Assessment of iodofolic supplementation on thyroid function in pregnant women with iodine sufficient status and their infants in Birjand

2021 ◽  
Vol 17 ◽  
Author(s):  
Maryam Rezaei ◽  
Naeemeh Ataei ◽  
Asghar Zarban ◽  
Nahid Mobasher ◽  
Tahereh Farkhondeh ◽  
...  

Background: Maintaining iodine at sufficient levels is necessary throughout the pregnancy to prevent adverse outcomes in infants. This study aimed to assess iodofolic supplementation's impact on thyroid function in women at the end of the third trimesters of gestation. Methods: This case-control study was conducted on 130 pregnant women in the Birjand, east of Iran, during the period from August 2017 to February 2019. We assessed iodofolic supplementation effect in the women at the first trimesters of gestation and followed them at the end of the third trimesters and also their infants on days 3-5. Serum samples were obtained from women and infants for measuring levels of thyroid-stimulating hormone (TSH). Urinary iodine concentration (UIC) was also determined at the end of the third trimester. Results: The median serum TSH concentration in the folic acid consumed group (3.26 ± 1.91) did not significantly differ from another group (2.98 ± 1.41), (p = 0.68). There is also no considerable difference in the mean serum TSH concentration between infants born from mothers who consumed folic acid in the first trimester of pregnancy and another group (p = 0.50). The TSH concentration in all infants was below 5 µM/L. The significant difference in the mean of UIC was also not observed between pregnant women in the folic acid consumed group (188.02 ± 105.38) and iodofolic consumed group (225.77 ± 130.26), (p = 0.13). Conclusion: Iodine intake in our study was sufficient according to the WHO recommendation and idofolic supplementation was not emphasized.

2018 ◽  
Vol 7 (5) ◽  
pp. 762-767 ◽  
Author(s):  
Verônica Carneiro Borges Mioto ◽  
Ana Carolina de Castro Nassif Gomes Monteiro ◽  
Rosalinda Yossie Asato de Camargo ◽  
Andréia Rodrigues Borel ◽  
Regina Maria Catarino ◽  
...  

Objectives Iodine deficiency during pregnancy is associated with obstetric and neonatal adverse outcomes. Serum thyroglobulin (sTg) and thyroid volume (TV) are optional tools to urinary iodine concentration (UIC) for defining iodine status. This cross-sectional study aims to evaluate the iodine status of pregnant women living in iodine-adequate area by spot UIC and correlation with sTg, TV and thyroid function. Methods Two hundred and seventy-three pregnant women were evaluated at three trimesters. All had no previous thyroid disease, no iodine supplementation and negative thyroperoxidase and thyroglobulin antibodies. Thyroid function and sTg were measured using electrochemiluminescence immunoassays. TV was determined by ultrasonography; UIC was determined using a modified Sandell–Kolthoff method. Results Median UIC was 146 µg/L, being 52% iodine deficient and only 4% excessive. TSH values were 1.50 ± 0.92, 1.50 ± 0.92 and 1.91 ± 0.96 mIU/L, respectively, in each trimester (P = 0.001). sTg did not change significantly during trimesters with median 11.2 ng/mL and only 3.3% had above 40 ng/mL. Mean TV was 9.3 ± 3.4 mL, which positively correlated with body mass index, but not with sTg. Only 4.5% presented with goitre. When pregnant women were categorized as iodine deficient (UIC < 150 µg/L), adequate (≥150 and <250 µg/L) and excessive (≥250 µg/L), sTg, thyroid hormones and TV at each trimester showed no statistical differences. Conclusions Iodine deficiency was detected frequently in pregnant women living in iodine-adequate area. sTg concentration and TV did not correlate to UIC. Our observation also demonstrated that the Brazilian salt-iodization programme prevents deficiency, but does not maintain iodine status within adequate and recommended ranges for pregnant women.


2017 ◽  
Vol 8 (1) ◽  
pp. 21-26
Author(s):  
PR Saha ◽  
R Maleque ◽  
S Biswas ◽  
R Haque ◽  
F Khondker ◽  
...  

