scholarly journals Iron and Iodine Status in Pregnant Women from A Developing Country and Its Relation to Pregnancy Outcomes

Author(s):  
Sehar Iqbal ◽  
Petra Rust ◽  
Lisbeth Weitensfelder ◽  
Inayat Ali ◽  
Michael Kundi ◽  
...  

Birth related complications and comorbidities are highly associated with a poor nutritional status of pregnant women, whereas iron and iodine are among especially important trace elements for healthy maternal and fetal outcomes. The study compares the status of iron, iodine, and related functional parameters in pregnant and non-pregnant women from a developing country and associates the data with pregnancy complications. The concentrations of ferritin, hemoglobin (Hb), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) were determined in the blood serum of 80 pregnant women at the time of delivery and compared with 40 non-pregnant healthy controls. Spot urine samples were taken to evaluate the urinary iodine concentration (UIC). In pregnant women, ferritin, Hb concentrations, and UIC were significantly lower, and TT4 values were significantly higher compared to controls. Higher Hb levels were tendentially associated with a reduced risk for pregnancy complications (OR = 0.747, CI (95%) 0.556–1.004; p = 0.053). Regarding covariates, only previous miscarriages were marginally associated with pregnancy complications. High consumption of dairy products was associated with lower Hb and ferritin values. Our results suggest that pregnant women from a developing country have lower iron status with Hb levels being possibly associated with pregnancy complications.

2021 ◽  
Vol 14 ◽  
pp. 117863882110253
Author(s):  
Husein Mohammed ◽  
Grace S Marquis ◽  
Frances Aboud ◽  
Karim Bougma ◽  
Aregash Samuel

Objectives: This study examines the hormonal mediators of the effect of iodized salt in pregnancy on child cognition. Methods: Sixty districts across 6 zones in the Amhara region of Ethiopia were randomly allocated to a control or intervention arm of early market access to iodized salt. Twenty-two villages per arm were randomly selected for this sub-study. A total of 1220 pregnant women who conceived after the intervention began were enrolled and assessed for their iodine and iron status. Data were collected once on the household socio-demographic status and iodized salt use, and maternal urinary iodine during pregnancy. Then, infants’ diet, urinary iodine level, cognitive development (Bayley III), serum hormonal levels, iron status, and inflammation markers were measured between 2 and 13 months of age. Results: The median maternal urinary iodine concentration was adequate and significantly higher in the intervention mothers than that of the controls (163 vs 121 µg/L, P < .0001). Intervention children compared to the control children had lower thyroid-stimulating hormone (TSH) (mean: 2.4 ± 1.0 µIU/mL vs 2.7 ± 1.0 µIU/mL, effect size = 0.18, P < .01) and thyroglobulin (Tg) (41.6 ± 1.0 ng/mL vs 45.1 ± 1.0 ng/mL, effect size = 0.14, P < .05). There was an interaction between the intervention and iron stores such that cognition was higher with iron (effect size = 0.28, 100 vs 94 IQ points). TSH was a partial mediator (12%) of the effect of the intervention on child cognition (Sobel z-score = 2.1 ± 0.06, P < .05). Conclusion: TSH partially mediated the effect of the iodized salt intervention on child cognition.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Solveig Adalsteinsdottir ◽  
Ellen Alma Tryggvadottir ◽  
Laufey Hrolfsdottir ◽  
Thorhallur Ingi Halldorsson ◽  
Bryndis Eva Birgisdottir ◽  
...  

AbstractHistorically, Iceland has been an iodine sufficient nation due to notably high fish and dairy consumption. Due to this fact the country does not have a strategy related to iodine status, such as fortification of salt. Iodine status of pregnant women has only been assessed once before in Iceland (in 2009). The median UIC was found to be 180 μg/L, which was in line with the recommended range of 150–249 μg/L defined by the World Health Organization (WHO). Intake of fish and dairy has decreased considerably in the past 10 years. The aim of the present study was to re-evaluate the iodine status of pregnant women in Iceland using data from the PREWICE study (PREgnant Women in ICEland). Subjects were women (n = 983; 73% of the eligible sample) attending their first ultrasound appointment in gestational weeks 11–14 in the period October 2017-March 2018. Spot urine samples were collected for assessment of urinary iodine concentration (UIC) and creatinine. The ratio of iodine to creatinine (I/Cr) was calculated. Diet was assessed using a semi-quantitative food frequency questionnaire (FFQ), which provided information on main dietary sources of iodine in the population studied (dairy and fish). The median UIC (95% CI) and I/Cr of the study population was 89 μg/L (42, 141) and 100 (94, 108) μg/g, respectively. UIC increased with higher frequency of dairy intake, ranging from median UIC of 55 (35, 79) μg/L for women consuming dairy products < 1 time per week to 124 (98, 151) μg/L in the group consuming dairy > 2 times per day (p for trend < 0.001). A small group of women reporting complete avoidance of fish (n = 18) had UIC of 50 (21, 123) μg/L and significantly lower I/Cr compared with those who did not report avoidance of fish (58 (34,134) μg/g vs. 100 (94, 108) μg/g, p = 0.041). Women taking supplements containing iodine (n = 34, 3.5%) had higher UIC compared with those who did not take supplements (141 (77, 263) vs. 87 (82, 94) μg/L, p = 0.037. For the first time, insufficient iodine status is being observed in an Icelandic population. There is an urgent need for a public health action aiming at improving iodine status of women of childbearing age in Iceland.


