Prevalence of iodine deficiency and associated factors among pregnant women in Ada district, Oromia region, Ethiopia: a cross- sectional study

Abstract

BackgroundMaternal iodine deficiency (ID) during pregnancy has been recognized as a major cause of abortion, stillbirth, congenital abnormalities, perinatal mortality and irreversible mental retardation. In Ethiopia limited information is available regarding the epidemiology of maternal ID. The purpose of the present study was to assess the prevalence of iodine deficiency and associated factors among pregnant women in Ada district, Oromia region, Ethiopia.MethodA community based, cross-sectional study was conducted in rural areas of Ada district, October to November, 2014. Data were collected from 356 pregnant women selected by multistage cluster sampling technique. Presence of goiter was examined by palpation and urinary iodine concentration was measured using inductively-coupled-plasma mass spectrometry. Salt iodine concentration was determined using a digital electronic iodine checker. Statistical analysis was done primarily using binary logistic regression. The outputs of the analysis are presented using adjusted odds ratio (AOR) with the respective 95% confidence intervals (CI).ResultsThe median urinary iodine concentration (UIC) was 85.7 (interquartile range (IQR): 45.7–136) μg/L. Based on UIC, 77.6% (95% CI: 73.0–82.0%) of the study subjects had insufficient iodine intake (UIC < 150 μg/L). The goiter rate was 20.2% (95% CI: 16.0–24.0%). The median iodine concentration of the household salt samples was 12.2 (IQR: 6.9–23.8) ppm. Of the households, only 39.3% (95% CI: 34.0–44.0%) consumed adequately iodized salt (≥15 ppm). Prevalence of goiter was significantly higher among pregnant women aged 30–44 years (AOR = 2.32 (95% CI: 1.05–5.14)) than among younger women and among illiterate women (AOR = 2.71 (95% CI: 1.54–4.79)). Compared to nulliparous, women with parity of 1, 2 and 3 or more had 2.28 (95% CI: 1.01–5.16), 2.81 (95% CI: 1.17–6.74) and 4.41 (95% CI: 1.58–12.26) times higher risk of goiter.ConclusionIodine deficiency was a public health problem in the study area. This indicates the need for further strengthening of the existing salt iodization program in order to avail homogenously and adequately iodized salt. Also it is necessary to find ways to provide iodine supplements as needed until universal salt iodization (USI) is fully established.

Maternal and neonatal outcomes and determinants of iodine deficiency in third trimester of pregnancy in an iodine sufficient area

“…Besides, there were meaningful relations between timing interval between most recent pregnancies, the desirability of the pregnancy, use nutritional micronutrients before and during pregnancy and mother's level education and urinary iodine concentration. In a study in Ethiopia age, multiparity and mother's level of education were found to be significantly related to maternal iodine content during pregnancy [31]. In another study in China the type of dietary salt, maternal age, occupation, consumption of complementary micronutrients and seafood were found to affect urinary iodine meaningfully [32].…”

Estado Nutricional De Iodo Na Gestação E Sua Influência Na Saúde Do Binômio Mãe-Filho

“…Ademais, a literatura tem mostrado que a iodação do sal tem sido o método mais eficaz de reduzir as prevalências de deficiência iódica, sobretudo quando comparada a estratégias de fortificação de apenas um grupo de alimentos em especial (CLIFTON et al, 2013;BOTTARO et al, 2016). Fereja et al (2018) também concluíram sobre os benefícios da iodação do sal para o estado nutricional de iodo em gestantes e reforçam que é necessário fortalecer os programas de iodação de sal como forma de garantir o acesso da população a fontes de iodo, de forma adequada e homogênea. Esses autores também evidenciaram risco até quatro vezes mais elevado de desenvolvimento do bócio em multíparas quando comparadas a nulíparas.…”

Urinary Iodine Concentration in 24-Hour Urine of Pregnant Women and Its Association with Food and Salt Intake

“…In Ethiopia, the IUC median was 85.7 μg / l, so that 77.6% of the pregnant women (95% CI: 73.0-82.0%) had insufficient iodine intake (UIC <150μg/l). The goiter rate was 20.2% (95% CI: 16.0-24.0%) [23]. Since ICP-MS was also used.…”