High prevalence of iodine deficiency in pregnant women living in adequate iodine area

Mioto, Verônica Carneiro Borges; Monteiro, Ana Carolina de Castro Nassif Gomes; Camargo, Rosalinda; Borel, Andréia Rodrigues; Catarino, Regina Maria; Kobayashi, Sérgio; Chammas, Maria Cristina; Marui, Suemi

doi:10.1530/ec-18-0131

Cited by 27 publications

(25 citation statements)

References 23 publications

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“…Most Chileans consume sufficient iodine, but iodine sufficiency and excess iodine intake may coexist in our population [ 20 ], similar to other countries in Latin America, as described by Mioto et al [ 21 ] in Brazil. In any case, since the population of Chile is classified as iodine-sufficient, spot urine samples should not be used for the purposes of individual diagnosis and treatment.…”

Section: Discussionsupporting

confidence: 59%

Thyroid-Stimulating Hormone Reference Ranges in the First Trimester of Pregnancy in an Iodine-Sufficient Country

et al. 2018

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BackgroundThyroid dysfunction is associated with negative neonatal and obstetric outcomes. Large differences in thyroid function reference intervals exist across different populations. These differences can be explained by population-specific factors, such as iodine status. Many countries in Latin America report iodine sufficiency, but relatively few countries have published up-to-date data on iodine levels and thyroid function in the overall population, and especially in pregnant women. We evaluated the iodine status of pregnant women in Chile and determined thyroid hormone reference ranges in this population.MethodsThis was a prospective observational study of healthy Chilean women at their first prenatal visit before week 14. Thyroid-stimulating hormone (TSH), total thyroxine (T4), free T4, antithyroid peroxidase antibody (TPOAb), and iodine levels from spot urine samples were measured. Iodine status and the reference ranges for TSH were calculated.ResultsA total of 1,022 pregnant women in the first trimester were selected. Urinary iodine levels were measured in 302 randomly-selected women. The median urinary iodine concentration was 173.45 µg/L (interquartile range, 108.11 to 249.35).The reference ranges of TSH were calculated in 670 patients selected according to the National Academy of Clinical Biochemistry guidelines. The median TSH level was 1.88 µIU/mL (2.5th percentile: 0.13 to 97.5th percentile: 5.37). Using the reference range in the 1,022 women, the prevalence of clinical hypothyroidism was 1.76%, and that of subclinical hypothyroidism was 3.92%. TPOAb positivity was more common in women with TSH levels above 3.5 µIU/mL.ConclusionWe found adequate iodine intake and a right-shifted distribution of serum TSH levels in pregnant women in Chile. The prevalence of hypothyroidism in our sample of pregnant women was higher than has been described in the literature.

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Section: Discussionsupporting

confidence: 59%

Thyroid-Stimulating Hormone Reference Ranges in the First Trimester of Pregnancy in an Iodine-Sufficient Country

et al. 2018

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“…A study from 2018 by Mioto et al conducted in Brazil (n = 273) examined PW from an iodine sufficient area. Those PW had a median Tg of 11.2 μg/L and only 3.3% had a value exceeding 40 μg/L; mUIC was 140 μg/L [4]. The extent of iodine insufficiency found in our study (a median Tg concentration of 17 μg/L and 14% exceeding 40 μg/L) was more moderate than what was found in the 2014 review, and more serious than what was found in the Mioto et al study.…”

Section: Relevant Studies From Other Countriescontrasting

confidence: 57%

“…3 Foreign studies department; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Jerusalem, Israel. 4 Faculty of Health Sciences, Ben-Gurion University of Negev, Ashkelon, Israel. 5 Laboratory of Clinical Biochemistry, Barzilai University Medical Center Ashkelon, Ashkelon, Israel.…”

Section: Fundingmentioning

confidence: 99%

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Low intake of iodized salt and iodine containing supplements among pregnant women with apparently insufficient iodine status - time to change policy?