2021 ◽  
Vol 9 (3) ◽  
pp. 791-799
Author(s):  
Syeda Farha S ◽  
Asna Urooj

During pregnancy, the daily requirement of iodine increases making those most at-risk population for iodine deficiency disorders. The available confined data shows that pregnant women are iodine deficient even in iodine sufficient regions with this background the objectives of the current study were to assess the urinary iodine concentration (UIC) and evaluate the relationship between the levels of hemoglobin, UIC, and thyroid status in first-trimester pregnant women. A cross-sectional hospital-based study with a total sample size of n=110 pregnant women at the13th week of gestation in the Mysuru district was selected. The UIC, anthropometric measurements, iodine intake, and selected biochemical parameters (TSH, FT3, FT4, and Hb) were assessed. The data was analysed using SPSS (v 16.0). Spearman’s rank correlation test was used to analyse correlations. The Mann- Whitney U test was used to compare differences between groups. ANOVA was used to study the comparison of pregnancy complications with UIC and hemoglobin. The median UIC (mUIC) was 194.2 µg/L and Hb was 10.5 g/dL. Even though the mUIC was normal, around 38.2% had insufficient UIC. Significant inverse relationship between UIC and TSH (r = -0.487, p<0.001), Hb and TSH (r = -0.355, p < 0.001), and between TSH and iodine intake (r=-0.476, p<0.001) were observed. It was interesting to observe that those with insufficient UIC were found to have mild anaemia and low FT4 levels and those with excess UIC had lower TSH levels. The pregnant women in the present study were found to have the normal median urinary iodine concentration and were mildly anaemic. Increased attention among pregnant women should be focused on iodine status along with iron status and thyroid functions. Larger comparative studies need to be performed to study the impact of altered iodine status on neonatal outcomes.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3975
Author(s):  
Aidy Gonzalez-Nunez ◽  
Pablo García-Solís ◽  
Silvia G. Ramirez-Garcia ◽  
German Flores-Ramirez ◽  
Marcela Vela-Amieva ◽  
...  

According to the Iodine Global Network, Mexico is considered a country with adequate national iodine intake (297 mg/L), but some regions have not been studied. We aimed to evaluate urinary iodine concentration (UIC) and its association with thyroid stimulating hormone (TSH) levels and the nutritional status in 307 children (aged 5 to 11 years) from three elementary schools of Monterrey, northern Mexico. UIC in spot urine samples and capillary TSH levels were measured to assess thyroid function, in addition to weight, height, body mass index (BMI), and waist circumference (WC). We found a median UIC of 442 mg/L and a significant association between UIC and TSH levels by logistic regression when data were adjusted for (1) age and sex; (2) age, sex, and WC; and (3) age, sex, and weight status. UIC values were higher in 7-year-old children compared to 11-year-old children. High prevalences of overweight/obesity (41%) and WC >90 pctl (22%) were observed. This study identified higher UIC levels in children than those previously reported in the country. The UIC showed a positive and significant correlation between TSH levels in the three models evaluated. More studies are needed to assess the causes and possible outcomes of high UIC levels.


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mahmood Sovid ◽  
Maryam Bahmani ◽  
Alamtaj Aamsami

Background: Iodine need is increased during pregnancy and its deficiency can lead to complications in mother and fetus. The latest international guidelines have recommended a higher intake of iodine. Iran has implemented a national salt iodization program since 25 years ago, and the general population is iodine-sufficient. However, recent studies have shown that a significant proportion of pregnant women have urinary iodine concentration (UIC) below the recommended range of 150 - 250 µg/L. Based on the results of these studies, iodine supplement during pregnancy is widely used, but this practice is controversial. Objectives: The aim of this study was to evaluate the necessity for iodine supplementation in pregnant women living in Shiraz, an iodine-replete area. Methods: In this cross-sectional case-control study, UIC and thyroid-stimulating hormone of 174 pregnant women taking 150 µg/day iodine (group 1) were compared with 124 pregnant women not taking the supplement (group 2). The proportion of women with UIC below the recommended level in each group was also determined. UIC of the women in different trimesters in each group was also investigated and compared. Results: Mean UIC in groups 1 and 2 was 175.71 ± 56.43 µg/Land 122.5 ± 44.37 µg/L and this difference was significant (P = 0.006). Also, 56% of women in group 2 and 24 % in group 1 had UIC below the recommended value (P < 0.01). Mean UIC in both groups decreased with advancing gestational age. In group 1, mean UIC remained in the recommended range, whereas in group 2, it decreased to less than 100 µg/L. Conclusions: In areas covered by the national salt iodine implementation program, it is necessary to recommend iodine supplement to pregnant women to prevent iodine insufficiency.


