Endocrine Abstracts

Objectives: Assessment of the utility of supplementing the iodine intake during pregnancy in women with chronic autoimmune thyroiditis (CAT) coming from the perimarine territory of Romania.

Material and method: The study included 28 pregnant women in the first trimester of pregnancy, diagnosed with CAT. The following variables were evaluated: TSH, FT4, ATPO. The iodine status of pregnant women was analyzed by 2 methods: 1 – the value of the urinary iodine concentration (UIC) from the spontaneous urine sample and 2 – the iodine concentration corrected after the urinary creatinine (UIC/Ucr).

Results : Most of the pregnancies came from the urban area (79%). The gestational age between 8 and 13 weeks predominated in proportion of 82%, whilst only 19% of pregnant women were evaluated in the first 2 months of pregnancy. The median value of TSH was 16.22 ± 23.82 mUI/l and for FT4 the median value was 14.70 ± 3.65 ng/ml. Pregnant women with TSH > 2.5 mUI/l were indicated for thyroxine replacement therapy. The median UIC in our study was 113, 74 mg/l (insufficient iodine intake according to WHO recommendations < 150 mg/l). Adjustment of iodide after urinary creatinine is necessary to eliminate the interference of increased diuresis specific to the pregnancy period due to the increased glomerular filtration rate. The median value of the UIC/UCr ratio was 170, 51 mg/g, placing pregnant women in the category with sufficient iodine intake. It should be mentioned that 2 patients had excessive iodine values (> 500 mg/l), both intermittently taking iodine supplements, the reassessment of iodide investigations after the UIC/UCr report found normal values.

Conclusions: The recommendation of iodine content supplement administration in pregnant women with CAT should be adjusted depending on the level of urinary iodine assessed during early pregnancy. The method of dosing iodine without reporting to urinary creatinine may suggest iodine supplementation in pregnant women without iodine deficiency, with a potential aggravation of thyroid autoimmune pathology. Normal or supplemented iodine intake in the perimarine area of ​​Romania does not, however, exclude individual cases with urinary iodine variations.