Assessment of Iodine Deficiency in Pregnant Women and Neonates in the Capital Territory of Pakistan

Authors

  • N. Zafeer Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi
  • J. Altaf Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi
  • M. Rafi Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad
  • M. M. Chaudhry Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad
  • M. Qayyum Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi
  • S. Naz PINSTECH, Nilore, Islamabad

Abstract

One of the major nutritional problems in Pakistan is the deficiency of iodine in different groups of population, e.g., pregnant women and neonates. The neonates and their expectant mothers have been significant target groups of the population to be studied for the deficiency of iodine. The objective of the present research work was to evaluate the status of iodine deficiency in neonates and their mothers in Islamabad, Pakistan. A hospital based study was carried out on two hundred sixty one pregnant women and one hundred twenty five neonates of these women, to find out iodine level among these samples. Fifty healthy and non pregnant women were used as control in the maternity and gynecological unit of the hospitals of Islamabad. The status of iodine of the pregnant and non-pregnant women was assessed by catalytic reduction method. Thyroid function was assessed by determining the concentration of TSH in the cord blood of neonates using radioimmunoassay technique, in the environmental laboratory of the Chemical and Materials Engineering Department at Pakistan Institute of Engineering and Applied Sciences (PIEAS) Islamabad. Ninety-four percent pregnant women and ninety-eight percent non-pregnant women exhibited urinary iodine concentration (UIC) between 20 µg/L to 99 µg/L respectively. It indicates that there was severe to mild iodine deficiency in population of study area. The median values of urinary iodine concentrations in the pregnant women and control group were 30.37 µg/L and 19.08 µg/L respectively. Statistically it was found that there was a significant (p<0.05) difference between the levels of urinary iodine concentration of non-pregnant and pregnant women. It was also found that there was a non-significant (p>0.05) difference in the concentration of urinary iodide between the pregnant women of different age groups. An overall 57.14% neonates exhibited TSH levels >5 mIU/L. From these results, it is concluded that the pregnant women had moderate iodine deficiency while their neonates had severe iodine deficiency. Keeping in view these results it is suggested that the practice of iodized salt utilization could be continued, and it is recommended that the screening of neonates or TSH levels should be compulsory in the iodine deficient areas.

Author Biographies

N. Zafeer, Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi

Department of Zoology

J. Altaf, Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi

Department of Zoology

M. Rafi, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad

Department of Physics & Applied Mathematics

M. M. Chaudhry, Pakistan Institute of Engineering and Applied Sciences (PIEAS), Nilore, Islamabad

Department of Nuclear Engineering

M. Qayyum, Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi

Department of Zoology

S. Naz, PINSTECH, Nilore, Islamabad

Materials Division

References

C.J. Eastman, “Where has all our iodine gone?â€, The Med. J. of Australia, vol. 171, no. 9, pp. 455-456, 1999.

J. Bernal and J. Nunez, “Thyroid hormones and brain developmentâ€, Eur. J. Endocrinol., vol. 133, no. 4, pp. 390-398, 1995.

M.T. Hays, “Estimation of total body iodine content in normal young menâ€, Thyroid, vol. 11, no. 7, pp. 671-675, 2001.

G. Phillppou, D.A. Koutras, G. Plperlngos, A. Souvatzoglou and S.D. Moulopoulos, “The effect of iodide on serum thyroid hormone levels in normal persons in hyperthyroid patients and in hypothyroid patients on thyroxine replacementâ€, Clinical Endocrinology, vol. 36, no. 6, pp. 573-578, 1992.

O.P. Soldin, “Controversies in urinary iodine determinationsâ€, Clinical Biochemistry, vol. 35, no. 8, pp. 575-579, 2002.

M. Rafi, S. Naz and M.M. Chaudhry, “Sporadic goitre prevalence and its association with iodine deficiency in drinking water of plain areas of Hyderabad and adjoining areas, Pakistanâ€, The Nucleus,

vol. 53, no. 2, pp. 134-139, 2016.

“Indicators for assessing IDD statusâ€, International Council for Control of Iodine Deficiency Disorders (ICCIDD), IDD Newsletter,

vol. 15, pp. 33-38, 1999.

“Indicators for assessing iodine deficiency disorders (IDD) and their control through salt iodization†World Health Organization Nutrition Unit, WHO, Geneva, pp. 36, 1994.

“Progress towards the elimination of iodine deficiency disorders (IDD)â€, WHO, UNICEF, ICCIDD. WHO Booklet, Geneva, pp. 1-33, 1999.

M.S. Ardawi, H.A. Nasrat and B.E. Mustafa, “Urinary iodine excretion and maternal thyroid function during pregnancy and postpartumâ€, Saudi Med. J., vol. 23, pp. 413-422, 2002.

S. Kurtoglu, M. Akcakus, C. Kocaoglu, T. Gunes, I. Karakucuk and M. Kula, “Iodine deficiency in pregnant women and in their neonates in the central Anatolian region (Kayseri) of turkeyâ€, Turk. J. Pediatr., vol. 46, pp. 11-15, 2004.

I.O.M. Copper, “Dietary reference intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zincâ€, Washington DC, National Academy Press, pp. 258-289, 2001.

“Assessment of the Iodine Deficiency Disorders and monitoring their eliminationâ€, WHO, UNICEF, ICCIDD, Geneva, WHO Publ. WHO/NHD/01.1, pp. 1-107, 2001.

