Urinary Iodine Status at Delivery in Rural Pregnant Mothers from KONKAN Region of India (BKLWHANC-2)

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Patil SN ◽  
◽  
Bhat P ◽  
Chavan S ◽  
Jadhav D ◽  
...  

Adequate iodine is necessary in pregnancy for normal maternal as well as fetal thyroid function. Fetus cannot produce thyroid hormone so it is exclusively dependent on mother. During pregnancy, iodine demand is increased by 50%. An adequate intake of dietary iodine in pregnancy is essential for the normal neurodevelopment of the offspring. We measured urinary iodine concentrations in 220 pregnant women who reported for delivery at a rural hospital in the KONKAN region of the State of Maharashtra, India. The mean age and gestation at delivery were 26.9 years and 38.2 weeks respectively. The observed median UIC was 84.6μg/l. Urinary iodine of mother was not associated with neonatal anthropometric measurements (weight, length and head circumference). We have found low median UIC levels at delivery among pregnant women. The increased demand in pregnancy could be met by iodine supplementation or increasing iodine content in the salt. The burden of poor iodine status in pregnant women will further adversely affect the fetal neurodevelopment. There should be universal screening of every pregnant woman for the identification of iodine status. A simple strategy of improving iodine content in the salt beyond the current recommendation for pregnant women might be beneficial for mother as well as fetus but continuous monitoring for adequate iodine is warranted.

2020 ◽  
Vol 124 (9) ◽  
pp. 971-978
Author(s):  
Zhengyuan Wang ◽  
Wei Jin ◽  
Zhenni Zhu ◽  
Xueying Cui ◽  
Qi Song ◽  
...  

AbstractAs city residents eat out more frequently, it is unknown that if iodised salt is still required in home cooking. We analysed the relationship of household salt and eating out on urinary iodine concentration (UIC) in pregnant women. A household condiment weighing method was implemented to collect salt data for a week. A household salt sample was collected. A urine sample was taken at the end of the week. Totally, 4640 participants were investigated. The median UIC was 139·1 μg/l in pregnant women and 148·7, 140·0 and 122·9 μg/l in the first, second and third trimesters. Median UIC in the third trimester was lower than in the other trimesters (P < 0·001). The usage rates of iodised (an iodine content ≥ 5·0 mg/kg) and qualified-iodised (an iodine content ≥ 21·0 mg/kg) salt were 73·9 and 59·3 %. The median UIC in the qualified-iodised salt group was higher than in the non-iodised group (P = 0·037). The median UIC in the non-iodised group who did not eat out was lower than in qualified-salt groups who both did and did not eat out (P = 0·007, <0·001). The proportion of qualified-iodised salt used in home cooking is low, but foods eaten out have universal salt iodisation according to the national compulsory policy. Household iodised salt did not play a decisive role in the iodine status of pregnant women. Pregnant women in their third trimester who are not eating out and using non-iodised salt at home require extra iodine.


2020 ◽  
Vol 11 ◽  
Author(s):  
Tal Schiller ◽  
Arnon Agmon ◽  
Viviana Ostrovsky ◽  
Gabi Shefer ◽  
Hilla Knobler ◽  
...  

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.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1037-1037
Author(s):  
Abu abdullah Mohammad Hanif ◽  
Md Mokbul Hossain ◽  
Mehedi Hasan ◽  
Abu Ahmed Shamim ◽  
Malay Kanti Mridha

Abstract Objectives Optimum Iodine status during pregnancy and lactation is crucial for normal fetal growth and child development. We assessed the urinary iodine concentration of pregnant and lactating women to determine their iodine status and measured salt iodine from their households. Methods We collected spot urine samples and corresponding household salt samples from 80 pregnant women (37 and 43 second and third-trimester women, respectively) and 49 lactating women (with children &lt;6 months). Urinary iodine was determined by manual digestion with ammonium persulfate followed by Sandell-Kolthoff Reaction using 96 multi-well plates and a micro-plate reader at 405 nm. The iodine content in salt was measured by iodometric titration method. Samples were analyzed at the icddr, b Immunology, Nutrition, and Toxicology Laboratory, Dhaka, Bangladesh. Results The median [IQR] UIC in the second-trimester women, third-trimester women, and lactating women was 90.6[41.9–171.5] mcg/L, 67.9[24.2–144.5] mcg/L, and 74.7[48.1–134.8] mcg/L, respectively. More than three-quarters of pregnant women (73% of the second-trimester women and 79% of the third-trimester women) and more than half of the lactating mothers (57%) were below the WHO recommended cut-offs. Only 42% of the household salts were adequately iodized. A moderate positive linear relationship was found between urinary and household salt iodine content (r = 0.51, P &lt; 0.0001). Conclusions Even with mandatory salt iodization policy in Bangladesh for about three decades, the iodine insufficiency among pregnant and lactating women is widespread and needs to be improved through ensuring the availability of adequately iodized salt or supplement. Funding Sources ETH Zurich, Switzerland.


