Yoganathan Thirunavukkarasu, Hettiarachchi Manjula, Arasaratnam Vasanthy, Liyanage Chandrani
Nuclear Medicine Unit, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.
Nuclear Medicine Unit, Faculty of Medicine, University of Ruhuna, Ruhuna, Sri Lanka.
Indian J Endocrinol Metab. 2015 Nov-Dec;19(6):817-23. doi: 10.4103/2230-8210.167563.
Iodine status of pregnant women and their newborns have not been studied in Jaffna District, Sri Lanka. This study was planned to assess the maternal iodine status and thyroid function at the third trimester of gestation and the thyrotrophin level of their neonate.
Four hundred and seventy-seven pregnant women and their newborns were randomly selected among six Medical Officers of Health Divisions out of 12 in Jaffna District, Sri Lanka. Maternal thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroglobulin (Tg), urinary iodine levels, and the neonatal thyrotrophin (nTSH) level were assessed.
In this study, mean age, weight, height, and gestational age of the mothers were 28.95 (±5.46) years, 63.02 (±11.56) kg, 154.39 (±6.00) cm, and 39.33 (±1.37) weeks, respectively. Maternal median urinary iodine concentration (UIC) was 140.0 μg/L (inter-quartile range 126.0-268.0 μg/L). Median values of the maternal serum TSH, fT4, and Tg were 1.9 mIU/L, 12.6 pmol/L, and 21.4 IU/L, respectively. Among the 477 newborns, 50.5% (n = 239) were males. Mean birth weight of newborn was 3.03 (±0.43) kg, while the mean length was 51.1 (±2.1) cm. Among the newborns, 18% (n = 86) had nTSH level > mIU/L and 37.7% (n = 180) within TSH level > mIU/L. nTSH level had positive but very weak correlations with maternal thyroid parameters, that is, UIC (r = 0.06, P = 0.13), fT4 (r = 0.01, P = 0.05), TSH (r = 0.09, P = 0.05), and Tg (r = 0.12, P = 0.03).
On the basis of the World Health Organization criteria, the iodine status of pregnant women was inadequate in this region and also nTSH levels indicate moderate iodine deficiency during pregnancy. Therefore, the continuous education on adequate iodine intake during pregnancy and monitoring of iodine status are useful.
斯里兰卡贾夫纳地区尚未对孕妇及其新生儿的碘状况进行研究。本研究旨在评估妊娠晚期孕妇的碘状况和甲状腺功能以及其新生儿的促甲状腺激素水平。
从斯里兰卡贾夫纳地区12个卫生区医务官辖区中的6个辖区中随机选取477名孕妇及其新生儿。评估孕妇的促甲状腺激素(TSH)、游离甲状腺素(fT4)、甲状腺球蛋白(Tg)、尿碘水平以及新生儿促甲状腺激素(nTSH)水平。
本研究中,母亲的平均年龄、体重、身高和孕周分别为28.95(±5.46)岁、63.02(±11.56)千克、154.39(±6.00)厘米和39.33(±1.37)周。孕妇尿碘中位数浓度(UIC)为140.0微克/升(四分位间距126.0 - 268.0微克/升)。孕妇血清TSH、fT4和Tg的中位数分别为1.9毫国际单位/升、12.6皮摩尔/升和21.4国际单位/升。在477名新生儿中,50.5%(n = 239)为男性。新生儿平均出生体重为3.03(±0.43)千克,平均身长为51.1(±2.1)厘米。在新生儿中,18%(n = 86)的nTSH水平>毫国际单位/升,37.7%(n = 180)的促甲状腺激素水平>毫国际单位/升。nTSH水平与孕妇甲状腺参数呈正相关但非常弱,即与UIC(r = 0.06,P = 0.13)、fT4(r = 0.01,P = 0.05)、TSH(r = 0.09,P = 0.05)和Tg(r = 0.12,P = 0.03)。
根据世界卫生组织标准,该地区孕妇的碘状况不足,且nTSH水平表明孕期存在中度碘缺乏。因此,持续开展关于孕期充足碘摄入的教育以及监测碘状况是有益的。