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      Prevalence of iodine deficiency among pregnant and lactating women: Experience in Kolkata

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          Abstract

          Objective:

          The cross-sectional study was carried out to assess the iodine status of pregnant and lactating mothers, using median urinary iodine excretion (UIE) as the measure of outcome, to document the prevalence of iodine deficiency.

          Materials and Methods:

          The present study assessed the UIE in the morning urine samples from 237 pregnant women, 73 lactating mothers and 59 healthy non-pregnant female controls.

          Results:

          Out of 237 pregnant women, 88 (37%) exhibited insufficient iodine nutrition (UIE < 150 μg/l), out of 73 lactating mothers, 24 (33%) exhibited insufficient iodine nutrition (UIE < 100 μg/l) and only 3% female control subjects exhibited insufficient iodine nutrition (UIE < 100μg/l). Additionally, a number (32.3%) of babies born of iodine deficient mothers had respiratory distress at birth.

          Conclusion:

          It appears that the present salt iodination program is adequate for the general population but insufficient for the pregnant and lactating mothers. They need to be targeted with iodine supplements throughout pregnancy and lactation. Increased incidence of respiratory distress in the new born of iodine deficient mothers merits further study.

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          Most cited references29

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          Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation.

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            Update on iodine status worldwide.

            Salt iodization has been introduced in many countries to control iodine deficiency. The two most commonly used approaches to assessing iodine nutrition on the population level are estimation of the household penetration of adequately iodized salt (HHIS) and measurement of urinary iodine concentrations (UICs). The aim of this review is to assess global and regional iodine status in 2012 by using each of these indicators. The most recent national data on HHIS were obtained from UNICEF. The most recent data on UICs, primarily national data in school-age children, were obtained from a systematic literature search, the International Council for the Control of Iodine Deficiency Disorders and the WHO Micronutrients Database. The median UIC was used to classify national iodine status and the UIC distribution to estimate the number of individuals with low iodine intakes. Thirty-two countries are iodine deficient based on the national median UIC. Globally, 29.8% of school-age children (246 million) are estimated to have insufficient iodine intake. Out of 128 countries with HHIS data, 37 countries have salt iodization coverage that meets the international goal of at least 90% of households consuming adequately iodized salt and 39 countries have coverage rates of less than 50%. Overall, ≈70% of households worldwide have access to iodized salt. Iodized salt programs need to be strengthened and extended to reach nearly one-third of the global population that still has inadequate iodine intakes.
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              Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition.

              This paper re-evaluates the requirements for iodine during pregnancy, lactation and the neonatal period, and formulates original proposals for the median concentrations of urinary iodine (UI) that indicate optimal iodine nutrition during these three critical periods of life. This paper also discusses the measurements that are used to explore thyroid functions during the same periods. An extensive and critical review of the literature on thyroid physiopathology during the perinatal period. Human studies conducted in various regions throughout the world. Pregnant women, lactating women, and newborns. The following proposals are made after extensive review of the literature: the requirement for iodine by the mother during pregnancy is 250-300 microg day-1; during lactation the requirement is 225-350 microg day-1; and during the neonatal period the requirement of the infant is 90 microg day-1. The median UI that indicates an optimal iodine nutrition during these three periods should be in the range of 150-230 microg day-1. These figures are higher than recommended to date by the international agencies. Pregnant women and young infants, but especially the second group, are more sensitive to the effects of an iodine deficiency (ID) than the general population because their serum thyroid-stimulating hormone (TSH) and thyroxine are increased and decreased, respectively, for degrees of ID that do not seem to affect thyroid function in the general population. Systematic neonatal thyroid screening using primary TSH could be the most sensitive indicator to monitor the process of ID control.
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                Author and article information

                Journal
                Indian J Endocrinol Metab
                Indian J Endocrinol Metab
                IJEM
                Indian Journal of Endocrinology and Metabolism
                Medknow Publications & Media Pvt Ltd (India )
                2230-8210
                2230-9500
                Jul-Aug 2014
                : 18
                : 4
                : 486-490
                Affiliations
                [1] Department of Medicine, Kali Pada Chaudhuri Medical College, Kolkata, West Bengal, India
                [1 ] Department of Home Science, Calcutta University, Kolkata, West Bengal, India
                [2 ] Vivekananda Institute of Medical Sciences, West Bengal University of Health Sciences, Kolkata, West Bengal, India
                Author notes
                Corresponding Author: Assoc. Prof. Anirban Majumder, 26A Gariahat Road South, Kolkata - 700 031, West Bengal, India. E-mail: dranirbanmazumdar@ 123456gmail.com
                Article
                IJEM-18-486
                10.4103/2230-8210.137491
                4138902
                25143903
                5bf771ad-4412-4a36-a483-f49d66e00590
                Copyright: © Indian Journal of Endocrinology and Metabolism

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Endocrinology & Diabetes
                gestation,iodine deficiency,pregnancy,thyroid,urinary iodine excretion
                Endocrinology & Diabetes
                gestation, iodine deficiency, pregnancy, thyroid, urinary iodine excretion

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