Iodine Status after a Decade of Universal Salt Iodization in Romania: A Bicentric Study in Urban Areas

Ursu, H; Podia-Igna, C.; Goran, D.; Găloiu, Simona; Giurgiu, D.; Davila, Carol; Parhon, C. I.; Rusescu, Alfred

doi:10.4183/aeb.2014.9

Cited by 7 publications

(10 citation statements)

References 27 publications

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“…(16). Of note, 10 years after the implementation of universal salt iodization in 2003 in Romania, median urinary iodine concentration in schoolchildren was shown to be normal in previous endemic iodine deficiency areas (17) and in most pregnant women in a maternity hospital from Bucharest (18).…”

Section: Discussionmentioning

confidence: 99%

Neonatal Screening for Congenital Hypothyroidism in Romania: Data From Medilog Medical Information Registry

et al. 2019

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Objective. Congenital hypothyroidism (CH) is one of the common preventable causes of intellectual disability in neonates, by early detection through neonatal screening. We present the 8-year experience of the National Institute for Mother and Child Health (INSMC) in using MEDILOG national registry for the neonatal screening of CH.Methods. Neonatal screening for CH, done by TSH measurement in dried blood spot, is organized in 5 regional centers, each with a reference laboratory.Results. In 2018 80% of all the newborns, from 80% of the maternity hospitals, were registered in MEDILOG. After re-testing of TSH and T4/FT4 from venous blood in positive cases, the incidence of confirmed CH in 2018 was 1/3576 -1/ 4746. In INSMC center (which includes 26 counties and Bucharest, out of 41 counties), in 2018 the incidence of positive CH cases at screening was 1/2094 (TSH cut-off ≥17 mIU/L) and of confirmed CH cases 1/3576 newborns. For positive screening cases, the median duration from birth to the INSMC laboratory result was 19 days: median of 9 days between screening and laboratory registration and 6 days between registration and test result.Conclusion. MEDILOG registry is a practical instrument for monitoring the steps of neonatal CH screening, the incidence of CH, the evolution of the diagnosed cases, for evaluation of iodine deficiency (by neonatal TSH), and also for research, with the aim of improving early disease detection and treatment.

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Section: Discussionmentioning

confidence: 99%

Neonatal Screening for Congenital Hypothyroidism in Romania: Data From Medilog Medical Information Registry

et al. 2019

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“…Twenty-nine women diagnosed with current or previous hyperthyroidism and their 36 singleton pregnancies, evaluated consecutively by the authors between 2000 and 2020 in a tertiary care center of Endocrinology and/or a tertiary care center of Obstetrics and Gynecology, were included in a retrospective analysis. The mean age (±standard deviation) was 30.3 ± 4.7 years (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) at the diagnosis of pregnancy; 5 women had 2 pregnancies and 1 woman 3 pregnancies.…”

Section: Methodsmentioning

confidence: 99%

Hyperthyroidism in Pregnancy: The Delicate Balance between Too Much or Too Little Antithyroid Drug

