An assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia2018

Abstract

<p>Previous findings from a state-wide Iodine Deficiency Disorders (IDD) study among pregnant women (PW) in Sarawak indicated that PW are at risk of IDD and further assessment is needed. This paper describes the methodology used in conducting this study for an assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia. A total of 30 maternal child health care clinics (MCHCs) were selected using probability proportional to population size (PPS) sampling technique. The PW sample size was calculated based on 95% confidence interval (CI), relative precision of 5%, design effect of 2, anticipated IDD prevalence of 65.0% and non-response rate of 20%. Thus, the total sample size required was 750 (25 respondents per selected MCHC). The WHO Expanded Programme on Immunization (EPI) surveys approach was used to randomly select the first respondent and subsequent respondents were chosen until the required number of PW was met. The required data were obtained through: face-to-face interviews (socio-demographic and food frequency questionnaire), clinical assessments (thyroid size, and hyper/hypothyroidism) and biochemical analysis (urine and blood serum). <strong>A</strong> total of 677 PW responded in the study with a response rate of 90.2%. Majority of the PW were at second gravida, aged 25-29 years old and of Malay ethnicity. The methodology used in this study was based on international guidelines which may provide state’s estimates. All the necessary steps were taken into consideration to ensure valid and reliable findings on current iodine status among PW.</p>

Pregnant Women Are Iodine Deficient While School-Aged Children Demonstrate Adequate Iodine Status in Sarawak, Malaysia

“…11 In PW, a study conducted in 2015 in all 11 divisions in Sarawak among first-trimester PW revealed the median UIC was 105.6 mg/L, indicating iodine deficiency. 12 The results of both studies were in agreement with several studies conducted among SAC and PW in many countries, which had also found that the adequate iodine status in SAC may not reflect adequate iodine status in PW although USI has been implemented. [13][14][15] Thus, in this study, we conducted a study among the SAC and PW simultaneously with the aim to determine the current status of IDD in both groups after 10 years of USI implementation in Sarawak.…”

“…Thus, many PW managed to obtain medical advice from the clinics. 12 The limitations of this study were the in-house modified microplate method based on the Sandel-Kolthoff reaction method 19 has several disadvantages, such as requires dedicated laboratory space, glassware, and experienced technician to provide an accurate urinary iodine result. 28 Currently, the inductively coupled plasma mass spectrometry method is often used as the "gold standard," and many countries have started to adopt this method due to its high degree of accuracy, versatility, little demand for technician time, and the capacity to analyze large numbers of samples.…”

“…1 Based on the median UIC results, the status of IDD among the PW in this study was also essentially unchanged compared to the previous Sarawak state IDD study conducted among first-trimester PW in 2015. 12 There are several reasons for this inadequacy. First, the comparable median UIC observed among PW (123.9 mg/L) and the SAC (126.0 mg/L) revealed that they are most probably sharing a common household food basket.…”

“…11 In PW, a study conducted in 2015 in all 11 divisions in Sarawak among first-trimester PW revealed the median UIC was 105.6 µg/L, indicating iodine deficiency. 12…”