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在印度古吉拉特邦瓦多达拉市的城市中心对孕妇进行碘缺乏症和缺铁的早期妊娠筛查。

Early gestation screening of pregnant women for iodine deficiency disorders and iron deficiency in urban centre in Vadodara, Gujarat, India.

作者信息

Joshi K, Nair S, Khade C, Rajan M G R

机构信息

1 Department of Foods and Nutrition, Faculty of Family and Community Sciences, The Maharaja Sayajirao University of Baroda, Gujarat, India.

2 RMC Unit, BARC, Tata Memorial Hospital, Lower Parel, Mumbai, Maharashtra, India.

出版信息

J Dev Orig Health Dis. 2014 Feb;5(1):63-8. doi: 10.1017/S2040174413000470.

Abstract

Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age <15 weeks) in urban Vadodara, Gujarat. n = 256 healthy pregnant women with uncomplicated singleton pregnancy were selected. The thyroid hormone was estimated by RIA, UIE using simple microplate technique and haemoglobin (Hb) concentration by acid hematin method. Median thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4) and UIE concentrations were 1.88 μIU/ml, 0.83 ng/dl, 10.24 μg/dl and 297.14 mcg/l, respectively. There was a significant correlation between TSH, FT4 and month of gestation. Mean Hb concentration was 9.27 ± 1.09 g/dl. The prevalence of iodine insufficiency (based on UI) was 16.79% and iron deficiency was 91%. Screening programme for iodine deficiency during early gestation should be implemented along with the existing programme of haemoglobin estimation at first prenatal visit. This would help prevent damage to the developing brain and growth of the foetus and also to trace at-risk pregnant women.

摘要

怀孕是一种特殊情况,由于对铁和碘等必需微量营养素的需求增加,可能会发生许多代谢变化。胎儿甲状腺在妊娠12周后开始产生自身的甲状腺激素。因此,孕早期对于满足母亲和胎儿的甲状腺激素需求至关重要。碘缺乏和铁缺乏可能会影响胎儿的智力和身体发育。因此,建立一项针对孕妇进行甲状腺功能障碍检测筛查以及已确定的铁状态评估的计划非常重要。因此,本研究旨在筛查孕早期孕妇的碘缺乏症和缺铁情况,对古吉拉特邦瓦多达拉市城市地区孕周<15周的孕妇甲状腺功能不全和缺铁情况进行现状分析。选择了n = 256例单胎妊娠无并发症的健康孕妇。采用放射免疫分析法(RIA)、简单微孔板技术测定尿碘排泄量(UIE)以及采用酸性正铁血红素法测定血红蛋白(Hb)浓度。促甲状腺激素(TSH)、游离甲状腺素(FT4)、总甲状腺素(TT4)和UIE浓度的中位数分别为1.88 μIU/ml、0.83 ng/dl、10.24 μg/dl和297.14 mcg/l。TSH、FT4与妊娠月份之间存在显著相关性。平均Hb浓度为9.27±1.09 g/dl。碘缺乏(基于尿碘)的患病率为16.79%,缺铁患病率为91%。应在首次产前检查时,在现有的血红蛋白估计计划的基础上,实施孕早期碘缺乏筛查计划。这将有助于预防对发育中胎儿大脑的损害及其生长发育,还能追踪高危孕妇。

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