 60% were from the Gomel oblast, which has been associated with relatively high levels of radioiodine fallout and increased incidence of thyroid cancer. Most of the median values indicate borderline/low iodine intake or mild iodine deficiency. Ranges were wide but 163 children excreted < 20 μgI/l urine and they should be considered severely deficient in iodine. L VanMiddlesworth, Dept. of Physiology and Biophysics, University of Tennessee, 894 Union Avenue, Memphis, TN 38163, USA

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Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency

Acta Endocrinologica ◽

10.1530/eje.0.1320546 ◽

1995 ◽

Vol 132 (5) ◽

pp. 546-549 ◽

Cited By ~ 68

Author(s):

Benedikt L Baltisberger ◽

Christoph E Minder ◽

Hans Bürgi

Keyword(s):

Iodine Deficiency ◽

Control Level ◽

Urinary Iodine ◽

Urinary Iodine Excretion ◽

Nodular Goitre ◽

Beneficial Effects ◽

Severe Deficiency ◽

Iodine Excretion ◽

Full Correction ◽

Toxic Nodular Goitre

Baltisberger BL, Minder CE, Bürgi H. Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency. Eur J Endocrinol 1995;132:546–9. ISSN 0804–4643 In 1980 the iodide content of salt was increased in Switzerland from 7.5 to 15 mg/kg. This raised the mean urinary iodine excretion from 90 (indicating mild iodine deficiency) to 150 μg/g creatinine. We examined whether this public health measure was followed by a change of the incidence of hyperthyroidism in a defined catchment area of 109 000 persons. Except for a 27% rise in the first year of the new salt, the total incidence of hyperthyroidism declined steadily to reach 44% of the control level in 1988/89. This was due to a decrease mostly of toxic nodular goitre (minus 73%), less so of Graves' disease (minus 33%). We conclude that correction of mild iodine deficiency has beneficial effects on the incidence of hyperthyroidism, contrary to what is seen initially after correction of severe deficiency. H Bürgi, Department of Medicine, Bürgerspital, CH-4500 Solothurn, Switzerland

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