Iodine nutrition status, thyroid function in the first trimester of pregnancy and pregnancy progression in women residing in an area of know moderate iodine deficiency

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (<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.

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Iodine nutrition status of women after 10 years of Lipiodol supplementation: a cross-sectional study in Xinjiang, China

British Journal Of Nutrition ◽

10.1017/s0007114520003918 ◽

2020 ◽

pp. 1-13

Author(s):

Lixiang Liu ◽

Peng Liu ◽

Qin Lin ◽

Xiaohui Su ◽

Jia Huang ◽

...

Keyword(s):

Iodine Deficiency ◽

Urinary Iodine ◽

Thyroid Volume ◽

Nutrition Status ◽

Thyroid Peroxidase ◽

Urinary Iodine Concentration ◽

Free Triiodothyronine ◽

Iodine Nutrition ◽

Detection Rates ◽

Status Of Women

Abstract This study examined the contribution of long-term use of Lipiodol capsules, as a supplement to iodised salt to the control of iodine deficiency disorders among women in Xinjiang of China. A total of 1220 women across Kashgar, Aksu, Turpan and Yili Prefectures were surveyed in 2017. Lipiodol capsules were administered twice yearly in Kashgar and once yearly in Aksu and Turpan, but not in Yili. Urinary iodine concentration (UIC), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody, thyroid peroxidase antibody and thyroid volume values were assessed. All the women in the four areas were in a state of non-iodine deficiency by UIC. The UIC were higher than adequate in Kashgar and Aksu (619·4 v. 278·6 μg/l). Thyroid hormone levels differed significantly in Turpan and Yili (FT3: 4·4 v. 4·6 pmol/l, FT4: 13·8 v. 14·2 pmol/l, TSH: 2·0 v. 2·7 mIU/l), but did not differ significantly in Kashgar, Aksu and Yili. The four areas did not differ significantly with regard to thyroid nodules, autoimmune thyroiditis or goitre. However, the detection rates of subclinical hypothyroidism (16·6 %) and total thyroid dysfunction (25·4 %) were higher among women in Yili. The supplementation with Lipiodol capsules had improved the iodine nutrition status of women in iodine-deficient areas of Xinjiang since 2006. To avoid negative effects of excess iodine, we suggest a gradual discontinuation of Lipiodol capsules in women with special needs based on the existing iodine nutrition level of local women.

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Maternal Thyroid Function during the First Trimester of Pregnancy in Korean Women

International Journal of Thyroidology ◽

10.11106/ijt.2017.10.1.36 ◽

2017 ◽

Vol 10 (1) ◽

pp. 36 ◽

Cited By ~ 2

Author(s):

Hyung Wook Choi ◽

You Jung Han ◽

Dong Wook Kwak ◽

So Young Park ◽

Sung Hoon Kim ◽

...

Keyword(s):

Thyroid Function ◽

First Trimester ◽

Korean Women ◽

First Trimester Of Pregnancy ◽

Maternal Thyroid

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The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status

Best Practice & Research Clinical Endocrinology & Metabolism ◽

10.1016/j.beem.2004.03.001 ◽

2004 ◽

Vol 18 (2) ◽

pp. 133-152 ◽

Cited By ~ 158

Author(s):

Daniel Glinoer

Keyword(s):

Thyroid Function ◽

Normal Pregnancy ◽

Nutrition Status ◽

Iodine Nutrition

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The Role of Iodine for Thyroid Function in Lactating Women and Infants

Endocrine Reviews ◽

10.1210/endrev/bnab029 ◽

2021 ◽

Author(s):

Maria Andersson ◽

Christian P Braegger

Keyword(s):

Thyroid Hormone ◽

Thyroid Function ◽

Iodine Deficiency ◽

Current Knowledge ◽

Iodine Intake ◽

Infants And Toddlers ◽

Iodine Nutrition ◽

Lactating Women ◽

Hormone Synthesis ◽

The Impact

Abstract Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.

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

BMJ Open ◽

10.1136/bmjopen-2018-025573 ◽

2019 ◽

Vol 9 (5) ◽

pp. e025573 ◽

Cited By ~ 1

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.

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Prevention of iodine deficiency disorders by oral administration of lipiodol during pregnancy

Acta Endocrinologica ◽

10.1530/eje.0.1300547 ◽

1994 ◽

Vol 130 (6) ◽

pp. 547-551 ◽

Cited By ~ 58

Author(s):

Mohamed L Chaouki ◽

Moulay Benmiloud

Keyword(s):

Oral Administration ◽

Iodine Deficiency ◽

Urinary Iodine ◽

First Trimester ◽

Free Thyroxine ◽

Untreated Group ◽

Iodine Deficiency Disorders ◽

Neonatal Hypothyroidism ◽

First Trimester Of Pregnancy ◽

Group D

Chaouki ML. Benmiloud M. Prevention of iodine deficiency disorders by oral administration of lipiodol during pregnancy. Eur J Endocrinol 1994;130:547–51. ISSN 0804–4643 The prevalence of iodine deficiency disorders and the thyroid status of the population were studied in an endemic goitre area in Algeria. After oral administration of lipiodol (0.5 ml), three treated groups of mother–newborn couples were compared to an untreated group: group A, mothers treated 1–3 months before conception; group B, mothers treated during the first month of pregnancy; group C, mothers treated during the third month of pregnancy. Untreated mothers were used as a control (group D). After lipiodol treatment, all newborn babies and mothers were clinically euthyroid. All tested newborn babies were full term and no goitre was observed in the four groups. In the mothers, goitre prevalence and thyrotrophin levels decreased significantly, whereas maternal milk and urinary iodine and serum-free thyroxine levels were significantly higher after treatment. The rate of prematurity, stillbirths and abortions in the treated groups was reduced when compared to the untreated group, whereas placental and birth weights were significantly higher. In group D two cases of neonatal hypothyroidism were detected. Their re-evaluation confirmed that hypothyroidism was transient. Groups A, B and C were statistically different from group D with regard to neonatal thyrotrophin and thyroxine. Positive correlations were found between neonatal thyroxine and birth weights and placental weights on the one hand, and maternal urinary iodine and free thyroxine on the other. Consequently, these data indicate that oral administration of lipiodol before or during the first trimester of pregnancy normalizes thyroid function in newborn babies and mothers, increases placental and birth weight and reduces the frequency of iodine deficiency disorders. Lipiodol at this dose and during the first trimester of pregnancy had no deleterious effects and may prevent hypothyroid or neurological cretinism. Mohamed Lamine Chaouki, Service d'Endocrinologie, Centre Hospitalo-Universitaire de Batna, Route de Tazoult 05000, Batna, Algeria

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