Gheorghiu

Borş

Gheorghișan-Gălățeanu

et al. 2021

JCM

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Overt hyperthyroidism (HT) during pregnancy is associated with a risk of maternal–fetal complications. Antithyroid drugs (ATD) have a potential risk for teratogenic effects and fetal–neonatal hypothyroidism. This study evaluated ATD treatment and thyroid function control during pregnancy, and pregnancy outcome in women with HT. Patients and methods: A retrospective analysis of 36 single fetus pregnancies in 29 consecutive women (median age 30.3 ± 4.7 years) with HT diagnosed before or during pregnancy; a control group of 39 healthy euthyroid pregnant women was used. Results: Twenty-six women had Graves’ disease (GD, 33 pregnancies), 1 had a hyperfunctioning autonomous nodule, and 2 had gestational transient thyrotoxicosis (GTT). Methimazole (MMI) was administered in 22 pregnancies (78.5%), Propylthiouracil (PTU) in 2 (7.1%), switch from MMI to PTU in 4 (14.2%), no treatment in 8 pregnancies (3 with subclinical HT, 5 euthyroid with previous GD remission before conception). In the 8 pregnancies of GD patients diagnosed during gestation or shortly before (<6 weeks), i.e., with fetal exposure to uncontrolled HT, there was 1 spontaneous abortion at 5 weeks (3.4% of all ATD-treated pregnancies), and 1 premature delivery at 32 weeks with neonatal death in 24 h (3.4%); 1 child had neonatal hyperthyroidism (3.3% of live children in GD women) and a small atrial sept defect (4% of live children in ATD treated women). In women treated more than 6 months until conception (20 pregnancies): (a) median ATD doses were lower than those in women diagnosed shortly before or during pregnancy; (b) ATD was withdrawn in 40% of pregnancies in trimester (T)1, all on MMI < 10 mg/day (relapse in 14.2%), and in up to 55% in T3; (c) TSH level was below normal in 37%, 35% and 22% of pregnancies in T1, T2 and T3 respectively; FT4 was increased in 5.8% (T1) and subnormal in 11.75% in T2 and T3; (d) no fetal birth defects were recorded; one fetal death due to a true umbilical cord knot was registered. Mean birth weight was similar in both ATD-treated and control groups. Hyperthyroidism relapsed postpartum in 83% of GD patients (at median 3 ± 2.6 months). Conclusion: In hyperthyroid women with long-term ATD treatment before conception, drugs could be withdrawn in T1 in 40% of them, the thyroid function control was better, and pregnancy and fetal complications were rarer, compared to women diagnosed during pregnancy. Frequent serum TSH and FT4 monitoring is needed to maintain optimal thyroid function during pregnancy.

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“…Autoimmune thyroid disease has emerged as the main cause of thyroid dysfunction after the frequency of goiter caused by iodine deficiency decreased following compulsory salt iodination in developing countries (13)(14)(15)(16). Worldwide, the most common conditions associated with thyroid dysfunction are overt and subclinical hypothyroidism (10,(17)(18)(19) due to autoimmune Hashimoto's thyroiditis (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of antithyroperoxidase antibodies in a multiethnic Brazilian population: The ELSA-Brasil Study

Janovsky

Bittencourt

Goulart

et al. 2019

Archives of Endocrinology and Metabolism

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Objective: In this study, we aimed to describe the prevalence and distribution of positive antithyroperoxidase antibodies (TPOAb) according to sex, age strata, and presence of thyroid dysfunction using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Materials and methods: Thyroid hormone tests were obtained from each study participant at baseline. Levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured using a third-generation immunoenzymatic assay. Antithyroperoxidase antibodies were measured by electrochemiluminescence and were considered to be positive when ≥ 34 IU/mL. Results: The prevalence of TPOAb among 13,503 study participants was 12%. Of participants with positive TPOAb, 69% were women. Almost 60% of the individuals with positive TPOAb were white. The presence of positive TPOAb was associated with the entire spectrum of thyroid diseases among women, but only with overt hyperthyroidism and overt hypothyroidism in men. Conclusion: The distribution of positive TPOAb across sex, race, age, and thyroid function in the ELSA-Brasil study is aligned with the worldwide prevalence of positive TPOAb reported in iodine-sufficient areas. In women, the presence of TPOAb was related to the entire spectrum of thyroid dysfunction, while in men, it was only related to the occurrence of overt thyroid disease.

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Iodine Status after a Decade of Universal Salt Iodization in Romania: A Bicentric Study in Urban Areas

Cited by 7 publications

References 27 publications

Neonatal Screening for Congenital Hypothyroidism in Romania: Data From Medilog Medical Information Registry

Neonatal Screening for Congenital Hypothyroidism in Romania: Data From Medilog Medical Information Registry

Hyperthyroidism in Pregnancy: The Delicate Balance between Too Much or Too Little Antithyroid Drug

Prevalence of antithyroperoxidase antibodies in a multiethnic Brazilian population: The ELSA-Brasil Study

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