Thyroid size and thyroid function during pregnancy: an analysis

Berghout, A; Wiersinga, Wilmar M.

doi:10.1530/eje.0.1380536

Cited by 121 publications

(101 citation statements)

References 45 publications

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“…This observation provides additional evidence for ID. Unlike other studies, we did not find any relation between thyroid volume and age, previous pregnancies, socioeconomic status, urinary or breast milk iodine, or the progeny's thyroid volume (21)(22)(23)(24)(25)(26), but only with the fishconsumption rate (25).…”

Section: Discussioncontrasting

confidence: 99%

“…While urinary iodine excretion is the most appropriate indicator for assessing recent iodine intake in epidemiological studies, other indices such as goiter are clinical hallmarks of ID (1)(2)(3)(20)(21)(22)(23)(24)(25)(26). In our study almost 14% of all pregnant women had gestational goiter, and heterogeneous echotexture patterns after pregnancy were often observed.…”

Section: Discussionmentioning

confidence: 61%

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Iodine Status of Pregnant Women and Their Progeny in the Minho Region of Portugal

Costeira

Oliveira

Segura

et al. 2009

Thyroid

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Background: Iodine sufficiency is particularly necessary throughout pregnancy, given its recognized impact on psychomotor performance of the offspring. There are no recent reports about iodine status or supplementation in Portugal, a country that the International Council for Control of Iodine Deficiency Disorders considered, in 2004, to have probably reached iodine sufficiency. The objective of this study was to evaluate in the Minho region of Portugal the iodine status of women throughout pregnancy and after delivery, and of their offspring. Methods: Urinary iodine concentration (UI) was determined in 78 nonpregnant premenopausal women, in 140 pregnant women in the three trimesters of pregnancy and after delivery, and in their 142 offspring. Milk iodine concentration was determined at day 3 and 3 months after delivery. The thyroid volume was determined in women in the third trimester of pregnancy and 3 months after delivery and in infants at 3 months of age. Results: Based on the World Health Organization criteria, both nonpregnant and pregnant women had iodine deficiency (ID), as documented by median UI of <75 mg=L and milk iodine concentration of <100 mg=L. Goiter was observed in 14% of the pregnant women. Concordant with the mother's ID, median neonatal UI was low (71 and 97 mg=L at 3 days and 3 months of age). Conclusion: Portuguese women of the Minho region have an inadequate iodine intake, which may compromise the potential for full psychomotor development of their progeny. These observations suggest that iodine supplementation should be implemented throughout pregnancy and lactation in Portugal.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 61%

Iodine Status of Pregnant Women and Their Progeny in the Minho Region of Portugal

Costeira

Oliveira

Segura

et al. 2009

Thyroid

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“…Studies of thyroid size in pregnancy measured by ultrasonography also indicate iodine nutrition is suboptimal in much of Europe. In countries affected by mild or moderate iodine deficiency (Ireland, Germany, Belgium, Italy, Denmark), thyroid volume increases 14-30% during pregnancy, while in iodinesufficient countries (Finland, the Netherlands), there is no increase in thyroid volume during pregnancy (Berghout & Wiersinga, 1998;Glinoer, 2003).…”

Section: Iodine Status Of Pregnant Womenmentioning

confidence: 99%

Iodine supplementation of pregnant women in Europe: a review and recommendations

Zimmermann

Delange²

2004

Eur J Clin Nutr

196

100

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Objective: Nearly two-thirds of the population of Western and Central Europe live in countries that are iodine deficient. Damage to reproductive function and to the development of the fetus and newborn is the most important consequence of iodine deficiency. The objective of this review was to examine the iodine status of pregnant women in Europe and the potential need for iodine supplementation. Design: A MEDLINE/PubMed search and compilation of all published studies since 1990 of iodine nutrition and iodine supplementation of pregnant women in Europe, as well as an Internet-based search and review on availability and legislation of iodine supplements in the European Union. Results: Although the data suggest most women in Europe are iodine deficient during pregnancy, less than 50% receive supplementation with iodine. Mild-to-moderate iodine deficiency during pregnancy adversely affects thyroid function of the mother and newborn and mental development of the offspring and these adverse effects can be prevented or minimized by supplementation. There are no published data on the effect of iodine supplementation on long-term maternal and child outcomes. The iodine content of prenatal supplements in Europe varies widely; many commonly used products contain no iodine. The European Union is developing legislation to establish permissible levels for iodine in food supplements. Conclusions: In most European countries, pregnant women and women planning a pregnancy should receive an iodinecontaining supplement (E150 mg/day). Kelp and seaweed-based products, because of unacceptable variability in their iodine content, should be avoided. Prenatal supplement manufacturers should be encouraged to include adequate iodine in their products. Professional organizations should influence evolving EU legislation to ensure optimal doses for iodine in prenatal vitamin-mineral supplements.

