A Longitudinal Study of Changes in Thyroid Related Hormones among Pregnant Women Residing in an Iodine Deficient Urban Area

Elahi, Shan; Hussain, Zaib

doi:10.1155/2013/234031

Cited by 9 publications

(16 citation statements)

References 23 publications

(50 reference statements)

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“…European pregnant women in many countries, including Belgium 11 , the Czech Republic 12 , Spain 13 , 14 , the United Kingdom 15 – 17 , Denmark 18 , Norway 19 , and France 20 , 21 , and those in the United States 20 , 22 , Australia 23 and New Zealand 24 have been documented well inadequate iodine intake. Nearly 80% of pregnant women in Vietnam 25 , 70% in Philippine 26 and more than half in Pakistan 27 had low UIC, while in Africa 28 , 29 and in south America 30 , pregnant women have already recorded iodine deficiency. Our findings confirm this information and further emphasize the need to surveillance pregnant women in intervals, even after the goal of elimination of IDD have achieved.…”

Section: Discussionmentioning

confidence: 99%

Iodine Deficiency in Zhejiang Pregnant Women in the Context of Universal Salt Iodization Programme

Wang

Xing

Zhu

et al. 2018

Sci Rep

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Zhejiang introduced universal salt iodization (USI) programme in 1995 and has achieved the goal of elimination of iodine deficiency disorders (IDD) since 2011. However, no systematical data of iodine nutritional status in population in pregnancy is available. In this cross-sectional study, pregnant women were interviewed to complete questionnaires in addition to handing in samples of urine and household table salt between March 2016 to February 2017. Date of birth, age of pregnancy, ethnicity and dietary iodine habits were recorded. The overall median urinary iodine concentration in 8561 pregnant women was 130.47 µg/L, which was lower than the cut-off value of iodine sufficiency of 150 µg/L recommended by the WHO. Participants using non-iodized salt, taking non-iodine-containing supplements, in coastal and in Han group were independently associated with iodine deficiency. The current USI programme did not supply Zhejiang pregnant women with sufficient iodine intake. They are generally iodine deficient, which have great public health importance since even mild IDD in pregnancy have adverse effects on fetal neurodevelopment. We strongly recommend urgent measures to improve iodine intake in pregnancy.

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Section: Discussionmentioning

confidence: 99%

Iodine Deficiency in Zhejiang Pregnant Women in the Context of Universal Salt Iodization Programme

Wang

Xing

Zhu

et al. 2018

Sci Rep

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“…It has to produce adequate amounts of thyroid hormone in order to meet the demands of the mother and the fetus, as up till the 12th week of gestation, the fetus is completely dependent on the mother for its supply of thyroid hormones [1]. The fetal thyroid gland begins to produce thyroid hormones by the end of the first trimester but that too, not independently, as it still is in need of an adequate supply of iodine from the mother [2]. In order to meet this increased demand, the thyroid gland undergoes several structural and functional changes, induced by the several physiological mechanisms in the mother’s body explained ahead.…”

Section: Introductionmentioning

confidence: 99%

“…According to few authors, differences in free thyroid hormone levels during pregnancy can also occur due to flaws or variations in the method employed to determine the hormone levels [4,9]. A local study conducted by Elahi et al on pregnant women in Lahore showed FT4 levels decreased during the first trimester of pregnancy whereas TSH and FT3 values increased [2].…”

Section: Introductionmentioning

confidence: 99%

“…A study conducted on pregnant women visiting a hospital in the city of Lahore reported 14.6% of the women having higher than normal TSH levels and 2.0% as having levels lower than normal [2]. Further evaluation showed 20.9% of women had FT4 levels lower than normal, whereas only 2.0% had levels higher than normal [2]. These findings are in accordance with the iodine levels of the region as decreased thyroid functioning seems to be more common among pregnant women of the region than an up regulation.…”

Section: Introductionmentioning

confidence: 99%

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Thyroid Screening During Early Pregnancy and the Need for Trimester Specific Reference Ranges: A Cross-Sectional Study in Lahore, Pakistan

