The evolution of hypothyroidism in pregnant women in County Mures between 20012006
Ildiko Kun1, Zsuzsanna Szanto2, I Kun2, B Szabo3 & Ligia Coros4
County Mures is a moderate/mild iodine-deficient area, the iodine-prophylaxis having an important role in prevention of IDD. Between 20012003 we made a partial screening at 320 pregnant women to detect thy-roid dysfunctions, and in 13% (43 cases) we observed hypo-thy-roidism, the majority being subclinical forms. The most frequent compli-ca-tions were threatened abortion or premature birth, and dys-gra-vidia. We found that even the subclinical hypothyroidism can cause se-ve-re complica-tions in preg-nan-cy or may contribute to their development.
The governmental decision from 2002 regarding the universal iodization of alimentary salt was put in practice from December 2003, while in 2004 was decided the obligatory iodization of the salt used in the baking industry. Consequently, in 2004 the iodized salt was used in 96% of households, according to some authors. Our aim was to evaluate the influence of these new measures on the thyroid function of pregnant women, so we restarted the TSH- and FT4-determinations between 20042006, and compared the results with those obtained bet-ween 20012003. In the period of 20042006 from the 205 pregnant women 7.3% (15) presented hypothyroidism (increased TSH-levels and/or decreased FT4-values), a much more reduced percentage as in the first period (13%). Thus, between 20042006 the frequency of hypo-thyro-idism decreased significantly comparing with 20012003 (P<0.05). However, the values of urinary iodine excretion of the two periods did not differ significantly, in concordance with the similar data obtained in whole country in 2004. So, other factors could contribute to the better results, i.e. a more rigurous follow-up of the thyroid function and a more adequate treatment of hypothyroidism in pregnancy, taking into account that this dysfunction can be determined besides the IDD by other thyroid disorders (especially by chronic thyroidites), too, or can be a consequence of an inadequately treated thyroid ablation.