Iodine status of pregnant women in Sri Lanka

Jayatisa, Renuka; Gunathilaka, MM; Ranbanda, JM; Peiris, Piyumaka; Jayasingha, J; Ekanayaka, P.

doi:10.4038/sjdem.v3i1.5469

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…36 On the contrary in a prospective study from iodine-replete Iran by Ainy et al MUIC in the three trimesters were 193 μg/L, 159 μg/ L, and 141 μg/L, respectively, a decrescendo pattern, with statistically significant inter-trimester variation and values reaching inadequate levels in the third trimester has been observed and similar statistically significant decrescendo pattern was also described by Jayatisa et al with MUIC 155.3 μg/L, 117.3 μg/L and 100.6 μg/L in 1st,2nd and 3rd Trimester respectively. 37,38 This is in contrast to Rajput et al who reported in their study that trimester specific MUIC levels decreased progressively from 193.2 μg/L to 111.8 μg/L to 97.65 μg/L as gestational age increased from 1st to 2nd to 3rd trimester respectively but this decrease with gestational age was not statistically significant. They stated that the increased thyroidal iodide clearance and shift to fetalplacental unit as pregnancy advances may explain the observation of progressive MUIC decrease during gestation.…”

Section: Trimester-wise Iodine Status Of Pregnant Womencontrasting

confidence: 67%

Status of iodine in rural pregnant women of different trimesters in Lucknow -A cross-sectional study

Sachan

Ali

et al. 2020

Clinical Epidemiology and Global Health

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Background and objectives: Iodine plays a critical role in fetal brain development and hence has immense importance during pregnancy. Even mild to moderate iodine deficiency in pregnancy has adverse effects on obstetric and neonatal outcome. So, the aim of this study was to assess the trimester-wise urinary iodine status of pregnant women in rural areas and determine their iodine intake. Methods: A cross-sectional study was conducted in Sarojini nagar, which is a rural block of Lucknow, Uttar Pradesh from August 2016 to July 2017. All married pregnant women (15-45 years) of different trimesters attending the primary health centre (PHC) for antenatal checkup were enrolled in the study after written consent. Total 300 pregnant women were interviewed for Knowledge, Attitude and Practice (KAP) survey. Urine and salt sample was taken from 200 of them for biochemical analysis of iodine. Estimation of iodine in urine was done by wet digestion method and in salt by iodometric titration. Results: The median urinary iodine concentration of the rural pregnant women was 246.5 μg/L with IQR of 194.9-383.4 μg/L. On comparing the urine iodine levels in the three trimesters, maximum deficiency was observed in first trimester (39.5%) followed by third trimester (31.6%) and a dip was seen in the second trimester (28.9%). The median urinary iodine levels did not show a significant difference across the three trimesters. Conclusion: Iodine insufficiency was observed among pregnant women. Maximum deficiency was observed in first trimester which is the most vulnerable period of gestation responsible for organogenesis and fetal brain development.

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Section: Trimester-wise Iodine Status Of Pregnant Womencontrasting

confidence: 67%

Status of iodine in rural pregnant women of different trimesters in Lucknow -A cross-sectional study

Sachan

Ali

et al. 2020

Clinical Epidemiology and Global Health

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“…Further, Sri Lanka was considered as having achieved all the criteria of WHO/ICCIDD for monitoring progress towards sustainable elimination of IDD. However, no national level studies have been conducted to assess the iodine nutrition in pregnant women in Sri Lanka up to 2010, when a study revealed that the overall median urine iodine concentration among pregnant women was 113.7 μg/L indicating an iodine deficiency in Sri Lankan pregnant women [ 24 ]. This cross sectional study showed that pregnant women who were in the second and third trimesters had lower UI level than first trimester pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…This study has some important points. The design was suited to evaluate changes in iodine nutrition during the course of the pregnancy because we measured the urine iodine excretion in each trimester in the same study subject whereas many of the other studies were done in cross- sectional manner [ 18 , 24 , 26 , 27 ]. Pregnant women of the study sample were not given iodine supplements and it mainly explores the effectiveness of iodized salt, diet and water as sources of iodine during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Urinary iodine and thyroid determinants in pregnancy: a follow up study in Sri Lanka