Pregnancy is accompanied by profound alteration of thyroid economy and relative iodine deficiency. Sub-optimal thyroid function in pregnancy is associated with impaired neuro intellectual development. Urinary iodine concentration is increased during pregnancy. The aims of this study were to evaluate urinary iodine level in pregnant women and also to elucidate its correlation with thyroid parameters (TSH&FT4) in pregnancy. This was a case control study carried out in the Department of Biochemistry, jointly with the Antenatal and Thyroid Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period of July 2003 to June 2004. Urinary iodine excretion was measured in 100 subjects of age range 20-35 years. Among them 60 were pregnant at first trimester and primi gravid. Rest 40 were non-pregnant women who were taken as control. Urinary iodine was measured by Wet digestion based on Sandell-Kolthoff principle. Thyroid Stimulating hormone (TSH) and free thyroxin (FT4) were measured by the AxSYM (Abbott -USA) by applying Micro particle Enzyme Immune Assay (MEIA) principle. The data was reported as Mean± SE; the mean age of the pregnant and nonpregnant women were 25.03±0.48 yrs and 25.20±0.60 yrs respectively. No significant difference was found regarding age. The median urinary iodine of pregnant women was 438.13µg/l (range240.50-490.0) and that non pregnant women was 412.50µg/l (range 240.0-473.75µgl). Mean serum TSH were 1.29±0.15 and 1.97±0.18 mIU/L and mean serum FT4 were 14.51±0.41 and 16.30 ±0.41pmol/L in pregnant and non pregnant women respectively. Urinary iodine level was significantly increased in pregnant women compared to that of the non pregnant group (p<0.05). A significant negative correlation was found between urinary iodine and serum TSH (p<0.01) whereas a positive correlation between urinary iodine and serum FT4 level is p<0.05 in pregnant and p<0.01 in non pregnant group. Urinary iodine excretion is increased in pregnancy than that in non pregnant women. Clinically and biochemically all the subjects were euthyroid and excretion rate of iodine in all subjects were above the normal range.Bangladesh J Med Biochem 2015; 8(1): 21-26


2019 ◽  
pp. 1-9 ◽  
Author(s):  
Carolina Martins Corcino ◽  
Tatiana Martins Benvenuto Louro Berbara ◽  
Débora Ayres Saraiva ◽  
Nathalie Anne de Oliveira e Silva de Morais ◽  
Annie Schtscherbyna ◽  
...  

AbstractObjectiveTo assess iodine status and its effects on maternal thyroid function throughout pregnancy.DesignIn the present prospective cohort study, three urinary samples were requested for urinary iodine concentration (UIC) determinations in both the first and third gestational trimesters. Serum thyrotropin (TSH) and free thyroxine (FT4) were analysed in both trimesters and thyroid antibodies were assessed once.SettingRio de Janeiro, Brazil.ParticipantsFirst-trimester pregnant women (n243), of whom 100 were re-evaluated during the third trimester.ResultsIodine sufficiency was found in the studied population (median UIC=216·7 µg/l). The first- and third-trimester median UIC was 221·0 and 208·0 µg/l, respectively. TSH levels (mean (sd)) were higher in the third trimester (1·08 (0·67)v. 1·67 (0·86) mIU/l;P<0·001), while FT4levels decreased significantly (1·18 (0·16)v. 0·88 (0·12) ng/dl;P<0·001), regardless the presence of iodine deficiency (UIC<150 µg/l) or circulating thyroid antibodies. UIC correlated (β; 95% CI) independently and negatively with age (–0·43; –0·71, –0·17) and positively with multiparity (0·15; 0·02, 0·28) and BMI (0·25; 0·00, 0·50). Furthermore, median UIC per pregnant woman tended to correlate positively with TSH (0·07; –0·01, 0·14). Women with median UIC≥250 µg/l and at least one sample ≥500 µg/l throughout pregnancy had a higher risk of subclinical hypothyroidism (OR=6·6; 95% CI 1·2, 37·4).ConclusionsIn this cohort with adequate iodine status during pregnancy, excessive UIC was associated with an increased risk of subclinical hypothyroidism.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Norman Blumenthal ◽  
Karen Byth ◽  
Creswell J. Eastman

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.