2020 ◽  
Vol 26 (2) ◽  
pp. 63-69
Author(s):  
Scrinic Olesea ◽  
Delia Corina Elena ◽  
Toma Geanina Mirela ◽  
Circo Eduard

Abstract Objective: Assessment of iodine nutritional status in pregnant women in the perimarine area of Romania, a region without iodine deficiency. Adequate iodine intake is the main source for normal thyroid function, ensuring the need for maternal thyroid hormones during pregnancy, but also for the development and growth of children in the fetal and postpartum period. Material and method: Prospective study performed on 74 pregnant women in the first 2 trimesters of pregnancy, originating from the perimarin area. The following indicators of iodine status were analyzed: urinary iodine concentration (UIC), the ratio between urinary iodine concentration and urinary creatinine (UIC/UCr), the prevalence of maternal goiter and the value of neonatal TSH (thyroid stimulating hormone). Results: The mean gestational age was 11 weeks. The ways of iodine intake are: iodized salt - 59.4%, iodized salt and iodine supplements- 23%, only iodine supplements -10.8% and 6.8% consume only non-iodized salt. The median of UIC was 133.03 mcg/l considered insufficient iodine intake (normal in pregnancy UIC >150 mcg/l), but the adjustment of UIC to urinary creatinine reveals a median of 152.83 mcg/g, a value that reflects an adequate iodine intake. The prevalence of goiter was 25.6% characteristic for a moderate iodine deficiency. The prevalence of neonatal TSH >5 mIU/L was registered in 18.8% characteristic of mild iodine deficiency. Conclusions: Monitoring of the iodine nutritional status is recommended for the prevention of disorders due to iodine deficiency under the conditions of universal salt iodization. Perimarine areas considered sufficient in iodine may show variations in iodine status in subpopulations under certain physiological conditions, such as pregnancy. An indicator of iodine status of the population is UIC, but the UIC/UCr ratio may be a more optimal indicator for pregnant women, to avoid possible overestimated results of iodine deficiency in pregnancy.


2021 ◽  
pp. 1-9 ◽  
Author(s):  
Cátia Pinheiro ◽  
Nara Xavier Moreira ◽  
Pedro Ferreira ◽  
Cláudia Matta Coelho ◽  
Juliana Guimarães ◽  
...  

Abstract Lack of knowledge about iodine has been suggested as a risk factor for iodine deficiency in pregnant women, but no studies have addressed this issue in Portugal. So, the aim of this study was to investigate iodine knowledge among Portuguese pregnant women and its association with iodine status. IoMum, a prospective observational study, included 485 pregnant women recruited at Centro Hospitalar e Universitário de S. João, Porto, between the 10th and 13th gestational weeks. Partial scores for knowledge on iodine importance, on iodine food sources or on iodised salt were obtained through the application of a structured questionnaire. Then, a total iodine knowledge score was calculated and grouped into low, medium and high knowledge categories. Urinary iodine concentration (UIC) was measured in spot urine samples by inductively coupled plasma MS. Of the pregnant women, 54 % correctly recognised iodine as important to neurocognitive development, 32 % were unable to identify any iodine-rich food and 71 % presented lack of knowledge regarding iodised salt. Of the women, 61 % had a medium total score of iodine knowledge. Knowledge on iodine importance during pregnancy was positively associated with iodine supplementation and also with UIC. Nevertheless, median UIC in women who correctly recognised the importance of iodine was below the cut-off for adequacy in pregnancy (150 µg/l). In conclusion, knowledge on iodine importance is positively associated with iodine status. Despite this, recognising iodine importance during pregnancy may not be sufficient to ensure iodine adequacy. Literacy-promoting actions are urgently needed to improve iodine status in pregnancy.


2021 ◽  
Vol 5 (1) ◽  
pp. 018-026
Author(s):  
Delshad Hossein ◽  
Azizi Fereidoun

