Introduction: Even mild to moderate maternal iodine deficiency during pregnancy is associated with impaired child cognition. Iodine deficiency is especially problematic in pregnant women, who have a higher iodine requirement (250 μg/day) than non-pregnant women (150 μg/day).
Objective: To assess iodine status (median urinary iodine concentration, UIC) in pregnant women from multiple endemic or non-endemic areas in Romania, 13 years after implementation of the Universal Salt Iodization (2540 mg iodine/kg salt).
Subjects and methods: Median UIC in the morning urine was evaluated by spectro-photometry in 409 pregnant women in the third trimester from seven geographical regions in Romania (age range 1644 years, median age 29 years, none treated with thyroxine, 80% from endemic regions, 59% from urban regions). Data regarding iodized salt intake, bread intake (usually containing 69 μg iodine/slice) and iodine supplements were assessed. The study was approved by the local Ethics Committee.
Results: Iodized salt was consumed by 87% of women, iodine supplements during pregnancy by 48% of women. Median UIC in the study group was 131 μg/l, reflecting iodine deficiency during pregnancy (normal values ≥150 μg/l). Lower median UIC (μg/l) were recorded in the endemic regions of Transilvania (92), Oltenia (114), Moldova (129) and Muntenia (149) as compared to Bucharest area (206) and other non-endemic regions (206.6), except Timis (140); 55.7% of women had values below 150 μg/l, 13% below 50 μg/l, 1.7% had values over 500 μg/l. Higher median UIC was recorded in women with a daily intake of ≥5 slices of bread, 166 vs 111 μg/l, P<0.01. Similar UIC were found in women taking prenatal vitamins containing iodine and in those with no supplements. In Transilvania region there is a discrepancy between schoolchildren (normal median UIC) and pregnant women (low median UIC). Urinary iodine/creatinine ratio was not significantly different from urinary iodine levels.
Conclusions: Mild iodine deficiency is still prevalent in Romanian pregnant women from historical endemic regions after 13 years of universal salt iodization. Iodine supplementation during pregnancy should be encouraged in these regions.
20 - 23 May 2017
European Society of Endocrinology