Iodine supply in pregnant women and newborns: results of monitoring based on newborn screening of TSH in 2020

Objective : The intake of adequate amounts of iodine during pregnancy is essential for the neurological development of the fetus. The aim of this study was to assess iodine nutrition status in pregnant women from the state of São Paulo, Brazil.Material and methods : We analyzed urinary iodine concentration (UIC) in 191 pregnant and 58 non-pregnant women matched by age. We used the World Health Organization criteria to define sufficient iodine supply (median UIC: 150-249 µg/L among pregnant women, and 100-199 µg/L for non-pregnant women).Results : Median UIC of the pregnant women studied was lower than the recommended value (median = 137.7 µg/L, 95% CI = 132.9 – 155.9), while non-pregnant women had UIC levels within the appropriate range (median = 190 μg/L; 95% IC = 159.3-200.1). UIC was below 150 µg/L in 57% of the pregnant women.Conclusions : Although a larger sample is needed to consolidate these findings, these results raise concerns about the adequacy of the iodine supply of pregnant women in Brazil, especially considering the new determinations of the Brazilian government, which have recently reduced the concentrations of iodine in table salt to 15-45 mg/kg of salt. Arq Bras Endocrinol Metab. 2014;58(3):282-7

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Community based screening for sickle haemoglobin among pregnant women in Benue State, Nigeria: I-Care-to-Know, a Healthy Beginning Initiative

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03974-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Osita U. Ezenwosu ◽

Ijeoma U. Itanyi ◽

Obiageli E. Nnodu ◽

Amaka G. Ogidi ◽

Fabian Mgbeahurike ◽

...

Keyword(s):

Prenatal Care ◽

Newborn Screening ◽

Pregnant Women ◽

Sickle Cell ◽

Sickle Cell Trait ◽

Tertiary Education ◽

Developed Countries ◽

Test Results ◽

Community Based ◽

Genotype Screening

Abstract Background Haemoglobin genotype screening at prenatal care offers women an opportunity to be aware of their genotype, receive education on sickle cell disease (SCD) and may increase maternal demand for SCD newborn screening. In developed countries, most pregnant women who access prenatal care and deliver at the hospital receive haemoglobin genotype screening. In settings with low prenatal care attendance and low hospital deliveries, community-based screening may provide similar opportunity for pregnant women. We assessed the feasibility and acceptability of integrating haemoglobin genotype screening into an existing community-based HIV program. Methods Onsite community-based integrated testing for HIV, hepatitis B virus and haemoglobin electrophoresis, were conducted for pregnant women and their male partners. Community Health Advisors implementing the NIH and PEPFAR-supported Healthy Beginning Initiative (HBI) program provided education on SCD, collected blood sample for haemoglobin electrophoresis and provided test results to participants enrolled into the HBI program. We concurrently conducted a cross-sectional study using a pretested, semi-structured, interviewer administered questionnaire to collect demographic data and assess awareness of individual haemoglobin “genotype” among HBI pregnant women participants. Results In this study, 99.9% (10,167/10,168) of pregnant women who received education on SCD accepted and completed the survey, had blood drawn for haemoglobin electrophoresis and received their results. A majority of participating pregnant women (97.0%) were not aware of their haemoglobin “genotype”. Among the participants who were incorrect about their haemoglobin “genotype”, 41.1% (23/56) of women who reported their haemoglobin “genotype” as AA were actually AS. The odds of haemoglobin “genotype” awareness was higher among participants who were in younger age group, completed tertiary education, had less number of pregnancies, and attended antenatal care. Overall prevalence of sickle cell trait (AS) was 18.7%. Conclusions It is feasible to integrate haemoglobin “genotype” testing into an existing community-based maternal-child program. Most pregnant women who were unaware of their haemoglobin “genotype” accepted and had haemoglobin genotype testing, and received their test results. Increasing parental awareness of their own haemoglobin “genotype” could increase their likelihood of accepting newborn screening for SCD.

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Role of iodine supply in neonatal adaptation of the thyroid system

Problems of Endocrinology ◽

10.14341/probl11471 ◽

2001 ◽

Vol 47 (3) ◽

pp. 10-15

Author(s):

E. P. Kasatkina ◽

D. Ye. Shilin ◽

L. M. Petrova ◽

Kh. A. Khatamova ◽

Ye. N. Lokteva ◽

...

Keyword(s):

