Inadequate iodine nutrition of pregnant women in an area of iodine sufficiency.

PURPOSE: I. R. Iran has been considered iodine replete since 2000, but iodine nutrition of vulnerable subjects is not clear. The main goal of this study was assessment of iodine nutrition and thyroid function in pregnant Iranian women.

METHODS: A total of 1072 pregnant women from ten provinces in the different parts of the country were recruited from November to March 2014. Median urinary iodine concentration (UIC) as the measure of iodine status and serum free T4 (FT4), thyrotropin (TSH), thyroglobulin (Tg), anti-thyroglobulin and anti-thyroid peroxidase antibodies (TgAb and TPOAb) were measured.

RESULTS: Mean ± SD age of the cohort was 27.0 ± 7.2 years and gestational age was 20.7 ± 10.0 weeks. The median UIC for pregnant women was 87.3 μg/L, being 92.1, 86.0 and 76.8 μg/L, in three trimesters of pregnancy, respectively. Median UIC of <100, 100-149, 150-249, 250-499 and ≥500 μg/L was found in 58.4, 19.8, 16.2, 5.13 and 0.46 % of subjects, respectively. Median (IQR) values in the first, second, and third trimesters were 1.7 (0.9-2.8), 2.1 (1.5-2.9), and 2.1 (1.4-2.8) mIU/L for TSH, and 16.4 (12.21-21.13), 14.34 (12.16-19.69), and 14/07 (12.02-18.64) pmol/L for FT4, respectively. The frequency of elevated serum TSH was 9.0 % (6.6 % subclinical, 2.4 % overt hypothyroidism). The frequency of low serum TSH was 0.6 %. The frequency of positive TPOAb was 7.6 %.

CONCLUSIONS: Results of this study have clarified that despite iodine sufficiency of school children in Iran, pregnant women have moderate iodine deficiency and need iodine supplementation.