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URINARY IODINE AND THYROID STATUS IN A GROUP OF PREGNANT WOMEN FROM THE PERIMARINE AREA OF ROMANIA
Abstract
Objective: Assessment of iodine and thyroid status in a group of pregnant women in the perimarine area of Romania, the geographical area without iodine deficiency. Undetected or untreated thyroid dysfunction can be associated with a number of materno-fetal complications. The administration of iodinated compounds in pregnancy requires individualization. The ratio of urinary iodine concentration (UIC)/urinary creatinine (UCr) may be an objective criterion for evaluating iodine nutrition in the perimarine area. Material and methods: Prospective study between 2018-2020 in the endocrinology outpacient clinic, including 71 pregnant women, originating from the Dobrogea area, median gestational age- 11 weeks (IQR:5,18). Thyroid status was evaluated: morphologically by ultrasound and functionally by thyroid hormones and antibodies concentration serum dosage: thyroid-stimulating hormone (TSH), free thyroxine (FT4), anti-thyroid peroxidase antibodies (TPOAb), anti-thyroglobulin antibodies (TgAb). Iodine status was assessed by: UIC, UCr and UIC/UCr ratio. Consumption of iodinated supplements and iodized salt was assessed by completing a questionnaire. Results: Thyroid morphological disorders: micronodules - 14.08%; microcysts - 9.85%; macronodules -1.4%; goiter I/II degree - 25.35%. The median TSH, FT4 was 2.07 mIU/L, respectively 15,19 pmol/L. Prevalence of functional disorders: overt/sublinical hypothyroidism = 9.85%/21.2%; overt/subclinical thyrotoxicosis= 4.22%. Incidence of chronic autoimmune thyroiditis (CAT) = 32.4% (60.8% experienced increased TSH). The rate of iodized salt consumption was - 96%. The iodine status appreciated by median UIC was 137,96 mcg/l, considering insufficient iodine intake 500 mcg/g = 1.4% (1 case). The comparative assessment between the UCI/UCr ratio between the first and the second trimester of pregnancy reveals 140,52 mcg/g and respectively 177,66 mcg/g. Conclusions: Early identification of thyroid disorders in pregnancy is a mandatory method to avoid perinatal materno-fetal complications. Deficiency, as well as excess iodine can be involved in the progression of autoimmune/non-autoimmune thyroid disorders with alteration of materno-fetal thyroid status and the need to initiate specific therapies. The UCI/UCr ratio is an optimal indicator for determining iodine intake during pregnancy.
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