Author(s):  
Masoomeh Shirzaiy ◽  
Zohreh Dalirsani

Abstract Objectives During pregnancy, systemic physiological alterations lead to some changes in the oral cavity, which could prepare the mouth environment for oral and dental problems. This study was aimed to investigate salivary α-amylase, sialic acid levels, and pH levels in pregnant and nonpregnant females. Materials and Methods In this analytical, case–control study, unstimulated saliva samples were collected with spiting method from 35 pregnant women (case group) and 35 nonpregnant women (control group) and transferred to the laboratory to assess salivary α-amylase, sialic acid, and pH levels. Data were analyzed by SPSS (version: 19) software through statistical methods of independent t-test and analysis of variance. Results The mean sialic acid levels were 2.285 ± 1.230 mg/dL in pregnant and 2.744 ± 1.326 in nonpregnant women without any significant difference (p = 0.138). The mean salivary α-amylase concentrations were 2.461 ± 1.869 U/L and 2.439 ± 2.058 U/L, respectively, in pregnant and nonpregnant women, with no significant difference (p = 0.963).The mean salivary pH in nonpregnant women was significantly more than that in pregnant women (7.845 ± 0.430 and 6.868 ± 0.413, respectively) (p < 0.001). Also, the mean salivary pH levels in pregnant women were 7.474 ± 0.420 in the first trimester, 6.868 ± 0.413 in the second trimester, and 6.568 ± 0.387 in the third trimester, which were significantly different (p < 0.001). Conclusion Salivary sialic acid and α-amylase levels among pregnant women were no different from those of other subjects. During pregnancy, the salivary pH significantly reduced, and the mean salivary pH during pregnancy had a decreasing trend from the first trimester to the third trimester.


2020 ◽  
Author(s):  
Zhengyuan Wang ◽  
Yiwen Wu ◽  
Zehuan Shi ◽  
Jun Song ◽  
Guoquan Wang ◽  
...  

Abstract Background: China’s universal salt-iodization program has all but eliminated iodine deficiency disorders. Concern has shifted to mild iodine deficiency. Our study examined factors with the potential to predict mild iodine deficiency in pregnant women. Methods: A total of 2 400 pregnant women were enrolled using a multistage, stratified, random-sampling method. Data were collected through face-to-face interviews, a standardized questionnaire, an iodine-related knowledge questionnaire, urine samples, and household cooking salt samples. Results: The median urinary iodine concentration (MUIC) was 148.0 μg/L for all participants, and 155.0 μg/L, 151.0 μg/L, and 139.6 μg/L in the first, second, and third trimesters, respectively. The third trimester’s MUIC was significantly lower than that of the first trimester, and the usage rates of iodized salt and qualified-iodized salt were 71.5% and 59.4%, respectively. Iodine-related knowledge was significantly different between the high and low UIC groups. Participants’ MUIC increased significantly with increases in iodine-related knowledge. The third trimester was a significant risk factor for high UIC, whereas abundant iodine-related knowledge, study the dietary knowledge urgently, and consumption of iodine-rich food within 48 hours of a urine iodine test were significant protective factors for high UIC (P<0.05). Conclusions: Iodine levels are adequate among pregnant women in Shanghai during the first and second trimesters, but insufficient in the third trimester. The use of iodized cooking salt does not determine the iodine status of pregnant women. Abundant iodine-related knowledge is important for pregnant women in the third trimester to maintain adequate urinary iodine.