Pregnant Women ◽

Potassium Iodide ◽

Iodine Deficiency ◽

Preventive Treatment ◽

Risk Groups ◽

Table Salt ◽

Intrauterine Development ◽

Thyrotropic Hormone ◽

Iodine Supply ◽

Iodine Treatment

Population frequency of neonatal hyperthyrotropinemia (NHT) in an iodine deficient region was studied with consideration for published reports about the relationship between prenatal iodine supply and fetal and neonatal thyroid function, and the efficiency of iodine prevention of this condition was evaluated by the results of overall screening of newborns for hypothyrosis. The concentrations of thyrotropic hormone (TTH) in whole blood specimens dried on paper were measured in 29588 newborns in the Belgorod region (Russia) in 1995-1998 using the Neonatal hTSH FEIA (Labsystems OY, Finland). Slight iodine deficiency in this region (median iodine excretion with urine 69 mcg/liter, n = 1313) was associated with an extremely high incidence of NHT: more than 5 iU/liter in 47% and more than 20 iU/liter in 7% newborns. Overall prevention with iodinated table salt during 1 year notably decreased the incidence of NHT (by 1.6 times, p < 0.001) and alleviated its severity from severe to mild degree. Preventive treatment of pregnant women by potassium iodide (200 mcg/day) during the same period more effectively decreased the incidence of the pathological parameter (five fold, p < 0.001). A lower incidence of NHT resultant from prenatal iodine treatment was associated with a lowering of the mean TTH level solely at the expense of the newborns with high levels of the hormone; if TTH levels were normal, they did not change. Therefore, thyroid dysfunction in newborns (NHT) indicates iodine deficiency in a region during intrauterine development; this abnormality can be prevented by iodine treatment in microdoses meeting the physiological requirement in iodine, which is increased during gestation. At the beginning of overall prevention of goiter by iodinated table salt, group prevention with potassium iodide is justified in risk groups, primarily in pregnant women; compensation of prenatal deficiency decreases the cost of screening for congenital hypothyrosis due to a lower requirement in TTH retesting.

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Unnoticed maternal Graves’ disease revealed by the baby’s low free thyroxine in newborn screening: an underestimated condition supporting thyroid disease screening among pregnant women

Journal of Endocrinological Investigation ◽

10.1007/s40618-017-0777-9 ◽

2017 ◽

Vol 41 (1) ◽

pp. 143-144

Author(s):

M. Adachi ◽

A. Soneda

Keyword(s):

Newborn Screening ◽

Pregnant Women ◽

Thyroid Disease ◽

Disease Screening ◽

Free Thyroxine ◽

Graves Disease

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A „silent” jódprofilaxis csak részben korrigálja a jódhiányt: a magyar történet (1970–2020)

Orvosi Hetilap ◽

10.1556/650.2020.31939 ◽

2020 ◽

Vol 161 (50) ◽

pp. 2107-2116

Author(s):

Ferenc Péter

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Public Information ◽

Numerical Data ◽

Iodine Content ◽

Monitoring And Evaluation ◽

Iodized Salt ◽

Food Sources ◽

Information Campaigns ◽

Iodine Supply

Összefoglaló. A szerző a bevezetőben emlékeztet a több mint 50 évvel korábbi publikációjára (Orv Hetil. 1968; 109: 360–363) és annak utóéletére: az 1970-es években megállt a jódprevenció fejlődése. Ezt követően ismerteti az utóbbi 50 év jódellátottságra vonatkozó fontosabb hazai eredményeit. A számszerű adatok szerint az iskolás gyermekek, várandós anyák, idősek és újszülöttek jódellátottságára, valamint az anyatej jódtartalmára vonatkozó sorozatvizsgálatok az ezredforduló előtt egybehangzóan enyhe, illetve mérsékelt jódhiányra utaltak. Az utóbbi két évtizedben egyre többször váltak adekváttá az ugyanezen kategóriák jódellátottságát jelző eredmények. A szabályozatlan jódozottsó-forgalom (fakultatív jódprevenció) ellenére, valószínűleg a sikeres felvilágosítási kampányok miatt, a lakosság jódellátottsága határozottan javult. Ezt a szituációt nevezik „silent” profilaxisnak. Ezzel a módszerrel nem lehet a jódhiányt teljesen felszámolni. A legnagyobb kockázatot a várandós anyák (közel felének!) hiányos jódpótlása jelenti az utódok agyfejlődésének veszélyeztetése miatt. A befejezésben az EUthyroid Consortium „Krakkói kiáltvány”-ának (2018) rövid ismertetése tartalmazza a teendőket. A kötelező jódprevencióhoz a nem jódozott sót ki kell váltani jódozott sóval szinte minden élelmiszerben. A graviditás alatt megnövekedett igényt az élelmiszerekben lévő jód gyakran nem fedezi, ilyenkor több jódpótlásra van szükség. Az egészségügyi szerveknek meg kell valósítaniuk a jóddúsító program összehangolt, rendszeres monitorozását és kiértékelését a lakosság optimális jódellátottságának biztosításához. Orv Hetil. 2020; 161(50): 2107–2116. Summary. In the introduction, the author reminds the readers of his publication presented more than 50 years ago in the same journal („Data to the present state of the goiter problem in Hungary”, 1968) and of its afterlife: the development of iodine prevention stopped in the 1970s. Then the major Hungarian results are reviewed related to the iodine supply gained in the latter 50 years. Numerical data are presented showing mild or moderate iodine deficiency according to the results of a range of screening studies among schoolchildren, pregnant women, elderly people and newborns as well as by iodine content of breast milk before the millennium. In the same categories, the data indicating the level of iodine supply became increasingly adequate in the recent two decades. The iodine supply of the people improved markedly, in spite of unregulated iodized salt trade (facultative prevention), presumably because of the successful public-information campaigns. This situation is called “silent” prophylaxis. The total eradication of iodine deficiency is impossible with this method. The highest risk is the deficient iodine supply of pregnant women (almost the half!) due to the endangerment of the offspring’s brain development. In the end, a brief review of the Krakow Declaration on Iodine of the EUthyroid Consortium comprises the round of the duties. To the mandatory iodine prevention, iodized salt should replace non-iodized salt in nearly all food productions. During pregnancy, the increased need for iodine is frequently not covered by food sources, more iodine supplement is needed. Health authorities should perform harmonized monitoring and evaluation of fortification programs at regular intervals to ensure optimal iodine supply to the population. Orv Hetil. 2020; 161(50): 2107–2116.

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