Talat

Khan

Nasreen

et al. 2019

Cureus

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BackgroundDerangements in thyroid hormone levels can cause multiple complications in the mother and the foetus. Thyroid stimulating hormone (TSH) and free thyroxine (free T4 or FT4) levels are used to screen for maternal thyroid dysfunction; these should be compared with population based trimester-specific reference ranges. Our goal was: to determine the prevalence of various thyroid derangements, in early pregnancy, according to the current reference ranges available; to determine the need for trimester specific reference ranges for the local population.MethodsA multi-centric, cross sectional population survey was conducted in Lahore, Pakistan. Serum TSH and FT4 levels were measured at the hormone lab of the Pathology department of Combined Military Hospital (CMH) Lahore. The results were entered and analysed using Statistical Package for the Social Sciences (SPSS) version 23. ResultsIn the 293 women sampled, mean FT4 and TSH levels were 15.03 (±5.62) pmol/L and 2.53 (±6.82) mIU/L respectively. According to the laboratory specific reference ranges, the prevalence of overt hyperthyroidism was 4.10%, (mean TSH= 0.03mIU/L); subclinical hyperthyroidism was 16.38%, (mean TSH= 0.17mIU/L); normal 70.65%, (mean TSH = 1.29mIU/L); subclinical hypothyroidism 4.44%, (mean TSH= 15.11mIU/L); overt hypothyroidism 4.44%, (mean TSH = 20.60mIU/L).ConclusionOur study showed a significant prevalence of thyroid dysfunction in the first trimester of pregnancy, and therefore highlights the need for more rigorous thyroid screening of women, in early pregnancy. There is a need to monitor these women in order to reduce maternal and foetal complications. Trimester specific reference ranges for thyroid hormones need to be developed in Pakistan.

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“…documented the prevalence of iodine deficiency, goiter and thyroid disorders in pregnant females in Lahore, Pakistan. [ 3 4 5 ] Palpable goiter prevalence as high as 12% and 23% has been reported in India in adults[ 6 ] and children,[ 7 ] respectively. There is, however, no data available for prevalence of thyroid disorders in the general population living in nonmountainous regions of Pakistan.…”

Section: Introductionmentioning

confidence: 99%

Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan (THYPAK) study

Jawa

Jawad

Riaz

et al. 2015

Indian J Endocr Metab

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Introduction:South Asian population has a particularly high prevalence of thyroid disorders mainly due to iodine deficiency and goitrogen use. There is no data available for prevalence of thyroid disorders in the general population living in nonmountainous regions of Pakistan.Materials and Methods:A total of 2335 residents of Pak Pattan, Punjab, Pakistan were interviewed about demographic, dietary, medical and environmental history as well as screened for goiter. Individuals of all ages and either gender were included.Results:Median age was 34 (10–88) years and 1164 (49.9%) were males. Median monthly income was 49 (3.9–137) USD. Six hundred and sixty-nine (28.7%) subjects had palpable goiter. 77.5% (n = 462) and 22.5% (n = 133) had World Health Organization Grade I and Grade II goiters respectively, further screened by measuring thyroid-stimulating hormone (TSH). In subjects with TSH <0.4 mg/dL, free T3 and free T4 levels were measured. In 185 goiter subjects when TSH was measured, 50% (n = 93) were euthyroid, 48% (n = 89) were hyperthyroid, and one subject each was hypothyroid and subclinically hyperthyroid. 29/89 hyperthyroid subjects underwent radionuclide scanning. Twelve subjects had heterogeneous uptake consistent with multinodular goiter, 12 subjects had diffuse uptake, two had cold nodules and two had hyperfunctioning single nodules. Goiter was significantly more common among females, unmarried individuals and individuals drinking tube well (subterranean) water. Goiter was less common among those who consumed daily milk, daily ghee (hydrogenated oil), spices, chilies, and turmeric.Discussion:In our study population, goiter was endemic with very high prevalence of hyperthyroidism. Turmeric use was association with reduced goitrogenesis. Further studies to assess iodine sufficiency, thiocyanate exposure and autoimmunity need to be conducted. Masses consuming high goitrogen diets should be educated to incorporate turmeric, spices and green chilies in their cooking recipes, to reduce the risk of goiter development. In addition, use of iodized salt in their daily diet cannot be overemphasized.

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A Longitudinal Study of Changes in Thyroid Related Hormones among Pregnant Women Residing in an Iodine Deficient Urban Area

Cited by 9 publications

References 23 publications

Iodine Deficiency in Zhejiang Pregnant Women in the Context of Universal Salt Iodization Programme

Iodine Deficiency in Zhejiang Pregnant Women in the Context of Universal Salt Iodization Programme

Thyroid Screening During Early Pregnancy and the Need for Trimester Specific Reference Ranges: A Cross-Sectional Study in Lahore, Pakistan

Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan (THYPAK) study

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