S. Elahi, N.B. Rizvi and S.A. Nagra, “Iodine deficiency in pregnant women of Lahoreâ€, J. Pak. Med. Assoc., vol. 59, no. 11, pp. 741-743, 2009.

E.B. Sandell and I.M. Kolthoff, “Micro determination of iodine by a catalytic methodâ€, Mikrochemica Acta, vol. 1, pp. 9-25, 1937.

T. Ohashi, M. Yamaki, C.S. Pandav, M.G. Karmarkar and M. Irie, “Simple microplate method for determination of urinary iodineâ€, Clin. Chem., vol. 46, no. 4, pp. 529-536. 2000.

F. Delange, “Optimal iodine nutrition during pregnancy, lactation and the neonatal periodâ€, Int. J. Endocrinol. Metab, vol. 2, pp. 1-12, 2004.

A. McElduff, P. McElduff and J.E. Gunton, “Neonatal thyroid-stimulating hormone concentrations in northern Sydney: further indications of mild iodine deficiency?, Med. J. Aust., vol. 176,

pp. 317-320, 2002.

M. Li, G. Ma and K. Guttikonda, “Re-emergence of iodine deficiency in Australiaâ€, Asia Pac. J. Clin. Nutr., vol. 10, pp. 200-203, 2001.

K.L. Hynes, C.L. blizzard, A.J. Venn and T. Dwyer, “Persistent iodine deficiency in a cohort of Tasmanian school children: Associations with socioeconomic status, geographical location and dietary factorsâ€, Aust. N. Z. J. Public Health, vol. 28, pp. 476- 481, 2004.

K. Guttikonda, C. Travers, P. lewis and S. Boyages, “Iodine deficiency in urban school children: A cross-sectional analysisâ€, Med. J. Aust., vol. 179, pp. 346-348, 2003.

M. Li, C.J. Eastman and K.V. Waite. “Are Australian children iodine deficiency? Results of the Australian national Iodine nutrition Studyâ€, Med. J. Aust., vol. 184, pp. 165-169, 2006.

C.A. Travers, K. CA Guttikonda, P.R. Norton, Lewis, L.J. Mollart, V. Wiley, B. Wilcken, C.J. Eastman and S.C. Boyages, “Iodine status in pregnant women and their newborns: Are our babies at risk of iodine deficiency?†M. J. A., vol. 184, no. 12, pp. 617-620, 2006.

E. Mezosi, I. Molnar, A. Jakab, E. Balogh, Z. Karanyi, Z. Pakozdy, P. Nagy, F. Gyory, J. Szabo, L. Bajnok, A. Leovey, G. Kakuk and E.V. Nagy, “Prevalence of iodine deficiency and goitre during pregnancy in east Hungaryâ€, European J. Endocrinol., vol. 143,

pp. 479-483, 2000.

I. Chakraborty, S. Chatterjee, D. Bhadra, B.B. Mukhopadhyaya,

A. Dasgupta and B. Purkait, “Iodine deficiency disorders among the pregnant women in a rural hospital of West Bengalâ€, Indian J. Med. Res., vol. 123, pp. 825-829, 2006.

J.T. Dunn, “What’s happening to our iodineâ€, J. Clin. Endocrinol. Metabol., vol. 83, pp. 3398-400, 1998.

“Vitamin and mineral requirements in human nutritionâ€, FAO/WHO, 2nd ed., WHO, Geneva, 2004.

“Assessment of iodine deficiency disorders and monitoring their elimination: A guide for program managersâ€, 3rd ed., WHO/UNICEF/ICCIDD, Geneva, 2007.

A.S. Green and E. Pearce, “Thyroid disorders in pregnancyâ€, Nat. Rev Endocrinol, vol. 8, pp. 650-658, 2012.

D.B. Nelson, B.M. Casey, D.D. McIntire and F.G. Cunningham, “Subsequent pregnancy outcomes in women previously diagnosed with subclinical Hypothyroidismâ€, Am. J. Perinatol., vol. 03, pp. 163-252, 2013.

T.G. Kazi, G.A. Kandhro, H.I. Afridi, J.A. Baig, A.Q. Shah, S.K. Wadhwa, S. Khan and N.F. Kolachi, “Evaluation of iodine, iron, and selenium in biological samples of thyroid mother and their newly born babiesâ€, Early human development, vol. 86, no. 10, pp. 649-55, 2010.

N.H. van Mil, H. Tiemeier, J.J. Bongers-Schokking, A. Ghassabian, A. Hofman, H. Hooijkaas, V.W. Jaddoe, S.M. de Muinck Keizer-Schrama, E.A. Steegers, T.J. Visser, W. Visser, “Low Urinary Iodine Excretion during Early Pregnancy is Associated with Alterations in Executive Functioning in Children–3â€, J. of Nutrition, vol. 142,

no. 12, pp. 2167-74, 2012.

Downloads

Published

30-01-2019

How to Cite

[1]
N. Zafeer, J. Altaf, M. Rafi, M. M. Chaudhry, M. Qayyum, and S. Naz, “Assessment of Iodine Deficiency in Pregnant Women and Neonates in the Capital Territory of Pakistan”, The Nucleus, vol. 55, no. 4, pp. 193–199, Jan. 2019.

Issue

Section

Articles