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Early gestation screening of pregnant women for iodine deficiency disorders and iron deficiency in urban centre in Vadodara, Gujarat, India

Published online by Cambridge University Press:  27 November 2013

K. Joshi ,
S. Nair ,
C. Khade  and
M. G. R. Rajan
K. Joshi*
Affiliation:
Department of Foods and Nutrition, Faculty of Family and Community Sciences, The Maharaja Sayajirao University of Baroda, Gujarat, India
S. Nair
Affiliation:
Department of Foods and Nutrition, Faculty of Family and Community Sciences, The Maharaja Sayajirao University of Baroda, Gujarat, India
C. Khade
Affiliation:
RMC Unit, BARC, Tata Memorial Hospital, Lower Parel, Mumbai, Maharashtra, India
M. G. R. Rajan
Affiliation:
RMC Unit, BARC, Tata Memorial Hospital, Lower Parel, Mumbai, Maharashtra, India
*
*Address for correspondence: K. Joshi, Department of Foods and Nutrition, Faculty of Family and Community Sciences, The Maharaja Sayajirao University of Baroda, Fatehgunj, Vadodara, Gujarat 390002, India. Email [email protected]
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Abstract

Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age <15 weeks) in urban Vadodara, Gujarat. n = 256 healthy pregnant women with uncomplicated singleton pregnancy were selected. The thyroid hormone was estimated by RIA, UIE using simple microplate technique and haemoglobin (Hb) concentration by acid hematin method. Median thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4) and UIE concentrations were 1.88 μIU/ml, 0.83 ng/dl, 10.24 μg/dl and 297.14 mcg/l, respectively. There was a significant correlation between TSH, FT4 and month of gestation. Mean Hb concentration was 9.27 ± 1.09 g/dl. The prevalence of iodine insufficiency (based on UI) was 16.79% and iron deficiency was 91%. Screening programme for iodine deficiency during early gestation should be implemented along with the existing programme of haemoglobin estimation at first prenatal visit. This would help prevent damage to the developing brain and growth of the foetus and also to trace at-risk pregnant women.

Keywords

iron deficiency anaemiamaternal iodine deficiencypregnancythyroid insufficiency
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 5 , Issue 1 , February 2014 , pp. 63 - 68
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2013 