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“…The median UIC of 111 mg/l in the pregnant women in the present survey does not attain this range, indicating that their iodine consumption is insufficient. This conclusion is supported by finding an increasing thyroid volume with the duration of pregnancy, since an increase in thyroid size during pregnancy has been a classical indicator of iodine deficiency (24,25) . The finding in a population-representative survey that pregnant women, while consuming the same diet, have lower UIC than school-age children is not unique for Kyrgyzstan (26)(27)(28) .…”

Section: Discussionmentioning

confidence: 80%

The current salt iodization strategy in Kyrgyzstan ensures sufficient iodine nutrition among school-age children but not pregnant women

Mamutova²,

Haar

2009

Public Health Nutr.

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Objective: Although goitre and cretinism were brought under control in Kyrgyzstan during the 1960s by centrally directed iodized salt supplies, iodine-deficiency disorders (IDD) had made a comeback when the USSR broke up in 1991. Upon independence, Kyrgyzstan started developing its own salt processing industry and by 2001 the Government enacted a law on IDD elimination, mandating universal salt iodization (USI) at 25-55 mg/kg. The present study aimed to evaluate the effectiveness of the USI strategy on the iodine consumption, iodine status and burden of IDD in the population of Kyrgyzstan. Design: A national, population-representative survey during autumn 2007 collected household salt and urine samples of school-age children and pregnant women for quantitative iodine measurements. Thyroid volume was measured by ultrasound. Results: The median iodine content in household salt was 11?2 mg/kg; 97?9 % of salt samples were iodized, but only 39?5 % had $15 mg iodine/kg. The median urinary iodine concentration (UIC) of 114 mg/l in children did not differ from the UIC of 111 mg/l in pregnant women. Thyroid volume in pregnant women increased with the duration of pregnancy. Strong relationships existed between salt iodine levels and the UIC values in children and women. Conclusions: The iodine nutrition status of the Kyrgyz population is highly responsive to household salt iodization. Although the results in children suggest adequate iodine nutrition, the iodine consumption among pregnant women did not assure their dietary requirements. In-depth analysis of the survey data suggest that excess iodine intake is not likely to become a public health concern in Kyrgyzstan when the salt supply meets agreed standards. Keywords Universal salt iodization Kyrgyzstan Pregnant women Iodine-deficiency disordersThe WHO monograph on Endemic Goiter of 1960 (1) characterized the Asian section of the former USSR as 'one of the most notorious goiter areas of the world'. Under an Ordinance of the Ministry of Health in Moscow in 1956, entitled 'On Improvement of Measures to Fight Endemic Goiter', the targeted distribution of iodized salt to areas documented with endemic goitre was a matter of high Soviet concern. After a detailed geological chemistry survey of the USSR during the 1960s was completed, the areas with the lowest iodine content in soil and water, including the Kirghiz Republic, were put under even stricter control in terms of mandatory iodized salt supply. A large-scale population survey in 1969 encompassing more than 30 million people demonstrated that the goitre occurrence in the vast Soviet territory had decreased to a sporadic level and that big-size goitres and cretinism were no longer observed. In consequence, the Ministry of Health officially declared that endemic goitre had been overcome; it abolished the central and regional oversight, cancelled the obligatory registration and monitoring of goitre cases, and broadened the orientation of the widespread network of specialist endocrine centres from its singular focu...

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Thyroid size and thyroid function during pregnancy: an analysis

Cited by 121 publications

References 45 publications

Iodine Status of Pregnant Women and Their Progeny in the Minho Region of Portugal

Iodine Status of Pregnant Women and Their Progeny in the Minho Region of Portugal

Iodine supplementation of pregnant women in Europe: a review and recommendations

The current salt iodization strategy in Kyrgyzstan ensures sufficient iodine nutrition among school-age children but not pregnant women

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