Thyroid volume is associated with family history of thyroid disease in pregnant women with adequate iodine intake: A cross-sectional study in southern Brazil

Soares, Rosane; Vanacor, Roberta; Manica, Denise; Dorneles, Luciana; Resende, Vinicius Labrea; Bertoluci, Marcello Casaccia; Furlanetto, Tânia Weber

doi:10.1007/bf03345612

Cited by 16 publications

(13 citation statements)

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“…Only few studies have analyzed pregnant women (25,30,43). Interesting, Ferreira evaluated 191 pregnant women in Ribeirao Preto, Sao Paulo, and found a very high IDD prevalence (57%) and an average UI of 144.4 μg/L (43).…”

Section: Discussionmentioning

confidence: 99%

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity

Campos

Barreto

Maia

et al. 2015

Arch. Endocrinol. Metab.

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Objectives: Iodine deficiency disorder (IDD) is the result of an inadequate dietary intake of iodine, which physiological consequences are endemic goiter and thyroid dysfunction. The objective of this study was to a analyze studies that assessed the status of Brazil's population iodine nutrition and IDD prevalence. Materials and methods: Systematic review using PRISMA statement. Electronic database: PubMed, Medline, SciELO and Lilacs. Quality of studies: Newcastle-Ottawa Scale. Metaanalysis was carried out with R Core Team Statistical Software, version 3.1.0 (2014). The summary measure (WMD) and its confidence interval (CI) of 95% were calculated. The "Funnel plot" graph assessed publication bias and heterogeneity. Results: Seventeen papers were eligible: pregnant women (2), school children (9), adults/elderly (4) and preschool children/infants (2). Geographic distribution: North (1), Northeast (1), Midwest (2), Southeast (13), South (3). Twenty-three thousand two hundred seventy-two subjects were evaluated between 1997 and 2013 and all have use urinary iodine (UI) measurement. However, only 7 studies could be included in meta-analysis, all from Southeast region. The overall prevalence of IDD in school children in southeast region was 15.3% (95% CI, 13-35%), however this data had an important heterogeneity, expressed by the I² Statistic of 99.5%. Conclusion: Only few studies have been performed and enrolled populations from south/southeast region of Brazil. The actual IDD prevalence analysis is complex because it was detected bias due influence of individual studies and very high heterogeneity. IDD might still be high in some areas but this remained unknown even after this meta-analysis evaluation. The generation of a national program for analysis of iodine status in all regions is urgently required. Arch Endocrinol Metab. 2015;59(1):13-22

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Section: Discussionmentioning

confidence: 99%

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity

Campos

Barreto

Maia

et al. 2015

Arch. Endocrinol. Metab.

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“…A palpação da glândula tireoide obedeceu a critérios adaptados pelo serviço, a partir da descrição da OMS, em 1994. Considerou-se bócio leve quando o lobo era palpável, mas ainda sem a visualização da tireoide à extensão do pescoço, bócio moderado quando a tireoide era visível à extensão do pescoço, bócio grave quando a tireoide era visível com pescoço na posição normal e bócio gravíssimo quando a tireoide era vista à distância 9,10 .…”

Section: Pacientes E Métodosunclassified

“…Quando se avaliou a frequência de pacientes com dosagem de iodo abaixo do considerado ideal (< 150 μg/L) identificaram-se 9 gestantes (24,3%), sendo que destas 4 (10,8%) tinham a dosagem urinária classificada como deficiência grave a moderada de iodo. Tais resultados são compatíveis com Soares et al (2008) que demonstraram que 19,7% de suas gestantes apresentavam insuficiência iódica 10 .…”

Section: Associação Entre a Ciu E Antecedentes Obstétricos De Aborto unclassified

Concentração de iodo urinário em urina de 24 horas de gestantes e sua associação com bócio tireoidiano materno, aborto e peso neonatal: estudo piloto

Mendes

Seabra

Bechtlufft

et al. 2019

CBR

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“…The UIE levels ranged from 22 μg/L to 534 μg/L, and 29 women (19.6%) had UIE below 150 µg/L. 15 The third study, published in 2014, evaluated 191 pregnant women aged 18 years and with gestational age up to 14 weeks, and it showed a median UIE of 137.7 µg/L. Interestingly, in this study, 19 (9.9%) pregnant women had UIE > 250 μg/L, 63 (33%) had UIE within the normal range (150-250 μg/L), and 109 (57.1%) had UIE < 150 μg /L.…”

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confidence: 95%

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2018

Rev Bras Ginecol Obstet

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Iodine is an essential micronutrient required for the production of thyroid hormones, which are critical for homeostasis and neurodevelopment. Because of increased thyroid hormone production, renal iodine excretion and fetal iodine requirements, dietary iodine requirements are higher in pregnancy than they are for nonpregnant adults. 1 Based on this, the World Health Organization (WHO) and the American Thyroid Association (ATA) recommend a daily iodine intake of 250 µg for pregnant and lactating women. 2,3 Iodine deficiency disorder (IDD) in pregnant women could result in harmful effects, including goiter, cretinism, hypothyroidism, growth retardation, pregnancy loss, and infant mortality. Moreover, inadequate iodine intake during pregnancy may lead to neurodevelopmental deficits in offspring, and iodine deficiency is currently considered the leading preventable cause of intellectual impairment worldwide. 4 On the other hand, the excess of iodine may result in fetal goiter and hypothyroidism. Exposures as minor as the vaginal application of povidone-iodine during delivery or local use of disinfectant in newborns can lead to increased serum TSH concentrations 5 and transient neonatal hypothyroidism. 6 With this information in mind, we read with great interest the 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. 7 Among other topics, the nutritional aspects related to iodine sufficiency are addressed in section IV, and a supplementation with 150 μg of potassium iodine per day is suggested on Recommendation 6 for women, in most regions of the world, who are planning a pregnancy or currently pregnant. This is optimally started 3 months in advance of planned pregnancy (strong recommendation, moderate-quality evidence). Could this recommendation improve the quality of the prenatal care of Brazilian pregnant women?The most efficient method of IDD prevention is salt iodination. Also, ongoing monitoring of population biomarkers, such as urinary iodine concentration, is essential to ensure that population iodine intakes are optimized. In Brazil, the salt iodination is controlled by federal law in partnership with the National Agency for Sanitary Surveillance (Anvisa, in the Portuguese acronym) and the salt productive sector. 8-10 Unfortunately, data on the iodine nutritional status are scarce and contradictory in Brazil. The national project of salt iodination (PNAIsal, in the Portuguese acronym) (which evaluated 477 locations and a total of 18,978 school children) identified Brazil as a country of "more than appropriate" iodine consumption, with a mean urinary iodine excretion (UIE) concentration of 276 µg/L. 11,12 A recent meta-analysis concluded that the majority of the data on this subject are derived from the population in the south/southeast region of Brazil, but the actual overall IDD prevalence is unknown and might still be high in some areas. 13 Regarding the pregnant population, three studies were published prior to Anvis...

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Thyroid volume is associated with family history of thyroid disease in pregnant women with adequate iodine intake: A cross-sectional study in southern Brazil

Abstract: The healthy pregnant women studied had adequate iodine intake. In this situation, the main thyroid size determinants are probably genetic factors.

Cited by 16 publications

References 20 publications

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity

Concentração de iodo urinário em urina de 24 horas de gestantes e sua associação com bócio tireoidiano materno, aborto e peso neonatal: estudo piloto

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