Iodine deficiency in pregnant women on São Miguel Island, Azores. Assessing the Impact of Corrective Measures

BackgroundPlacental transport of iodide is required for fetal thyroid hormone production. The sodium iodide symporter (NIS) mediates active iodide transport into the thyroid and the lactating mammary gland and is also present in placenta. NIS is competitively inhibited by thiocyanate from maternal smoking, but compensatory autoregulation of iodide transport differs between organs. The extent of autoregulation of placental iodide transport remains to be clarified.ObjectiveTo compare the impact of maternal smoking on thyroglobulin (Tg) levels in maternal serum at delivery and in cord serum as markers of maternal and fetal iodine deficiency.MethodsOne hundred and forty healthy, pregnant women admitted for delivery and their newborns were studied before the iodine fortification of salt in Denmark. Cotinine in urine and serum classified mothers as smokers (n=50) or nonsmokers (n=90). The pregnant women reported on intake of iodine-containing supplements during pregnancy and Tg in maternal serum at delivery and in cord serum were analyzed.ResultsIn a context of mild-to-moderate iodine deficiency, smoking mothers had significantly higher serum Tg than nonsmoking mothers (mean Tg smokers 40.2 vs nonsmokers 24.4 μg/l, P=0.004) and so had their respective newborns (cord Tg 80.2 vs 52.4 μg/l, P=0.006), but the ratio between Tg in cord serum and maternal serum was not significantly different in smokers compared with nonsmokers (smoking 2.06 vs nonsmoking 2.22, P=0.69).ConclusionMaternal smoking increased the degree of iodine deficiency in parallel in the mother and the fetus, as reflected by increased Tg levels. However, placental iodide transport seemed unaffected despite high thiocyanate levels, suggesting that thiocyanate-insensitive iodide transporters alternative to NIS are active or that NIS in the placenta is autoregulated to keep iodide transport unaltered.

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Women Remain at Risk of Iodine Deficiency during Pregnancy: The Importance of Iodine Supplementation before Conception and Throughout Gestation

Nutrients ◽

10.3390/nu11010172 ◽

2019 ◽

Vol 11 (1) ◽

pp. 172 ◽

Cited By ~ 8

Author(s):

Kristen Hynes ◽

Judy Seal ◽

Petr Otahal ◽

Wendy Oddy ◽

John Burgess

Keyword(s):

At Risk ◽

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Supplement Use ◽

Iodine Supplementation ◽

The Impact

In Australia, pregnant women are advised to take an iodine supplement (I-supp) (150 µg/day) to reduce risks to the foetus associated with iodine deficiency (ID). To examine the impact of this recommendation on iodine status, and to identify factors that contribute to adequacy during gestation, supplement use and Urinary Iodine Concentration (UIC) was measured in 255 pregnant women (gestation range 6 to 41 weeks) in Tasmania. The median UIC (MUIC) of 133 µg/L (Inter-quartile range 82–233) was indicative of ID, being below the 150–249 µg/L range for adequacy during pregnancy. Women taking an iodine-containing-supplement (I-supp) had a significantly higher MUIC (155 µg/L) (n = 171) compared to the combined MUIC (112.5 µg/L) (n = 84) of those who had never (120 µg/L) (n = 61) or were no longer taking an I-supp (90 µg/L) (n = 23) (p = 0.017). Among women reporting I-supp use, the MUIC of those commencing the recommended 150 µg/day prior to conception was significantly higher than those starting supplementation following pregnancy confirmation: 196 (98–315) µg/L (n = 45) versus 137.5 (82.5–233.5) µg/L (n = 124), p = 0.032. Despite recommendations for iodine supplementation pregnant Tasmanian women remain at risk of ID. Commencing an I-supp of 150 µg/day prior to conception and continuing throughout pregnancy is required to ensure adequacy. Timely advice regarding the importance of adequate iodine nutrition, including supplementation is needed to reduce the risk of irreversible in utero neurocognitive damage to the foetus.

