Should Iodine be Supported in Pregnancy? A Hospital Based Study

Öz

Objective: Iodine deficiency causes adverse effects in pregnant women and neurological-cognitive disorders in their babies. Our aim was to define the status of iodine deficiency among pregnant women, who attended our hospital outpatient polyclinics. Materials and Methods: This cross-sectional and descriptive study was performed in 2014 with 94 pregnant women. Iodine levels in spot urine and serum thyroid hormones have been analyzed. The iodine levels of spot urine less than 150 µg/L were accepted as iodine deficiency. Results: The mean age was 30.6±3.92 years, mean gestational age was 18.9±9.64 weeks. Mean urinary iodine concentrations (UIC) were 160.32±5.88 μg/L and the ratio of pregnant women whose UIC less than 150 μg/L was 33% (n=31) and the percentage of the women, who declared iodised salt use was 90.2%. Conclusion: In this study, in one-third of pregnant women the urine iodine concentrations were inadequate despite the high rate of iodised salt intake. Nevertheless, most prenatal vitamins and salts do not include adequate iodine, iodine monitoring and supplementation may be recommended before and during pregnancy.

Giriş: İyot eksikliği, gebelerde olumsuz etkilere, bebeklerinde ise nörokognitif bozukluklara neden olmaktadır. Çalışmamızda hastanemiz polikliniklerine başvuran gebe kadınlarda iyot eksikliğinin araştırılması amaçlanmıştır. Yöntem: Bu kesitsel ve tanımlayıcı çalışmaya, 2014 yılında takip edilen, 94 gebe dahil edilmiştir. Çalışmaya alınan gebelerin, anlık (spot) idrarda iyot düzeyleri ve tiroid fonksiyon testleri analiz edilmiştir. Spot idrarda iyot düzeyi <150 µg/L ise iyot eksikliği olarak kabul edilmiştir. Bulgular: Çalışmamızda ortalama yaş 30,6±3,92 yıl, ortalama gebelik yaşı 18,9±9,64 hafta idi. Ortalama idrar iyot atılımı 160,32±5,88 μg/L olarak saptanmış olup, iyot eksikliği olanların oranı %33 olarak bulunmuştur. İyot katkılı tuz kullandığını belirten gebelerin oranı %90,2 idi. Sonuç: İyot katkılı tuz kullanımının yüksek oranda olmasına karşın, gebelerin üçte birinde idrar iyot düzeyleri yetersiz düzeyde saptanmıştır. Bulgularımız, gebelerde iyot eksikliği prevalansının önemli bir düzeyde olduğunu vurgulamaktadır. Ülkemizde prenatal vitaminlerin çoğunda ve tuzlarda yeterli iyot bulunmamaktadır, bu nedenle gebelik sırasında veya öncesinde iyot durumunun değerlendirilmesi ve desteklenmesi önerilebilir.

Anahtar Kelimeler

• Pregnancy,iodine deficiency

Kaynakça

1. 1. Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. Journal of Nutrition 2012;142: 744–750
2. 2. Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: A Review. Am J Clin Nutr 2009; 89(2):668-672.
3. 3. Zimmermann MB, Delange F. Iodine supplementation of pregnant women in Europe: A review and recommendations. Eur J Clin Nutr 2004; 58(7): 979-984.
4. 4. Yarrington C, Pearce EN. Iodine and Pregnancy. Journal of Thyroid Research. 2011;2011:934104.
5. 5. Vitti P, Rago T, Aghini-Lombardi F, Pinchera A. Iodine deficiency disorders in Europe. Public Health Nutr.2001;4(2B):529-535.
6. 6. Russel R, Beard J, Cousins R, Dunn J, Ferland G, Hambidge KM et al. Panel on micronutrients. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc, National Academy Press, Washington, DC, USA. 2001:275-278
7. 7. Braverman LE. Adequate iodine intake—the good far outweighs the bad. European Journal of Endocrinology 1998;139(1):14-15.
8. 8. Egri M, Ercan C, Karaoglu L. Iodine deficiency in pregnant women in eastern Turkey (Malatya Province): 7 years after the introduction of mandatory table salt iodization. Public Health Nutr 2009;12(6) 849-52.

9. 9. Erdoğan MF, Ağbaht K, Altunsu T, Ozbas S, Yucesan F, Tezel B. et al. Current iodine status in Turkey. J Endocrinol Invest 2009;32(7):617-622.
10. 10. Kut A, Gursoy A, Senbayram S, Nilüfer B, Isıl IB, Akgün S. Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey. J Endocrinol Invest 2010;33(7):461-464.
11. 11. Qian M, Wang D, Watkins WE, Gebski V, Yan YQ, et al. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pac J Clin Nutr. 2005;14(1):32.
12. 12. Erdoğan MF. The iodine status of Turkey: Where were we? Where are we now? Review. Türkiye Klinikleri J Endocrin Special Topics 2008; 1 (3):8-13.
13. 13. Pearce EN, Andersson M, Zimmermann MB. Global iodine nutrition: Where do we stand in 2013? Thyroid. 2013;23(5):523-528.
14. 14. Oguz Kutlu A, Kara C. Iodine deficiency in pregnant women in the apparently, iodine-sufficient capital city of Turkey. Clin Endocrinol (Oxf) 2012;77(4):615-620.
15. 15. Katarzyna W, Krystyna SB. Effect of storage conditions on potassium iodide stability in iodized table salt and collagen preparations. International Journal of Food Science & Technology 2007;43(5):895 -899.