Amiri Parisa, Hamzavi Zarghani Najmeh, Nazeri Pantea, Ghofranipour Fazlollah, Karimi Mehrdad, Amouzegar Atieh, Mirmiran Parvin, Azizi Fereidoun
1 Research Center for Social Determinants of Endocrine Health and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
2 Department of Health Education and Health Promotion, Tarbiat Modares University , Tehran, Iran .
Thyroid. 2017 Mar;27(3):418-425. doi: 10.1089/thy.2016.0185. Epub 2017 Jan 30.
Because of their increased need for iodine, pregnant women are among the high-risk groups for iodine deficiency. The purpose of this study was to evaluate the effectiveness of an educational program on the iodine nutrition status of pregnant women.
In this randomized controlled trial, 100 pregnant women were randomly selected from five healthcare centers in the southern region of Tehran, the capital of Iran. In the intervention group, pregnant women received a four-month educational program, which included two face-to-face educational sessions, using a researcher-designed educational pamphlet in the second and third trimesters, and two follow-up telephone calls. Knowledge, attitude, and practice (KAP) scores, urinary iodine concentration (UIC), and salt iodine content were assessed at baseline and four months after the intervention.
At baseline, there were significant associations between knowledge and attitude (r = 0.38, p = 0.03) between practice and UIC (r = 0.28, p = 0.01) and between UIC and iodine content of salt (r = 0.24, p = 0.009). Although a significant difference was found in mean KAP scores between the two groups after the educational intervention, scores were significantly higher in the intervention group compared with controls (p < 0.01). There were no significant differences in UIC and iodine content of salt between the two groups at follow-up.
Despite educational intervention increasing KAP among women regarding the importance of iodine and iodized salt consumption during pregnancy, their iodine status did not improve. Considering the main socio-environmental determinants of iodine deficiency, in particular, the monitoring of salt fortification, prescribing iodine containing supplements as well as improving health literacy in pregnant women seem essential strategies.
由于孕妇对碘的需求增加，她们属于碘缺乏的高危人群。本研究的目的是评估一项教育计划对孕妇碘营养状况的有效性。
在这项随机对照试验中，从伊朗首都德黑兰南部地区的五个医疗中心随机选取了100名孕妇。在干预组中，孕妇接受了为期四个月的教育计划，其中包括两次面对面的教育课程，在孕中期和孕晚期使用研究人员设计的教育手册，以及两次随访电话。在基线和干预后四个月评估知识、态度和行为（KAP）得分、尿碘浓度（UIC）和盐碘含量。
在基线时，知识与态度之间（r = 0.38，p = 0.03）、行为与UIC之间（r = 0.28，p = 0.01）以及UIC与盐碘含量之间（r = 0.24，p = 0.009）存在显著关联。尽管教育干预后两组的平均KAP得分存在显著差异，但干预组的得分显著高于对照组（p < 0.01）。随访时两组的UIC和盐碘含量无显著差异。
尽管教育干预提高了女性对孕期碘和碘盐消费重要性的KAP，但她们的碘状况并未改善。考虑到碘缺乏的主要社会环境决定因素，特别是盐强化监测、开含碘补充剂以及提高孕妇的健康素养似乎是必不可少的策略。