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THE IMPACT OF THE PSYCHOLOGICAL GESTATIONAL DOMINANCE OF THE MOTHER ON THE STATE OF HEALTH OF BORN CHILDREN

Российский педиатрический журнал ◽

10.18821/1560-9561-2017-20-6-324-328 ◽

2019 ◽

Vol 20 (6) ◽

pp. 324-328

Author(s):

V. N. Shestakova ◽

Marina Aleksandrovna Ermasheva ◽

S. P. Zagday ◽

Yu. V. Marchenkova

Keyword(s):

Pregnant Women ◽

Musculoskeletal System ◽

Children With Disabilities ◽

Negative Impact ◽

The State ◽

State Of Health ◽

Impaired Vision ◽

Corrective Measures ◽

Health Disorders ◽

The Impact

There is presented data of the analysis of the influence of various types of the psychological gestational dominant of the mother on the health of born children, which is important for the development of preventive and corrective measures. Children with disabilities were found to be more often born by mothers with euphoric, anxious and rejecting variants of the psychological gestational dominance, which should be taken into consideration long before the birth of the child. The state of health of the child is closely related with the course of pregnancy and the type of the psychological gestational dominant of the mother. Pathological types of the psychological gestational dominant of the mother are associated with certain forms of somatic pathology in born children. Women with pathological variants of the psychological gestational dominant were shown to more often deliver children with impaired vision, hearing, speech and musculoskeletal system. This indicates to a negative impact of the pathological gestational dominant on the health of the fetus and the newborn. The authors believe all pregnant women to have to be tested for determining the type of psychological gestational dominance with following monitoring of the fetus and newborn’s condition for timely correction of health disorders and medical, psychological and pedagogical support of children at all stages of the development.

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No Association Was Found Between Mild Iodine Deficiency During Pregnancy and Pregnancy Outcomes: a Follow-up Study Based on a Birth Registry

Biological Trace Element Research ◽

10.1007/s12011-021-03028-y ◽

2022 ◽

Author(s):

Xueying Cui ◽

Huiting Yu ◽

Zhengyuan Wang ◽

Hai Wang ◽

Zehuan Shi ◽

...

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Iodine Deficiency ◽

Pregnancy Outcomes ◽

Monitoring Program ◽

Adverse Pregnancy Outcomes ◽

Birth Registry ◽

Adverse Pregnancy ◽

The Impact

Abstract Background Severe iodine deficiency during gestation is associated with adverse pregnancy outcomes; however, the impact of mild-to-moderate iodine deficiency, though prevalent in pregnancy, remains unclear. Methods We extracted follow-up data for 7435 pregnant women from a national iodine deficiency disorders monitoring program from 2016 to 2018 and a mother–child cohort study in 2017 based on a birth registry in Shanghai. Birth outcomes were collected from the registry. Spot urine and household salt samples were collected for iodine testing. Single-factor analysis and logistic regression were used to evaluate the association between maternal iodine status and pregnancy outcomes. Results The median urine iodine level in pregnant women was 137.5 μg/L (interquartile range 82.4–211.5), suggesting mild deficiency according to WHO standards. The incidence of pregnancy termination, preterm birth, congenital malformations, low birth weight, and cesarean section was 3.2%, 4.3%, 1.4%, 2.7%, and 45.2% in the mildly iodine-deficient group and 3.4%, 4.5%, 1.4%, 2.7%, and 44.5% in the normal group, respectively. After adjusting for maternal age and education, trimesters, and preterm birth rate in the general population, the odds ratios for any outcome did not differ significantly between the two groups. Conclusion The present study suggests that mild maternal iodine deficiency is not associated with adverse pregnancy outcomes.

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A COMPARATIVE STUDY OF IODINE METABOLISM IN PREGNANCY, SPORADIC GOITRE AND THYROTOXICOSIS

Acta Endocrinologica ◽

10.1530/acta.0.0480014 ◽

1965 ◽

Vol 48 (1) ◽

pp. 14-22 ◽

Cited By ~ 3

Author(s):

S. A. Aboul-Khair ◽

J. Crooks

Keyword(s):

Comparative Study ◽

Pregnant Women ◽

Iodine Deficiency ◽

Physiological Responses ◽

Iodine Uptake ◽

Thyroid Activity ◽

Deficiency State ◽

Iodine Metabolism ◽

Inorganic Iodine ◽

In Pregnancy

ABSTRACT Studies of iodine metabolism have been carried out in 15 pregnant women, 33 cases with sporadic goitre and 11 with thyrotoxicosis. A low plasma inorganic iodine was common to the three groups. In pregnancy and sporadic goitre the thyroid clearance of iodine was elevated and the absolute iodine uptake normal. A high thyroid clearance of iodine in thyrotoxicosis was associated with a high absolute iodine uptake. The results suggest that both pregnancy and sporadic goitre are physiological responses to an iodine deficiency state while the iodine deficiency state of thyrotoxicosis is secondary to increased thyroid activity.

