Pregnancy And Iodine Deficiency

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Prevention of iodine deficiency diseases during pregnancy

In recent years, Russia has seen a significant increase in thyroid diseases in pregnant women. The number of women with euthyroid diffuse and nodular goiter, subclinical hypothyroidism and thyrotoxicosis has increased significantly [1]. The main cause of these conditions is insufficient iodine intake. It is well known that almost the entire territory of Russia is iodine deficient and endemic for goiter. Iodine deficiency is exacerbated by economic and environmental factors. In recent decades, the consumption of iodine-containing products has decreased, and mass and group iodine prophylaxis is not carried out [3].

Pregnant and lactating women have the greatest risk of developing iodine deficiency disorders, since the need for iodine during this period increases several times [1,6,7]. Lack of iodine can lead to the formation of goiter and subsequent changes in thyroid function. The relevance of this problem is also due to the fact that in half of women after pregnancy the goiter does not undergo reverse development, which creates the preconditions for the formation of thyroid pathology [7,10].

During pregnancy, insufficient iodine intake causes changes in the functional parameters of the thyroid gland in both the mother and the fetus [7,8]. The resulting chronic stimulation of the thyroid gland often leads to the development of thyroid pathology. It is this fact that many researchers explain the high incidence of thyroid diseases in women compared to men [6,7,8]. Adequate iodine consumption by a woman during pregnancy is a reliable measure for the prevention of thyroid disorders and a necessary condition for the normal development of the fetus and newborn [5,9].

Purpose of the study

Study of the characteristics of thyroid function in conditions of moderate iodine deficiency and against the background of iodine prophylaxis in women during pregnancy.

Material and methods

A study of thyroid function was carried out in 45 pregnant women who had no previous diseases of the thyroid gland. Subsequently, these women were divided into 2 groups. The main group included 27 women who, after examination for preventive purposes, were prescribed potassium iodide (the drug Iodomarin produced by the German pharmaceutical company Berlin-Chemie) at a daily dose of 200 mcg (in accordance with WHO recommendations). The control group consisted of 18 women.

Women in both groups underwent repeated ultrasound examinations of the thyroid gland in the 1st, 2nd and 3rd trimesters of pregnancy. The sizes of the right and left lobes and isthmus of the thyroid gland, its volume and structure were assessed. The studies were carried out in the laboratory of functional diagnostics of the Scientific Center of AGP of the Russian Academy of Medical Sciences.

The study of hormonal thyroid function in the 1st, 2nd and 3rd trimesters of pregnancy in both groups included the determination of thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free fractions of T3 and T4, antibodies to thyroglobulin (AT TG), antibodies to thyroid peroxidase (AT TPO). The studies were carried out in the laboratory of endocrinology of the Scientific Center of the Academy of Medical Sciences of the Russian Academy of Medical Sciences.

Research results and discussion

Features of the functioning of a woman’s thyroid gland throughout the entire period of gestation in conditions of moderate iodine deficiency are of particular interest, since it is known that pregnancy in this case serves as a trigger for the development of iodine deficiency diseases [6,7].

Normalization of the endocrine status of a pregnant woman ensures full functional activity of both the maternal and fetal thyroid glands [3,5,9]. Currently, in most European countries with iodine deficiency, iodine prophylaxis is carried out during pregnancy and lactation. The most optimal method is considered to be daily intake of potassium iodide in order to replenish and maintain iodine balance [3,4,5].

According to WHO estimates, the daily iodine requirement for pregnant women is