Zoysa

Hettiarachchi

Liyanage

2016

BMC Pregnancy Childbirth

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BackgroundIodine deficiency and thyroid dysfunction during pregnancy is associated with number of adverse outcomes that includes mental and physical disabilities creating a huge human and economic burden in later life. Several indicators are used to assess the iodine status of a population: thyroid size by palpation and/or by ultrasonography, urinary iodine excretion and the blood thyroid hormone profile.MethodsThis prospective study was designed to assess the iodine nutrition during the course of pregnancy with reference to urine iodine concentration (UIC) and thyroid determinants among 425 pregnant women from Galle district, Sri Lanka. UIC was estimated in all three trimesters and thyroid functions were assessed in first and third trimesters.ResultsMedian (inter-quartile range IQR) UIC was 170.9 (100.0–261.10) μg/L, 123.80 (73.50–189.50) μg/L and 105.95 (67.00–153.50) μg/L in the first, second and third trimesters respectively (p < 0.001). Median thyroid stimulating hormone (TSH) level in the first trimester was 1.30 (0.80–1.80) µIU/mL. This value significantly increased (p < 0.001) to 1.60 (1.20–2.10) µIU/mL at the 3rd trimester even though it was maintained within the reference range (0.3 – 5.2 µIU/mL). In the assessment of thyroid gland, 67 (16.0 %) women had palpable or visible goitres and 55 (13.1 %) had a goitre that was palpable but not visible. The median thyroid volume of the sample was 5.16 mL (4.30; 6.10 mL) as measured by ultra sound (US) scanning. In multiple regression analysis after controlling for other independent variables (anthropometric, demographic and biochemical parameters); initial body mass index (BMI), goitre size, thyroid volume and parity had significant correlations with the third trimester urinary iodine levels. The thyroid volume accounted for 4.5 % of the urinary iodine variation.ConclusionsEven though iodine status was progressively worsening with the advancement of pregnancy and iodized salt consumption has not met with the increasing demand for iodine, it was not reflected in the serum TSH level. Therefore, it is worthwhile to assess the long term effects of rising TSH levels and inadequate iodine nutrition during pregnancy on the offspring to prevent even mild iodine deficiency.

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“…(a) The median UIC of pregnant women is only marginally above the recommended cut off of 150 µg/L, and iodine-insufficient in the first trimester (102.3 (61.7-147.1) µg/L (Table 2)). There was a remarkable improvement in the iodine status of pregnant women compared to 2011 (113.7 µg/L) [30]. There was also a significant minority of pregnant women (nearly 10%) who had a median UIC of <50 µg/L.…”

Section: Discussionmentioning

confidence: 88%

Stable Iodine Nutrition During Two Decades of Continuous Universal Salt Iodisation in Sri Lanka

et al. 2020

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Universal salt iodisation (USI) was introduced in Sri Lanka in 1995. Since then, four national iodine surveys have assessed the iodine nutrition status of the population. We retrospectively reviewed median urine iodine concentration (mUIC) and goitre prevalence in 16,910 schoolchildren (6–12 years) in all nine provinces of Sri Lanka, the mUIC of pregnant women, drinking-water iodine level, and the percentage of households consuming adequately (15 mg/kg) iodised salt (household salt iodine, HHIS). The mUIC of schoolchildren increased from 145.3 µg/L (interquartile range (IQR) = 84.6–240.4) in 2000 to 232.5 µg/L (IQR = 159.3–315.8) in 2016, but stayed within recommended levels. Some regional variability in mUIC was observed (178.8 and 297.3 µg/L in 2016). There was positive association between mUIC in schoolchildren and water iodine concentration. Goitre prevalence to palpation was a significantly reduced from 18.6% to 2.1% (p < 0.05). In pregnant women, median UIC increased in each trimester (102.3 (61.7–147.1); 217.5 (115.6–313.0); 273.1 (228.9–337.6) µg/L (p = 0.000)). We conclude that the introduction and maintenance of a continuous and consistent USI programme has been a success in Sri Lanka. In order to sustain the programme, it is important to retain monitoring of iodine status while tracking salt-consumption patterns to adjust the recommended iodine content of edible salt.

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Iodine status of pregnant women in Sri Lanka

Cited by 5 publications

References 2 publications

Status of iodine in rural pregnant women of different trimesters in Lucknow -A cross-sectional study

Status of iodine in rural pregnant women of different trimesters in Lucknow -A cross-sectional study

Urinary iodine and thyroid determinants in pregnancy: a follow up study in Sri Lanka

Stable Iodine Nutrition During Two Decades of Continuous Universal Salt Iodisation in Sri Lanka

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