2020 ◽  
Vol 24 (4) ◽  
pp. 618-623
Author(s):  
O. B. Lastovetska ◽  
O. V. Bulavenko

Annotation. The prevention of early pregnancy loss, taking into account the polymorphism of the genes of enzymes that controlling folate metabolism, have become the goal of clinical studies in recent years, and the determination of risk factors for patients of late reproductive age and embryonic losses in history becomes critical for the development of effective measures to prevent miscarriage. The use of medical prevention of perinatal pathology using a biologically active form of folate in the form of 5-methyltetrahydrofolate in women with anamnestic loss of pregnancy looks promising. The aim of the study was to evaluate the effectiveness of drug prevention in patients with anamnestic embryonic losses, taking into account the role of the rs1801133 (677 C>T) polymorphism of the MTHFR gene based on the results of the dynamics of serum levels of homocysteine, betaine, and methionine. The patients were divided into the main group (polymorphism rs1801133 (677 C>T) of the MTHFR gene and anamnestic embryonic loss), which was divided into 2 subgroups: I subgroup included 20 women who received folic acid preparations (400 μg per day), II subgroup – 20 patients who received a complex preparation containing 5-methyltetrahydrofolate and control groups (practically healthy women) (n=20). Prescribing drugs began at the pre-gravid stage 8–10 weeks before pregnancy planning, and the administration ended up to 26 weeks of pregnancy. Determination of serum homocysteine levels and markers of folate metabolism - methionine and betaine – were performed at the end of the 1st – beginning of the 2nd trimester of pregnancy and in the third trimester. In the study of the effectiveness of preventive therapy on the dynamics of markers of folate metabolism functionality in pregnant women of late reproductive age with anamnestic embryonic losses and polymorphism rs1801133 (677 C>T) of the MTHFR gene when using a combined drug containing folic acid and 5-methyltetrahydrofolate, at the first end – at the beginning In the second trimester, there was a significant increase in betaine and methionine (p<0.05), while in the third trimester, a positive statistically significant difference (p<0.05) was diagnosed in an increase in methionine, betaine and a decrease in serum homocysteine levels.


2010 ◽  
Vol 95 (7) ◽  
pp. 3207-3215 ◽  
Author(s):  
Elizabeth N. Pearce ◽  
John H. Lazarus ◽  
Peter P. A. Smyth ◽  
Xuemei He ◽  
Daniela Dall'Amico ◽  
...  

Context: Thyroid hormone, requiring adequate maternal iodine intake, is critical for fetal neurodevelopment. Perchlorate decreases thyroidal iodine uptake by competitively inhibiting the sodium/iodide symporter. It is unclear whether environmental perchlorate exposure adversely affects thyroid function in pregnant women. Thiocyanate, derived from foods and cigarette smoke, is a less potent competitive sodium/iodide symporter inhibitor than perchlorate. Objective: Our objective was to determine whether environmental perchlorate and/or thiocyanate exposure is associated with alterations in thyroid function in pregnancy. Design and Setting: We conducted a cross-sectional study at health centers in Cardiff, Wales, and Turin, Italy. Patients: During 2002–2006, 22,000 women at less than 16 wk gestation were enrolled in the Controlled Antenatal Thyroid Screening Study. Subsets of 261 hypothyroid/hypothyroxinemic and 526 euthyroid women from Turin and 374 hypothyroid/hypothyroxinemic and 480 euthyroid women from Cardiff were selected based on availability of stored urine samples and thyroid function data. Main Outcome Measures: Urinary iodine, thiocyanate, and perchlorate and serum TSH, free T4 (FT4), and thyroperoxidase antibody were measured. Results: Urinary iodine was low: median 98 μg/liter in Cardiff and 52 μg/liter in Turin. Urine perchlorate was detectable in all women. The median (range) urinary perchlorate concentration was 5 μg/liter (0.04–168 μg/liter) in Turin and 2 μg/liter (0.02–368 μg/liter) in Cardiff. There were no associations between urine perchlorate concentrations and serum TSH or FT4 in the individual euthyroid or hypothyroid/hypothyroxinemic cohorts. In multivariable linear analyses, log perchlorate was not a predictor of serum FT4 or TSH. Conclusions: Low-level perchlorate exposure is ubiquitous but did not affect thyroid function in this cohort of iodine-deficient pregnant women.


