The effect of iodine deficiency (ID) on thyroid function in African women during pregnancy and postnatal period was examined, for which very limited information is available. Serum T(4), T(3), TSH, TBG, thyroxine binding capacity (TBK), free thyroxine index (FT(4)I=T(4)/TBK) and T(4)/TBG were determined by ELISA technique in 32 pregnant women (resident of Plateau state, Nigeria- an ID zone) through pregnancy upto term delivery, and in 5 women up to 6 weeks post delivery. Urinary iodide level was measured at delivery to determine the degree of iodine deficiency. Results were matched with a non pregnant control comprising 44 subjects. 5555 birth weights (BW) of term babies in the region were analysed to determine the prevalence of 'small for dates' (SFD) babies in the population. Results show that the level of serum FT(4)I was elevated very significantly at late gestation (P<.001) but the women were not hyperthyroid, suggesting a marked disturbance in binding of T(4) with TBG during pregnancy. Five women with SFD babies were found in 'compensated hypothyroid state' and showed a significant depression (p<.01) in serum T(4)/TBG, T(4), FT(4)I and T(3) levels to a low normal range, with a concurrent significant rise (p.<.001) in TSH level (above normal range) throughout pregnancy. Incidence of SFD babies was higher (p.<.001) in ID zone (Bassa 15.2%) compared to control zone (Jos 9.8%). It is concluded that a state of maternal 'subclinical (compensated) hypothyroidism' during pregnancy possibly plays an important role in the aetiopathogenesis of SFD babies in Africans. A normal reference range for thyroid parameters at various stages of pregnancy in healthy African women is established for the first time.

Das SC, Isichei UP. The "feto-maternal" thyroid function interrelationships in an iodine-deficient region in Africa-the role ofTs in possible fetal defence. Acta Endocrinol 1993;128:116-19. The thyroid status was investigated in 26 pregnant African women at term delivery in an iodine\x=req-\ deficient region (Jengere) of Nigeria, West Africa including the measurement of serum T4, T3, TSH, thyroxine binding capacity, TBG, free thyroxine index (FT4I) and the results were matched with those obtained in a corresponding group of 46 women at delivery in Jos, the non-iodine-deficient region which was used as a control. Corresponding cord-blood samples were obtained from all the neonates of the two groups. Twenty-three urinary samples in the former and 14 in the latter group were analysed for iodide levels to ascertain the degree of iodine deficiency. The results demonstrate that compared to the values seen in the Jos group the maternal serum T4, T3 and FT4I levels were significantly reduced in the iodine-deficient group, while TSH, TBG and thyroxine binding capacity were elevated. Cord serum samples showed a corresponding fall in T4 and FT4I levels in the group from the iodine-deficient region, while the T3 levels were significantly elevated with a concurrent significant rise in TSH and TBG levels. Significant correlations were found between the maternal and cord serum T4, TSH, TBG, thyroxine binding capacity and FT4I levels, but not T3. From these findings we suggest that fetal T3 plays an important defensive role against the danger of long-standing environmental iodine deficiency.Environmental Iodine Deficiency (EfD) is known to cause alterations in several thyroid function tests. Thus, in mild to moderate iodine deficiency serum T4 is often subnormal, serum T3 often slightly elevated and serum TSH mildly elevated (1-7). Conversely, in regions with marked iodine deficiency both serum T4 and T5 levels are often decreased together with elevated TSH concentra¬ tions, suggesting a spectrum of hypothyroid states prevailing in the region, ranging from subclinical (com¬ pensated form) to full-blown, with a relatively high incidence of endemic cretins and other forms of neuro¬ logical disorders (2, 4, 5). Environmental and dietary goitrogens in appreciable quantities can also accentuate a state of mild to severe iodine deficiency by depriving the thyroid of the little iodide available to it. Urinary iodide excretions (UIE) in subjects from such areas will be comparatively elevated, although their thyroids will be more severely iodine-deficient. The present study exam¬ ines the changes in fetal and maternal thyroid status in an iodine-deficient area of tropical Africa. Subjects and methodsIn our previous studies carried out in Plateau State, Nigeria we established that the Jengere region of Bassa Local Government Council (LGC) is a clearly iodinedeficient region (8-11); [Goitre prevalence (GP) in schoolchildren 25% (8), adults 42% (11); UIE in school¬ children 710±450 nmol/1 (9.04±5.7 mg/1) (8) and drinking water iodide (DWI)...

SUMMARY The total protein, albumin, globulin, and immunoglobulin levels of sera from 96 children with homozygous sickle cell disease were studied. A comparison of the results with the levels found in a control group of normal children of the same age shows that the sicklers have higher total protein, globulin, and IgM levels.The amounts of albumin and IgA seen were almost the same in both groups. The IgG levels differed considerably, the sicklers having only about half the quantity seen in normal children.

To investigate the level of neonatal chemical hypothyroidism (NCH), thyroid function was measured in the cord blood of 271 neonates in an area with a high prevalence of endemic goitre, Bassa (n = 140), and a nonendemic area, Jos (n = 131), in Plateau State, Nigeria. NCH was defined as T4 < 40 nmol/L and TSH > 49 mU/L and borderline compensated NCH as T4 31-50 nmol/L and TSH 41-49 mU/L. NCH was detected in 16.4% of neonates in Bassa and in 3.8% in Jos. Borderline compensated NCH was detected in an additional 18.6% in Bassa and 8.4% in Jos. Contamination of foodstuffs and water by iodine-containing antiseptics and disinfectants during the antenatal period, in addition to factors responsible for endemic goitre, e.g. iodine deficiency and goitrogens, are considered to be responsible for the high prevalence of NCH in the Bassa area. As most infants' thyroid function recovers with time, the former might be a more important factor in the aetiology of NCH.