Iodine status and its determinants in subpopulation of pregnant women in rural Central India

Abstract

Background: There is an increased demand for iodine and thyroid hormones, in pregnancy starting from the early weeks of pregnancy suggesting that there may be a need for additional supplements of iodine in high risk population to prevent iodine deficiency and its associated disorders. Hence this study was undertaken to determine the iodine status and its determinants in a subpopulation of pregnant women from a rural area of Central India.Methods: A hospital based, cross-sectional, observational study was carried out among pregnant women seeking antenatal care at Kasturba Hospital of MGIMS, Sewagram, a rural tertiary care institute in central India. Information was collected about demographic variables, use of iodized salt, iodine rich food and goitrogens as part of diet and other determinants. Spot urine samples were obtained, and assessment of urine iodine concentration was done by using Sandell-Kolthoff reaction.Results: Among 250 pregnant women of first trimester, iodine deficiency (ID) was present in 11.8 %, of which 59.25% had mild deficiency, 33.33% moderate deficiency and 7.4% severe deficiency. More women with iodine deficiency were of higher age, had less formal education and belonged to lower middle and lower economic class. Higher number of women with iodine deficiency had family history of thyroid disorders compared to iodine sufficient (18.51% versus 5.58%), more iodine deficient commonly had goitrogens (cabbage, cauliflower, radish, sweet potato, soya etc) as part of their meals (77.77% versus 68.60%), lesser women with ID ate iodine rich food (fish, milk yoghurt, bread) (18.51% versus 68.60%) and fewer of them used iodized salt during food preparation (25.92% versus 69.95%) compared to iodine sufficient, with a significant difference.Conclusions: Iodine deficiency is prevalent in pregnant women in this geographic region of central India. Age, low socioeconomic status, lack of education, family history, low intake of iodized salt and iodine rich food and more consumption of goitrogenic food as part of diet are risk factors. Appropriate health education, promoting use of iodized salt, quality assurance of universal salt iodization by household survey and screening in high risk group is suggested.

A cross-sectional study on iodine status among pregnant and non-pregnant women of Tripura: a North-Eastern state of India

“…The recommended dietary intake of iodine during pregnancy and the cut-off values for UIE concentration were revised by the Technical Consultation convened by WHO Secretariat in 2007 and were later endorsed by WHO/ICCIDD/UNICEF. 16,17 The standards of salt iodization in India require an iodine content of 30ppm at the time of manufacture, so as to deliver 15ppm at the retail level (due to loss during transportation). The iodine content of the packaged salt was tested from household women at random in our study and found consistent with package description.…”

Urinary iodine in second trimester of pregnancy: A cross sectional study in tertiary care hospital of Belagavi

“…Two cross-sectional studies from Rajasthan, revealed median UIC was 127µg/L and 118µg/L in pregnant women of >28 weeks of gestation which indicates deficiency. 6 Another study conducted in New Delhi 19 and Haryana 20 showed median urinary iodine 150µg/L indicating dietary sufficiency. The study in Dhaka 21 showed that maternal urinary iodine is negatively correlated with their serum TSH.…”

“…4 As far as India is concerned heavy rainfall/flooding results in mineral depletion and makes the soil iodine deficient. 6 Dietary iodine deficiency leads to altered synthesis of thyroid hormone and/or thyroid enlargement (goiter).…”