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References

1. Glinoer, D. The regulation of thyroid function in pregnancy: Pathways of endocrine adaption from physiology to pathology, endocrine reviews. Endocr Rev. 1997; 18, 404–433.CrossRefGoogle Scholar
2. Glinoer, D, De Nayer, P. Thyroid and its diseases in pregnancy. In Thyroid Diseases: Clinical Fundamentals and Therapy (eds. Monaco F, Satta MA, Sharpiro B, Troncone L), 1993; pp. 517–527. CRC Press: Boca Raton, FL.Google Scholar
3. Ablovich, M, Glinoer, D. Pregnancy and hypothyroidism: autoimmune thyroiditis and iodine deficiency complicating mother and fetus. Comprehensive Handbook of Iodine, chapter 113, 2009; 1113–1122.Google Scholar
4. Singh, MB, Fotedar, R, Lakshminarayana, J. Micronutrient deficiency status among women of desert areas of western Rajasthan, India. Public Health Nutr. 2009; 12, 624–629.CrossRefGoogle ScholarPubMed
5. Ategbo, EA, Sankar, R, Schultink, W, van der Haar, F, Pandav, CS. An assessment of progress toward universal salt iodization in Rajasthan, India, using iodine nutrition indicators in school-aged children and pregnant women from the same households. Asia Pac J Clin Nutr. 2008; 17, 56–62.Google Scholar
6. Chakraborty, I, Chatterjee, S, Bhadra, D, et al. Iodine deficiency disorders among the pregnant women in a rural hospital of West Bengal. Indian J Med Res. 2006; 123, 825–829.Google Scholar
7. Kant, S, Misra, P, Baridalyne, N, et al. Iodine status of pregnant women residing in an urban resettlement colony of Delhi. Obstet Gynecol. 2003; 53, 554–557.Google Scholar
8. Kapil, U, Pathak, P, Singh, C, Tandon, M, Pradhan, R. Micronutrient deficiency disorders amongst pregnant women in three urban slum communities of Delhi. Indian Pediatr. 1999; 36, 983–989.Google Scholar
9. Kapil, U, Saxena, N, Ramachandran, S, Nayar, D. Iodine status of pregnant women residing in a district of endemic iodine deficiency in the state of Himachal Pradesh, India. Asia Pacific J Clin Nutr. 1997; 6, 224–225.Google Scholar
10. Dodd, NS, Madan, J. Iodine status in pregnancy. Asia Pacific J Clin Nutr. 1993; 2, 119–123.Google ScholarPubMed
11. Pathak, P, Singh, P, Kapil, U, Raghuvanshi, RS. Prevalence of iron, vitamin A, and iodine deficiencies amongst adolescent pregnant mothers. Indian J Pediatr. 2003; 70, 299–301.Google Scholar
12. Srinath, S. Iodine status of pregnant women attending antenatal care clinic at comprehensive rural health services project (C.R.H.S.P.), Ballabgarh, Haryana, North India, MD dissertation, Faculty of All India Institute of Medical Sciences, New Delhi, India.Google Scholar
13. Zimmerman, M. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. Am J Clin Nutr. 2009; 89, 688S–672S.CrossRefGoogle Scholar
14. National Family Health Statistics III (NFHS-III) (2005–2006), Ministry of Family and Health Welfare, Government of India.Google Scholar
15. Ezzati, M, Lopus, AD, Dogers, A, Vander, HS, Murray, C. Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360, 1347–1360.CrossRefGoogle ScholarPubMed
16. Zimmerman, M. The influence of iron status on iodine utilization and thyroid function. Annu Rev Nutr. 2006; 26, 367–389.CrossRefGoogle Scholar
17. Hess, SY, Zimmermann, MB, Arnold, M, et al. Iron deficiency anemia reduces thyroid peroxidase activity in rats. J Nutr. 2002; 132, 1951–1955.CrossRefGoogle ScholarPubMed
18. Beard, JL, Borel, MJ, Derr, J. Impaired thermoregulation and thyroid function in iron-deficiency anemia. Am J Clin Nutr. 1990; 52, 813–819.Google Scholar
19. Eftekhari, MH, Keshavarz, SA, Jalali, M, et al. The relationship between iron status and thyroid hormone concentration in iron-deficient adolescent Iranian girls. Asia Pac J Clin Nutr. 2006; 15, 50–55.Google ScholarPubMed
20. Zel'tser, ME, Mezinova, NN, Kobzar’, NN, et al. Thyroid status in anemic pregnant women under conditions of endemic goiter. Probl Endokrinol (Mosk). 1994; 40, 20–22.Google Scholar
21. Duntas, LH, Papanastasiou, L, Mantzou, E, Koutras, DA. Incidence of sideropenia and effects of iron repletion treatment in women with subclinical hypothyroidism. Exp Clin Endocrinol Diabetes. 1999; 107, 356–360.Google Scholar
22. Ohashi, T, Yamaki, M, Pandav, CS, Karmarkar, MG, Irie, M. Simple microplate method for determination of urinary iodine. Clin Chem. 2000; 46, 529–536.CrossRefGoogle ScholarPubMed
23. The Endocrine Society. Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guidelines. J Clin Endocrinol Metab. 2007; 92, S1–S47.CrossRefGoogle Scholar
24. WHO/UNICEF/UNU. Iron-Deficiency Anemia: Assessment, Prevention and Control: A Guide for Program Managers, 2001. World Health Organization: Geneva.Google Scholar
25. WHO, UNICEF, ICCIDD. Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: A Guide for Programme Managers, 3rd edn, 2007. WHO: Geneva.Google Scholar
26. Springer, D, Zima, T, Limanova, Z. Reference intervals in evaluation of maternal thyroid function during the first trimester of pregnancy. Eur J Endocrin. 2009; 160, 791–797.Google Scholar
27. Panesar, NS, Li, CY, Rogers, MS. Reference intervals for thyroid hormones in pregnant Chinese women. Ann Clin Biochem. 2001; 38, 329–332.Google Scholar
28. Mansourian, A. Thyroid function tests during first-trimester of pregnancy: a review of literature. Pak J Biol Sci. 2010; 13, 664–673.Google Scholar