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Maternal-Fetal Management in Trombophilia Related and Placenta-Mediated Pregnancy Complications

Revista de Chimie ◽

10.37358/rc.18.9.6541 ◽

2018 ◽

Vol 69 (9) ◽

pp. 2396-2401

Author(s):

Costin Berceanu ◽

Elena Loredana Ciurea ◽

Monica Mihaela Cirstoiu ◽

Sabina Berceanu ◽

Anca Maria Ofiteru ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Complications ◽

Case Control Study ◽

Case Control ◽

Placental Insufficiency ◽

Management Options ◽

Specific Therapy ◽

Pregnancy Morbidity ◽

The Impact ◽

Control Study

It is widely accepted that thrombophilia in pregnancy greatly increases the risk of venous thromboembolism. Pregnancy complications arise, at least partly, from placental insufficiency. Any change in the functioning of the gestational transient biological system, such as inherited or acquired thrombophilia, might lead to placental insufficiency. In this research we included 64 pregnant women with trombophilia and 70 cases non-trombophilic pregnant women, with or without PMPC, over a two-year period. The purpose of this multicenter case-control study is to analyze the maternal-fetal management options in obstetric thrombophilia, the impact of this pathology on the placental structure and possible correlations with placenta-mediated pregnancy complications. Maternal-fetal management in obstetric thrombophilia means preconceptional or early diagnosis, prevention of pregnancy morbidity, specific therapy as quickly as possible and fetal systematic surveilance to identify the possible occurrence of placenta-mediated pregnancy complications.

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Clinical Pharmacokinetic Studies in Pregnant Women and the Relevance of Pharmacometric Tools

Current Pharmaceutical Design ◽

10.2174/1381612825666190320135137 ◽

2019 ◽

Vol 25 (5) ◽

pp. 483-495 ◽

Cited By ~ 7

Author(s):

André Dallmann ◽

Paola Mian ◽

Johannes Van den Anker ◽

Karel Allegaert

Keyword(s):

Pregnant Women ◽

Clinical Pharmacokinetic ◽

Individual Variability ◽

Current Status ◽

Pharmacokinetic Studies ◽

Full Potential ◽

Pbpk Models ◽

Pregnancy And Postpartum ◽

Population Pk ◽

The Impact

Background: In clinical pharmacokinetic (PK) studies, pregnant women are significantly underrepresented because of ethical and legal reasons which lead to a paucity of information on potential PK changes in this population. As a consequence, pharmacometric tools became instrumental to explore and quantify the impact of PK changes during pregnancy. Methods: We explore and discuss the typical characteristics of population PK and physiologically based pharmacokinetic (PBPK) models with a specific focus on pregnancy and postpartum. Results: Population PK models enable the analysis of dense, sparse or unbalanced data to explore covariates in order to (partly) explain inter-individual variability (including pregnancy) and to individualize dosing. For population PK models, we subsequently used an illustrative approach with ketorolac data to highlight the relevance of enantiomer specific modeling for racemic drugs during pregnancy, while data on antibiotic prophylaxis (cefazolin) during surgery illustrate the specific characteristics of the fetal compartments in the presence of timeconcentration profiles. For PBPK models, an overview on the current status of reports and papers during pregnancy is followed by a PBPK cefuroxime model to illustrate the added benefit of PBPK in evaluating dosing regimens in pregnant women. Conclusions: Pharmacometric tools became very instrumental to improve perinatal pharmacology. However, to reach their full potential, multidisciplinary collaboration and structured efforts are needed to generate more information from already available datasets, to share data and models, and to stimulate cross talk between clinicians and pharmacometricians to generate specific observations (pathophysiology during pregnancy, breastfeeding) needed to further develop the field.

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Impact of Novel Coronavirus (COVID-19) on Pregnant Women: A Review

Coronaviruses ◽

10.2174/2666796701999201116123457 ◽

2020 ◽

Vol 01 ◽

Author(s):

Saima Habeeb ◽

Manju Chugani

Keyword(s):

Pregnant Women ◽

Vertical Transmission ◽

Respiratory Infections ◽

Age Groups ◽

Well Being ◽

Fetal Outcome ◽

Global Public Health ◽

Coronavirus Infection ◽

Novel Coronavirus ◽

The Impact

: The novel coronavirus infection (COVID‐19) is a global public health emergency.Since its outbreak in Wuhan, China in December 2019, the infection has spread at an alarming rate across the globe and humans have been locked down to their countries, cities and homes. As of now, the virus has affected over 20million people globally and has inflicted over 7 lac deaths. Nevertheless, the recovery rate is improving with each passing day and over 14 million people have recuperated so far. The statistics indicate that nobody is immune to the disease as the virus continues to spread among all age groups; newborns to the elders, and all compartmentsincluding pregnant women. However, pregnant women may be more susceptible to this infection as they are, in general, highly vulnerable to respiratory infections. There is no evidence for vertical transmission of the COVID-19 virus among pregnant women, but an increased prevalence of preterm deliveries. Besides this, the COVID-19 may alter immune response at the maternal-fetal interface and affect the well-being of mothers as well as infants. Unfortunately, there is limited evidence available in the open literature regarding coronavirus infection during pregnancy and it now appears that certain pregnant women have infected during the present 2019-nCoV pandemic. In this short communication, we study the impact of the COVID-19 infection on vertical transmission and fetal outcome among pregnant women.