Author(s):  
Arfat Bashir ◽  
Samreen Naz ◽  
Marium Khalil ◽  
Mehmil Aslam ◽  
Fida Hussain ◽  
...  

Introduction: The most common dento-alveolar procedure is surgical removal of an impacted third molar, which is associated with post-operative pain, swelling, and trismus. Objective: To determine the effect of submucosal dexamethasone injection on the post-operative outcomes in third molar surgeries. Materials and Methods: It was a descriptive study conducted in Department of Oral & Maxillofacial Surgery, Liaquat College of Medicine & Dentistry, Karachi between November 7, 2019 to May 6, 2020. All patients who fulfilled the inclusion criteria and visited to LCMD, Karachi were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, all the patients (n=65) received 4mg submucosal dexamethasone injection. The duration of surgery was recorded with postoperative outcomes in terms of pain, trismus and swelling were measured on 3rd and 7th day. All the collected data were entered into the proforma and used electronically for research purpose. Results:  The mean SD of age was 25.9 ± 7.2 years. Right side surgery was documented in 39 (60%) patients, while left side surgery was documented in 26 (40%) patients. On the third and seventh day, the mean SD of VAS pain score was (5.9 ± 3.2), (3.8 ± 4.4), swelling was (2.5 ± 1.1), (0.9 ± 0.6) mm, and trismus was (16.9 ± 9.7), (11.8 ± 9.1) mm, respectively. Conclusion:  It is to be concluded that a significant difference in outcomes was observed between the third and seventh post-operative days in patients who had submucosal dexamethasone injections in third molar surgeries.


2021 ◽  
Vol 8 ◽  
Author(s):  
Sicelosethu S. Siro ◽  
Jeannine Baumgartner ◽  
Maryke Schoonen ◽  
Jennifer Ngounda ◽  
Linda Malan ◽  
...  

Background: The sodium iodide symporter is responsible for the transfer of iodine into breast milk and is encoded for by the SLC5A5 gene. The role of genetic variants in the SLC5A5 gene locus in relation to the transfer of iodine from plasma into breast milk in healthy lactating individuals has, to our knowledge, not been explored.Objective: To identify and characterize possible genetic variants of the SLC5A5 gene in women of African descent living in urban South Africa, and to study associations with breast milk iodine concentrations (BMIC) in lactating women.Methods: This study is affiliated to the Nutrition during Pregnancy and Early Development (NuPED) cohort study (n = 250 enrolled pregnant women). In a randomly selected sub-sample of 32 women, the SLC5A5 gene was sequenced to identify known and novel variants. Of the identified variants, genotyping of selected variants was performed in all pregnant women who gave consent for genetic analyses (n = 246), to determine the frequency of the variants in the study sample. Urinary iodine concentration (UIC) in spot urine samples and BMIC were measured to determine iodine status. Associations of SLC5A5 genetic variants with BMIC were studied in lactating women (n = 55).Results: We identified 27 variants from sequencing of gene exomes and 10 variants were selected for further study. There was a significant difference in BMIC between the genotypes of the rs775249401 variant (P = 0.042), with the homozygous GG group having lower BMIC [86.8 (54.9–167.9) μg/L] compared to the (A) allele carriers rs775249401(AG+AA) [143.9 (122.4–169.3) μg/L] (P = 0.042). Of the rs775249401(GG), 49% had UIC &lt;100 μg/L and 61% had BMIC &lt;100 μg/L. On the other hand, 60% of the rs775249401(AG+AA) carriers had UIC &lt;100 μg/L, and none had a BMIC &lt;100 μg/L.Conclusion: Our results suggest that A-allele carriers of rs775249401(AG+AA) are likely to have higher iodine transfer into breast milk compared to the homozygous GG counterparts. Thus, genetic variations in the SLC5A5 gene may play an important role in the transfer of iodine from plasma into breast milk and may partially explain inter-individual variability in BMIC.


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