Iodine status of pregnant women from a coastal Brazilian state after the reduction in recommended iodine concentration in table salt according to governmental requirements

Saraiva, Débora Ayres; Morais, Nathalie de Oliveira e Silva de Anne; Corcino, Carolina Martins; Berbara, Tatiana Martins Benvenuto Louro; Schtscherbyna, Annie; Santos, Mischelle; Botelho, Heron; Teixeira, Patrícia de Fátima dos Santos

doi:10.1016/j.nut.2018.02.001

Cited by 18 publications

(30 citation statements)

References 35 publications

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“…The study was conducted from March 2016 to May 2017. All participants were recruited while attending routine antenatal visits at Tanggu Maternity Hospital, Tianjin Child Health Care Service Center, and Gaoqing Child Health Hospital in different trimesters, including the first trimester (<13 gestational weeks [GW]), the second trimester (GW [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], and the third trimester (≥28 GW). The exclusion criteria were as follows: (1) living in the local area for <5 years; (2) multiple pregnancy; (3) age below 18 or above 35 years; (4) personal/family history of thyroid disease; (5) history of autoimmune diseases; and (6) taking iodine supplements during pregnancy.…”

Section: Participants and Study Designmentioning

confidence: 99%

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

et al. 2020

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Objectives: To explore trimester-specific thyroid function changes under different iodine statuses throughout pregnancy. Methods: A cross-sectional study was conducted to assess the pregnancy iodine status, and 2,378 healthy pregnant women covering all 3 trimesters were recruited. Urinary iodine concentration (UIC) was measured by collecting spot urine samples. Blood samples were collected to evaluate thyroid function. Thyroid B-ultrasonography was conducted to measure the thyroid volume (Tvol). Results: The median UIC was 168 μg/L (111-263 μg/L). The UIC, free triiodothyronine (FT3), and free thyroxine (FT4) were significantly decreased as the pregnancy progressed (p < 0.001, p for trend <0.001), while Tvol increased (p < 0.001, p for trend <0.001). Thyrotropin (TSH) was significantly different between the 3 trimesters and showed an upward trend (p < 0.001), but the p for trend was not significant (p for trend = 0.88). After stratification by UIC, there were no significant differences in serum TSH, FT4, or FT3 level between UIC groups. Tvol was significantly higher in the UIC ≥500 μg/L group in the first trimester (β: 2.41, 95% CI: 1.09-3.72, p <0.001), as well as in the 250 ≤ UIC < 500 μg/L group (β: 1.65, 95% CI: 0.61-2.70, p < 0.001) and UIC ≥500 μg/L group (β: 3.35, 95% CI: 1.96-4.74, p < 0.001) in the third trimester. Conclusions: No difference was observed in TSH, FT3, or FT4 among the different iodine status groups throughout pregnancy. Tvol increased as the pregnancy progressed, and it was especially higher in the UIC ≥500 μg/L group in the first and third trimesters.

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Section: Participants and Study Designmentioning

confidence: 99%

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

et al. 2020

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“…Considering that Brazil is a country of continental proportions, it is also possible that the divergences found are due to demographic differences, such as different profiles of iodine consumption. Our population was considered to have iodine sufficiency (12).…”

Section: Discussionmentioning

confidence: 99%

“…This multiple-center, cross-sectional study was performed with an ongoing prospective cohort that included pregnant women attending prenatal programs in four public health care units from an urban area with iodine sufficiency (12) in a Brazilian coastal state. During the recruitment period, each unit was visited regularly, but at different times -not necessarily concomitantly.…”

Section: Methodsmentioning

confidence: 99%

“…Body mass index (BMI) was calculated as weight (kg) divided by height squared (m²). As previously reported, the population studied was considered to have iodine sufficiency (12). Morning blood samples were collected from all patients to determine serum levels of thyrotropin (TSH), free thyroxine (FT4), anti-thyroperoxidase (TPO-Ab), and anti-thyroglobulin (Tg-Ab) antibodies.…”

Section: Methodsmentioning

confidence: 99%

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Selective case finding versus universal screening for detecting hypothyroidism in the first trimester of pregnancy: a comparative evaluation of a group of pregnant women from Rio de Janeiro

Berbara¹,

Morais²,

Saraiva³

et al. 2020

Archives of Endocrinology and Metabolism

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Objective: Maternal hypothyroidism during pregnancy may lead to adverse outcomes. Recently published guidelines by the American Thyroid Association (ATA) do not advocate for universal screening but recommend a case-finding approach in high-risk pregnant women. The present study aims to evaluate the accuracy of this approach in identifying women with thyroid dysfunction during early pregnancy. Subjects and methods: This is a multiple-center, cross-sectional study. Three hundred and one pregnant women were enrolled. Anamnesis and a physical examination were performed to detect which women fulfilled the criteria to undergo laboratory screening of thyroid dysfunction, according to the ATA's 2017 guidelines. The Zulewski's validated clinical score was applied to assess signs and symptoms of hypothyroidism. Serum levels of thyrotropin (TSH), free thyroxine (FT4), anti-thyroperoxidase (TPO-Ab), and anti-thyroglobulin (Tg-Ab) antibodies were determined. Results: Two hundred and thirty one women (78%) were classified as high risk, and 65 (22%) were classified as low risk for thyroid dysfunction. Regarding the clinical score, 75 patients (31.2%) presented mild symptoms that were compatible with SCH, of which 22 (7.4%) had symptoms as the only risk factor for thyroid disease. 17 patients (5.7%) had SCH, of which 10 (58.8%) belonged to the high-risk group, and 7 (41.2%) belonged to the low-risk group. OH was found in 4 patients (1.4%): 3 (75%) in the high-risk group and 1 (25%) in the low-risk group. Conclusions: The ATA's proposed screening criteria were not accurate in the diagnosis of thyroid dysfunction in pregnancy. Testing only the high-risk pregnant women would miss approximately 40% of all hypothyroid patients. Arch

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“…Potential explanations for the divergence include differences in iodine consumption among the populations. A recent trial (20) with pregnant women from Rio de Janeiro showed that this population is iodine sufficient, while some other have reported an increased iodine deficiency prevalence in the state of Minas Gerais (20). In addition, in the study from Minas Gerais (19), thyroid ultrasound and thyroglobulin antibody were not performed to exclude thyroid autoimmunity, but these differences could justify a higher, but not a lower upper serum TSH reference limit.…”

mentioning

confidence: 97%

Region-specific reference intervals for TSH in pregnancy: time for changes in Brazil

Sgarbi¹

2018

Archives of Endocrinology and Metabolism

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Iodine status of pregnant women from a coastal Brazilian state after the reduction in recommended iodine concentration in table salt according to governmental requirements

Cited by 18 publications

References 35 publications

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

Selective case finding versus universal screening for detecting hypothyroidism in the first trimester of pregnancy: a comparative evaluation of a group of pregnant women from Rio de Janeiro

Region-specific reference intervals for TSH in pregnancy: time for changes in Brazil

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