Serum Levels of Some Micronutrients and Congenital Malformations: A Prospective Cohort Study in Healthy Saudi-Arabian First-Trimester Pregnant Women

2020

Preprint

Background: Despite the serious maternal and foetal complications associated with iodine deficiency during pregnancy, surveys related to pregnant women in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, measured urine iodine concentrations (UIC) alongside the potential socioeconomic factors contributing towards iodine inadequacy in reproductive age and pregnant Saudi women from the Western province of KSA. Methods: Spot urine samples were collected from 1222 pregnant and 400 age-matched non-pregnant/non-lactating reproductive age women. The socioeconomic characteristics were obtained through a structured questionnaire. The WHO criteria for iodine sufficiency in non-pregnant (100–199 μg/L) and pregnant (150–249 μg/L) women were applied. Results: The median UIC in the non-pregnant women (101.64 μg/L; IQR: 69.83 – 143.55) was at the lowermost WHO recommended cut-off, whereas the pregnant group were iodine deficient (112.99 μg/L; IQR: 81.01 – 185.57). Moreover, the median UIC was below adequacy across the different trimesters. Multiparity (OR = 3.091; 95%CI: 1.707–5.598) and earning below the minimum wage (2.520; 95%CI: 1.038–6.119) significantly increased the risk of iodine deficiency only in the non-pregnant women. Passive smoking, however, was an independent risk factor for iodine deficiency in the non-pregnant (OR = 1.818; 95%CI: 1.097–3.014) and pregnant (OR = 1.653; 95%CI: 1.043–2.618) groups. The use of non-iodised salt also significantly increased the risk of iodine deficiency in the non-pregnant (OR = 2.052; 95%CI: 1.118–3.766) and pregnant women (OR = 3.813; 95%CI: 1.992–7.297), whereas iodine supplements significantly lowered the risk in both groups (OR = 0.364; 95%CI: 0.172–0.771 and OR = 0.002; 95%CI: 0.001–0.005, respectively). Moreover, BMI correlated independently and significantly with median UIC in the non-pregnant in both study populations. Conclusions: This study is the first to show borderline iodine sufficiency in reproductive age Saudi women from the Western province, whereas mild iodine deficiency was observed in the pregnant population and could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous maternal-foetal health consequences of iodine deficiency.

Section: Discussionmentioning

confidence: 78%

Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia

2020

Preprint

“…Hence, iodine deficiency in our pregnant population could be related to inappropriate nutrition since many studies have indicated malnourishment in Saudi pregnant women, and they consumed essential nutrients below the recommended requirements [34][35][36][37]. Saudi women from the Western region also had significantly low micronutrients intake, thus their offspring had a higher risk of developing birth defects [38][39][40]. In agreement, the use of iodine supplements was only confirmed by a minority (27.6%) of our pregnant population.…”

Section: Discussionmentioning

confidence: 99%

Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia

BMC Pregnancy Childbirth

2020

Background: Despite the serious maternal and foetal complications associated with iodine deficiency during pregnancy, surveys related to pregnant women in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, measured urine iodine concentrations (UIC) alongside the potential socioeconomic factors contributing towards iodine inadequacy in reproductive age and pregnant Saudi women from the Western province of KSA. Methods: Spot urine samples were collected from 1222 pregnant and 400 age-matched non-pregnant/nonlactating reproductive age women. The socioeconomic characteristics were obtained through a structured questionnaire. The WHO criteria for iodine sufficiency in non-pregnant (100-199 μg/L) and pregnant (150-249 μg/L) women were applied. Results: The median UIC in the non-pregnant women (101.64 μg/L; IQR: 69.83-143.55) was at the lowermost WHO recommended cutoff , whereas the pregnant group was iodine deficient (112.99 μg/L; IQR: 81.01-185.57). Moreover, the median UIC was below adequacy across the different trimesters. The use of non-iodised salt significantly increased the risk of iodine deficiency in the non-pregnant (OR = 2.052; 95%CI: 1.118-3.766) and pregnant women (OR = 3.813; 95%CI: 1.992-7.297), whereas taking iodine supplements significantly lowered the risk in both groups (OR = 0.364; 95%CI: 0.172-0.771 and OR = 0.002; 95%CI: 0.001-0.005, respectively). Passive smoking was also an independent risk factor for iodine deficiency in the non-pregnant (OR = 1.818; 95%CI: 1.097-3.014) and pregnant (OR = 1.653; 95%CI: 1.043-2.618) groups. Additionally, BMI correlated independently and significantly with median UIC in the non-pregnant and pregnant populations. However, multiparity (OR = 3.091; 95%CI: 1.707-5.598) and earning below the minimum wage (2.520; 95%CI: 1.038-6.119) significantly increased the risk of iodine deficiency only in the non-pregnant women. Conclusions: This study is the first to show borderline iodine sufficiency in reproductive age Saudi women from the Western province, whereas mild iodine deficiency was observed in the pregnant population and could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous consequences of iodine deficiency on maternal-foetal health.

“…Several studies conducted among the Saudi population have also indicated that most of pregnant women were malnourished and their consumption of essential nutrients were below the recommended daily requirements [41][42][43][44]. Saudi women from the Western region had also significantly lower intake of micronutrients during the first trimester, thus their offspring had an increased risk of developing birth defects [45][46][47]. Our findings agree with the earlier observations since they showed that only 27.6% of the enrolled pregnant population were using iodine supplements, which was associated with significantly lower risk of developing iodine deficiency during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Iodine adequacy in reproductive age women living in the Western region of Saudi Arabia

2019

Preprint

Background Despite the significance of iodine deficiency in women of reproductive age due its associated serious maternal and foetal complications, surveys related to this vulnerable population in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, aimed to measure the frequency alongside the potential socioeconomic factors contributing towards iodine inadequacy in Saudi women of childbearing age from the Western province of KSA.Methods Urinary iodine concentrations IUIC) were measured in random spot samples collected from 1222 pregnant women and 400 age-matched non-pregnant/non-lactating women. The socioeconomic characteristics were obtained through a structured questionnaire. The classification of iodine sufficiency was based on the WHO criteria for UIC in pregnant (150–249 μg/L) and non-pregnant women (100–199 μg/L).Results The UIC median in the non-pregnant women (101.64 μg/L; IQR: 73.72) was at the lowest WHO recommended cut-off. The pregnant women, on the other hand, had a median UIC (112.99 μg/L; IQR: 104.56) markedly below the minimal WHO limit for pregnancy. Coherently, the median IUC was below adequacy across the trimesters and was lowest during the first trimester. Additionally, 49.7% (n = 199) of the non-pregnant and 62.5% (n = 764) of pregnant women were iodine deficient as per the WHO criteria. While pregnancy (OR = 4.3; 95%CI: 3.08–5.96) and using non-iodised salt (OR = 1.96; 95%CI: 1.35–2.83) significantly increased the risk of iodine deficiency, the intake of iodine supplements significantly lowered the risk (OR = 0.010; 95%CI: 0.006–0.017). On the other hand, the intake of iodine above requirement was observed in 8.5% and 4.2% of the non-pregnant and pregnant women, respectively. Moreover, BMI was the sole independent factor increasing the odds (OR = 1.061; 95%CI: 1.010–1.114) of taking iodine above requirements.Conclusions This study is the first to show high prevalence of mild iodine deficiency among reproductive age Saudi women, which could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous maternal-foetal health consequences of iodine deficiency.