During the last few decades painstaking efforts have been made to eliminate iodine deficiency through the world. Nowadays 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. Severe iodine deficiency during pregnancy increases the risk of irreversible brain damage, intellectual disability, neurologic abnormalities, stunted growth, increased pregnancy loss, infant mortality, impairments in child development and cretinism. The potential effects of mild-to-moderate iodine deficiency are debated. Results from animal studies and observational human studies indicate that maternal mild-to-moderate iodine deficiency disturbs thyroid function in pregnancy and it also may affects fetal neurodevelopment. The effect of supplementation of iodine on thyroid function of pregnant women and their newborn, neurodevelopment of infants and cognitive performance of children have been investigated using iodine nutrition in pregnancy, based on median urinary iodine concentration. However they have found conflicting results regarding the benefits or harms of iodine supplementation in pregnancy. Although many epidemiological, interventional and clinical studies have supported the association between thyroid function in pregnant women and later psychomotor and mental development of their children, the effect of iodine supplementation in pregnant women on neurodevelopment of children is inconclusive. Even in areas with well-established universal salt iodization program, pregnancy could be at risk of having iodine deficiency and despite WHO/ICCIDD/UNICEF recommendation which believe that dietary iodine fortification during pregnancy depends primarily on the extent of pre-existing iodine deprivation, systematic dietary fortification needs to be implemented in this vulnerable group. However, iodine supplementation of mildly iodine deficient pregnant women may not have beneficial effects in their thyroid function or neurodevelopment of their children.


Author(s):  
Katarzyna Gajewska ◽  
Marzena Laskowska ◽  
Anna Blazewicz

Abstract Preeclampsia (PE) is one of the leading causes of perinatal and maternal morbidity. Although subclinical hypothyroidism in pregnancy is one of the established risk factors for PE, the link between iodine deficiency and PE is not fully understood. The aim of our study was to assess urinary iodine concentration (UIC), serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) levels in Polish women with PE (PE group, n=78) compared with healthy non-pregnant women (CNP group, n=30), and healthy pregnant women (CP group, n=46). The UIC was determined by inductively coupled plasma mass spectrometry (ICP-MS). Both the mean UIC of 144.6±36.4 μg/L in the CP group and the mean of 125.8±33.6 μg/L in the PE group, respectively, were lower compared to non-pregnant women (149.8±28.8 μg/L), and the difference between the PE and CNP groups was statistically significant. TSH values were the highest in the PE group, while the lowest average level was for the CNP group. The fT3 and fT4 values in the PE group were significantly lower compared to the CNP and CP groups. Despite iodine supplementation during pregnancy, the UIC was lower compared to non-pregnant women, while in women with PE it was at a significantly lower level. To reduce the incidence of possible health complications, proper iodine supplementation and monitoring of the UIC is recommended for pregnant women suffering from PE or at risk of developing PE.


2016 ◽  
Vol 20 (7) ◽  
pp. 1154-1161 ◽  
Author(s):  
Sonja Y Hess ◽  
Césaire T Ouédraogo ◽  
Rebecca R Young ◽  
Ibrahim F Bamba ◽  
Sara Stinca ◽  
...  

AbstractObjectiveTo assess iodine status among pregnant women in rural Zinder, Niger and to compare their status with the iodine status of school-aged children from the same households.DesignSeventy-three villages in the catchment area of sixteen health centres were randomly selected to participate in the cross-sectional survey.SettingSalt iodization is mandatory in Niger, requiring 20–60 ppm iodine at the retail level.SubjectsA spot urine sample was collected from randomly selected pregnant women (n662) and one school-aged child from the same household (n373). Urinary iodine concentration (UIC) was assessed as an indicator of iodine status in both groups. Dried blood spots (DBS) were collected from venous blood samples of pregnant women and thyroglobulin (Tg), thyroid-stimulating hormone and total thyroxine were measured. Iodine content of household salt samples (n108) was assessed by titration.ResultsMedian iodine content of salt samples was 5·5 ppm (range 0–41 ppm), 98 % had an iodine content <20 ppm. Median (interquartile range) UIC of pregnant women and school-aged children was 69·0 (38·1–114·3) and 100·9 (61·2–163·2) µg/l, respectively. Although nearly all pregnant women were euthyroid, their median (interquartile range) DBS-Tg was 34·6 (23·9–49·7) µg/l and 38·4 % had DBS-Tg>40 µg/l.ConclusionsIn this region of Niger, most salt is inadequately iodized. UIC in pregnant women indicated iodine deficiency, whereas UIC of school-aged children indicated marginally adequate iodine status. Thus, estimating population iodine status based solely on monitoring of UIC among school-aged children may underestimate the risk of iodine deficiency in pregnant women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Afsaneh Keramat ◽  
Mina Malary ◽  
Mahmood Moosazadeh ◽  
Nastaran Bagherian ◽  
Mohammad-Reza Rajabi-Shakib

Abstract Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P <  0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P <  0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.


Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 916 ◽  
Author(s):  
Andrea Hemmingway ◽  
Karen O’Callaghan ◽  
Áine Hennessy ◽  
George Hull ◽  
Kevin Cashman ◽  
...  

Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks’ gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = −0.311, p < 0.001), but not with calcium intake or serum calcium (r = −0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800–1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration.


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