Rosen

Ovadia

Anteby

et al. 2020

Isr J Health Policy Res

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Background: Iodine is an essential nutrient for human health throughout the life cycle, especially during early stages of intrauterine life and infancy, to ensure adequate neurocognitive development. The growing global reliance on desalinated iodine-diluted water raises the specter of increased iodine deficiency in several regions. The case of Israel may be instructive for exploring the link between iodine status and habitual iodine intake in the setting of extensive national reliance on desalinated water. The aim of this study was to explore the relationship between iodine intake, including iodized salt and iodine-containing supplements intake, and iodine status among pregnant women residing in a sub-district of Israel that is highly reliant on desalinated iodine-diluted water. Methods: A total of 134 consecutive pregnant women were recruited on a voluntary basis from the obstetrics department of the Barzilai University Medical Center during 2018. Blood was drawn from participants to determine levels of serum thyrotropin (TSH), thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and thyroglobulin (Tg). An iodine food frequency questionnaire (sIFFQ) was used to assess iodine intake from food, IS and ICS. A questionnaire was used to collect data on demographic and health characteristics. Results: A total of 105 pregnant women without known or reported thyroid disease were included in the study. Elevated Tg values (≥ 13 μg/L), were found among 67% of participants, indicating insufficient iodine status. The estimated iodine intake (median, mean ± SD 189, 187 ± 106 μg/d by sIFFQ) was lower than the levels recommended by the World Health Organization and the Institute of Medicine (250 vs. 220 μg/day respectively). The prevalence of iodized salt intake and iodine containing supplement intake were 4 and 52% (respectively). Values of Tg > 13 μg/L were inversely associated with compliance with World Health Organization and Institute of Medicine recommendations.

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“…However, such discrepancies between UIC and serum thyroglobulin have already been reported. In a Brazilian study by Mioto et al (47) , pregnant women were found to be marginally iodine-deficient based on median UIC (146 μg/l), with median serum thyroglobulin 11•2 ng/ml and 3•3 % of investigated subjects with thyroglobulin >40 ng/ml (aTgA status was not assessed).…”

Section: Iodine Nutrition Monitoring In Polandmentioning

confidence: 99%

Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population?

Trofimiuk–Müldner

Konopka

Sokołowski

et al. 2020

Public Health Nutr.

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Objective: The monitoring of the populations’ iodine status is an essential part of successful programmes of iodine deficiency elimination. The current study aimed at the evaluation of current iodine nutrition in school children, pregnant and lactating women as a marker of the effectiveness and sustainability of mandatory iodine prophylaxis in Poland. Design: The following iodine nutrition indicators were used: urinary iodine concentration (UIC) (all participants) and serum thyroglobulin (pregnant and lactating women). Setting: The study was conducted in 2017 within the National Health Programme in five regions of Poland. Participants: The research included 300 pregnant women, 100 lactating women and 1000 school children (aged 6–12 years). Results: In pregnant women, median UIC was 111·6 µg/l; there was no significant difference in median UIC according to the region of residence. In 8 % of pregnant women, thyroglobulin level was >40 ng/ml (median thyroglobulin 13·3 ng/ml). In lactating women, median UIC was 68·0 µg/l. A significant inter-regional difference was noted (P = 0·0143). In 18 % of breastfeeding women, thyroglobulin level was >40 ng/ml (median thyroglobulin 18·5 ng/ml). According to the WHO criteria, the investigated sample of pregnant and lactating women was iodine-deficient. Median UIC in school children was 119·8 µg/l (with significant inter-regional variation; P = 0·0000), which is consistent with iodine sufficiency. Ninety-four children (9·4 %) had UIC < 50 µg/l. Conclusions: Mandatory iodisation of household salt in Poland has led to a sustainable optimisation of iodine status in the general population. However, it has failed to assure adequate iodine nutrition during pregnancy and lactation.

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High prevalence of iodine deficiency in pregnant women living in adequate iodine area

Cited by 27 publications

References 23 publications

Thyroid-Stimulating Hormone Reference Ranges in the First Trimester of Pregnancy in an Iodine-Sufficient Country

Thyroid-Stimulating Hormone Reference Ranges in the First Trimester of Pregnancy in an Iodine-Sufficient Country

Low intake of iodized salt and iodine containing supplements among pregnant women with apparently insufficient iodine status - time to change policy?

Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population?

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