Influence of environmental iodine deficiency on neonatal thyroid screening results

Sorcini, Mariella; Diodato, A.; Fazzini, Cristina; Sabini, G.; Carta, Salvatore; Grandolfo, Michele; Guidi, Marco Enrico Luigi; Vasta, M; Maestri, J. Locatelli de; Donati, L; Romagnoli, Costantino; Luciano, R.; Bourdoux, Pierre; Delange, François

doi:10.1007/bf03350156

Cited by 18 publications

(3 citation statements)

References 12 publications

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“…Neonatal b-TSH, which is used in most countries to screen for congenital hypothyroidism, is considered a sensitive marker of subclinical primary hypothyroidism and a suitable index of the presence of factors causing thyroid enlargement and potential alterations in function [ 1 , 29 , 30 ]. Our results from the Seveso population showed that newborns of mothers with high body burdens of TCDD, resulting from accidental dioxin exposure occurring approximately 20–30 y earlier, had higher neonatal b-TSH concentrations compared to newborns of nonexposed women.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Thyroid Function in Seveso 25 Years after Maternal Exposure to Dioxin

et al. 2008

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BackgroundNeonatal hypothyroidism has been associated in animal models with maternal exposure to several environmental contaminants; however, evidence for such an association in humans is inconsistent. We evaluated whether maternal exposure to 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), a persistent and widespread toxic environmental contaminant, is associated with modified neonatal thyroid function in a large, highly exposed population in Seveso, Italy.Methods and FindingsBetween 1994 and 2005, in individuals exposed to TCDD after the 1976 Seveso accident we conducted: (i) a residence-based population study on 1,014 children born to the 1,772 women of reproductive age in the most contaminated zones (A, very high contamination; B, high contamination), and 1,772 age-matched women from the surrounding noncontaminated area (reference); (ii) a biomarker study on 51 mother–child pairs for whom recent maternal plasma dioxin measurements were available. Neonatal blood thyroid-stimulating hormone (b-TSH) was measured on all children. We performed crude and multivariate analyses adjusting for gender, birth weight, birth order, maternal age, hospital, and type of delivery. Mean neonatal b-TSH was 0.98 μU/ml (95% confidence interval [CI] 0.90–1.08) in the reference area (n = 533), 1.35 μU/ml (95% CI 1.22–1.49) in zone B (n = 425), and 1.66 μU/ml (95% CI 1.19–2.31) in zone A (n = 56) (p < 0.001). The proportion of children with b-TSH > 5 μU/ml was 2.8% in the reference area, 4.9% in zone B, and 16.1% in zone A (p < 0.001). Neonatal b-TSH was correlated with current maternal plasma TCDD (n = 51, β = 0.47, p < 0.001) and plasma toxic equivalents of coplanar dioxin-like compounds (n = 51, β = 0.45, p = 0.005).ConclusionsOur data indicate that environmental contaminants such as dioxins have a long-lasting capability to modify neonatal thyroid function after the initial exposure.

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Section: Discussionmentioning

confidence: 99%

Neonatal Thyroid Function in Seveso 25 Years after Maternal Exposure to Dioxin

et al. 2008

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“…Serum thyroid-stimulating hormone (TSH) is determined mainly by the level of circulating thyroid hormone, which in turn refl ects iodine intake. TSH can be used as an indicator of iodine nutrition 14 in the newborn period, 15 and is used in many countries for routine newborn screening to detect congenital hypothyroidism.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Iodine content of mother’s milk and urine with their child’s TSH level

et al. 2015

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Background: Iodine defi ciency is still a signifi cant public health problem. In the rural plains of Nepal, it remains a mild-to-moderate public health problem among pregnant and lactating women despite the availability of iodized salt. To date, only limited attention has been paid to breast-milk iodine content despite its importance in the intellectual development of infants. Objectives: (i) To determine iodine content in mother's urine, mother's milk and to measure their respective child's TSH level. (ii) To correlate iodine content of mother's urine with child's TSH level and also mother's milk content with child's TSH level. Setting and Design: Cross sectional study in human using consecutive sampling technique. Materials and Methods: Mother's urinary and milk iodine level was measured by Ammonium Persulfate Digestion Microplate method using Sandell-Kolthoff reaction in a sealing cassette (Hitachi, Japan) and child's TSH by ELISA commercial Kit from Eliscan (RFCL, India) based on classical sandwich technique. Statistical Analysis: Spearman's correlation was performed in quantitative variables. A p-value less than 0.05 and 0.001 were considered statistically signifi cant and highly signifi cant respectively. Results: The median mother's urine was 174.96 μg/L (97.39-215.43) and their respective median child TSH level was 3.86 mIU/L (2.66-4.80). Median mother's milk iodine was 129.90 μg/L (94.14-165.94).There was signifi cant negative correlation between mothers' urinary iodine content and their child's TSH (r2= -0.391, p = 0.005) and between mother's urinary iodine and their child's TSH (r2= -0.471, p = 0.001). There was positive correlation between mother's milk iodine and mother urinary iodine but not statistically signifi cant ((r2= 0.261, p = 0.067). Conclusion: Mothers urinary iodine, mother's milk iodine and child TSH are interrelated with each other.

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“…In neurocognitive testing that was carried out, mean developmental quotients were higher in children whose mothers were supplemented stating in week 4-6 of pregnancy (27). Apart from the determination of UIC in pregnant women, the screening of TSH in newborns can be useful in assessing the nutritional iodine status of women in the final weeks of pregnancy (26,(30)(31)(32)(33). The neonatal TSH concentration reflects the saturation of brain cell receptors with thyroid hormones, and constitutes the single best indicator of the risk of brain damage and mental retardation (34,35).…”

Section: Discussionmentioning

confidence: 99%

Patterns of Iodine Intake and Urinary Iodine Concentrations During Pregnancy and Blood Thyroid-Stimulating Hormone Concentrations in the Newborn Progeny

Marco

Vicente

Castro

et al. 2010

Thyroid

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In a region with a history of borderline iodine deficiency the UICs were below 150 μg/L in a substantial percentage of pregnant women who did not take iodine supplements, regardless of whether or not they took iodized salt. Our results support the use of iodine supplements from the start of the pregnancy, or even before pregnancy in women who live in regions with a history of even small degrees of iodine deficiency. In addition, neonate TSH screening is not the best tool to assess whether the iodine status in populations is ideal.

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Influence of environmental iodine deficiency on neonatal thyroid screening results

Cited by 18 publications

References 12 publications

Neonatal Thyroid Function in Seveso 25 Years after Maternal Exposure to Dioxin

Neonatal Thyroid Function in Seveso 25 Years after Maternal Exposure to Dioxin

Correlation of Iodine content of mother’s milk and urine with their child’s TSH level

Patterns of Iodine Intake and Urinary Iodine Concentrations During Pregnancy and Blood Thyroid-Stimulating Hormone Concentrations in the Newborn Progeny

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