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Impact of influenza virus during pregnancy: from disease severity to vaccine efficacy

Future Virology ◽

10.2217/fvl-2020-0024 ◽

2020 ◽

Vol 15 (7) ◽

pp. 441-453

Author(s):

Ana Vazquez-Pagan ◽

Rebekah Honce ◽

Stacey Schultz-Cherry

Keyword(s):

Influenza Virus ◽

Virus Infection ◽

Immune Responses ◽

Pregnant Women ◽

Disease Severity ◽

Influenza A ◽

Antiviral Treatment ◽

Influenza Virus Infection ◽

Severe Influenza ◽

The Impact

Pregnant women are among the individuals at the highest risk for severe influenza virus infection. Infection of the mother during pregnancy increases the probability of adverse fetal outcomes such as small for gestational age, preterm birth and fetal death. Animal models of syngeneic and allogeneic mating can recapitulate the increased disease severity observed in pregnant women and are used to define the mechanism(s) of that increased severity. This review focuses on influenza A virus pathogenesis, the unique immunological landscape during pregnancy, the impact of maternal influenza virus infection on the fetus and the immune responses at the maternal–fetal interface. Finally, we summarize the importance of immunization and antiviral treatment in this population and highlight issues that warrant further investigation.

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Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) Cohort Study: influences of complex environmental exposures on maternal and child health in Suriname

BMJ Open ◽

10.1136/bmjopen-2019-034702 ◽

2020 ◽

Vol 10 (9) ◽

pp. e034702

Author(s):

Wilco Zijlmans ◽

Jeffrey Wickliffe ◽

Ashna Hindori-Mohangoo ◽

Sigrid MacDonald-Ottevanger ◽

Paul Ouboter ◽

...

Keyword(s):

Cohort Study ◽

Occupational Health ◽

Pregnant Women ◽

Fish Consumption ◽

Depression Scale ◽

Environmental Exposures ◽

International Standards ◽

Long Term Effects ◽

The Impact ◽

Environmental And Occupational Health

PurposeThe Caribbean Consortium for Research in Environmental and Occupational Health prospective environmental epidemiologic cohort study addresses the impact of chemical and non-chemical environmental exposures on mother/child dyads in Suriname. The study determines associations between levels of environmental elements and toxicants in pregnant women, and birth outcomes and neurodevelopment in their children.ParticipantsPregnant women (N=1143) were enrolled from December 2016 to July 2019 from three regions of Suriname: Paramaribo (N=738), Nickerie (N=204) and the tropical rainforest interior (N=201). Infants (N=992) were enrolled at birth. Follow-up will take place until children are 48 months old.Findings to dateBiospecimens and questionnaire data on physiological and psychosocial health in pregnant women have been analysed. 39.1% had hair mercury (Hg) levels exceeding values considered safe by international standards. Median hair Hg concentrations in women from Paramaribo (N=522) were 0.64 µg/g hair (IQRs 0.36–1.09; range 0.00–7.12), from Nickerie (N=176) 0.73 µg/g (IQR 0.45–1.05; range 0.00–5.79) and the interior (N=178) 3.48 µg/g (IQR 1.92–7.39; range 0.38–18.20). 96.1% of women ate fish, respective consumption of the three most consumed carnivorous species, Hoplias aimara, Serrasalmus rhombeus and Cichla ocellaris, known to have high Hg levels, was 44.4%, 19.3% and 26.3%, respectively, and was greater among the interior subcohort. 89% frequently consumed the vegetable tannia, samples of which showed presence of worldwide banned pesticides. 24.9% of pregnant women had Edinburgh Depression Scale scores indicative of probable depression.Future plansFish consumption advisories are in development, especially relevant to interior women for whom fish consumption is likely to be the primary source of Hg exposure. Effects of potentially beneficial neuroprotective factors in fish that may counter neurotoxic effects of Hg are being examined. A pesticide literacy assessment in pregnant women is in progress. Neurodevelopmental assessments and telomere length measurements of the children to evaluate long-term effects of prenatal exposures to toxicant mixtures are ongoing.

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