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.


2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
David Larbi Simpong ◽  
Yaw Asante Awuku ◽  
Kenneth Kwame Kye-Amoah ◽  
Martin Tangnaa Morna ◽  
Prince Adoba ◽  
...  

Background. Iodine deficiency causes maternal hypothyroidism which can lead to growth, cognitive, and psychomotor deficit in neonates, infants, and children. This study examined the iodine status of pregnant women in a periurban setting in Ghana. Methods. This longitudinal study recruited 125 pregnant women by purposeful convenience sampling from the antenatal clinic of the Sefwi Wiawso municipal hospital in Ghana. Urinary iodine concentration (UIC) was estimated by the ammonium persulfate method at an estimated gestational age (EGA) of 11, 20, and 32 weeks. Demographic information, iodized salt usage, and other clinical information were collected using a questionnaire. Results. The prevalence of iodine deficiency among the pregnant women was 47.2% at EGA 11 and 60.8% at both EGA of 20 and 32, whereas only 0.8% of participants not using iodized salt had iodine sufficiency at EGA 32. 18.4%, 20%, and 24% of participants using iodized salt had iodine sufficiency at EGA 11, 20, and 32, respectively. Conclusion. A high prevalence of iodine deficiency was observed among our study cohort.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Tafere Gebreegziabher ◽  
Barbara Stoecker

Abstract Objectives The objective of this study was to assess the effects of two sources of iodine supplementation on maternal and infant thyroid function and on visual information processing (VIP) of infants in southern Ethiopia Methods A community-based, randomized, supplementation trial was conducted. Mother infant dyads (n = 106) were recruited within the first week after delivery to participate in this study. Mothers were randomly assigned either to receive a potassium iodide capsule (225 µg iodine) daily for 26 weeks or appropriately iodized salt weekly for 26 weeks for household consumption. Maternal thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH), thyroglobulin (Tg), urinary iodine concentration (UIC), breast milk iodine concentration (BMIC) and infant T4, TSH, UIC and VIP were measured as outcome variables. Results At baseline, neither mothers nor infants in the two groups (capsule and iodized salt groups) were significantly different in any of the biomarkers and anthropometry measurements. Maternal TSH and goiter rate significantly decreased following iodine supplementation but T3, T4 and Tg didn't change. Maternal UIC and BMIC and infant UIC were not different among groups. Conclusions A maternal dose of 225 µg iodine daily or adequately iodized salt initiated within a week after delivery decreased goiter and TSH but did not impact infant T4, TSH or VIP. The two treatment groups didn't differ in any of the outcome variables. Funding Sources The study was funded by Nestlé Foundation and Oklahoma State University.


2015 ◽  
Vol 113 (6) ◽  
pp. 944-952 ◽  
Author(s):  
Dominique Condo ◽  
Maria Makrides ◽  
Sheila Skeaff ◽  
Shao J. Zhou

Adequate iodine is important during pregnancy to ensure optimal growth and development of the offspring. We validated an iodine-specific FFQ (I-FFQ) for use in Australian pregnant women. A forty-four-item I-FFQ was developed to assess iodine intake from food and was administered to 122 pregnant women at 28 weeks gestation. Iodine supplement use was captured separately at 28 weeks gestation. Correlation between iodine intake from food estimated using the I-FFQ and a 4 d weighed food record as well as correlation between total iodine intake and 24 h urinary iodine excretion (UIE), 24 h urinary iodine concentration (UIC), spot UIC and thyroid function were assessed at 28 weeks gestation. A moderate correlation between the two dietary methods was shown (r0·349,P< 0·001), and it was strengthened with the addition of iodine supplements (r0·876,P< 0·001). There was a fair agreement (k= 0·28,P< 0·001) between the two dietary measures in the classification of women as receiving adequate ( ≥ 160 μg/d) or inadequate ( < 160 μg/d) iodine intake from food, but the limits of agreement from the Bland–Altman plot were large. Total iodine intake was associated with 24 h UIE (β = 0·488,P< 0·001) but not with spot UIC. Iodine intake from food using the I-FFQ was assessed at study entry ( < 20 weeks gestation) in addition to 28 weeks gestation, and there was a strong correlation in iodine intake at the two time points (r0·622,P< 0·001), which indicated good reproducibility. In conclusion, the I-FFQ provides a valid tool for estimating iodine intake in pregnant women and can be used to screen women who are at risk of inadequate intake.


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