Urinary Iodine Excretion In Pregnancy: A Pilot Study in The Region of Nepal

Abstract

Background: Pregnancy is accompanied by profound alterations in the thyroid economy and the relative iodine deficiency. The median Urinary Iodine Excretion (UIE) is the most reliable indicator of the population's iodine nutrition. The physiological alterations in normal pregnancy, such as an increased glomerular filtration rate, potentially invalidate UIE as an assessment tool in pregnancy. Objectives:To assess the Urinary Iodine Excretion (UIE) in pregnant mothers and to enquire about the current status of their iodised salt intake. Methods:We carried out a cross-sectional study in which urine samples were collected from 45 pregnant mothers who were admitted to the antenatal ward. The iodine level in the urine was analysed by a method which was provided by Singh and Ali, to determine the Urinary Iodine Excretion (UIE). A questionnaire was introduced to document the status of the dietary intake of iodised salt. The UIE was expressed in median (interquartile) and the other data are expressed in frequency and percentage. Fisher Exact test was applied to compare between UIE and iodine intake.Results: Thirteen (28.88%) pregnant mothers had UIEs of <150 µg/L, which were below the cut-off point of the UIE for pregnant mothers. Overall, 33 mothers were from the Terai region; among them, one third had UIEs of <150 µg/L. Among the 45 pregnant women, 15 (33.34%) were not using iodised salt and the rest were using iodised salt. Among those who were using iodised salt (30 out of 45), 8 pregnant women had UIEs of <150 µg/L and among those who were not using iodised salt, 5 pregnant women had UIEs of < 150 µg/L. Conclusion:The UIE was below 150µg/L in a substantial percentage (28.89%) of pregnant women of the Terai region, regardless of their intake of iodised salt.

Two-thirds of pregnant women attending antenatal care clinic at the University of Gondar Hospital are found with subclinical iodine deficiency, 2017

“…Furthermore, the finding of the study is far greater than those of studies conducted in Nepal (28.9%) [ 25 ], and Kolkata (37%) [ 26 , 27 ]. Poor dietary intake of iodine-rich food and low utilization of iodized salt could explain the observed discrepancies.…”

“…Poor dietary intake of iodine-rich food and low utilization of iodized salt could explain the observed discrepancies. As an illustration, iodized salt utilization coverage in Nepal was (66.7%) [ 28 ], which is far better than Ethiopia (23.3%) [ 17 ].…”

Adequate iodine levels in healthy pregnant women. A cross-sectional survey of dietary intake in Turkey

“…Despite the higher UICs found in the present study than in other Turkish studies, the percentage of pregnant women with inadequate (28.8% versus 28.1%), adequate (37.78% versus 34.1%) and more than adequate (33.3% versus 34.8%) iodine intakes were similar in a study conducted among pregnant women in Nepal. 14 A study of 1322 healthy pregnant women in northern Spain reported a median UIC in the second trimester of 140 µg/L. The study also reported that 54.4% of subjects had iodine deficiency while 18.8% of subjects had higher than recommended UIC.…”