Health Research and Development Magelang, Indonesia Ministry of Health, Magelang, Indonesia.
Department of Women and Children's Health, King's College London, London, United Kingdom.
PLoS One. 2020 Nov 19;15(11):e0242575. doi: 10.1371/journal.pone.0242575. eCollection 2020.
Iodine is an essential micronutrient for cognitive development and growth. Optimal intakes are critical during pregnancy. We report the iodine status and thyroid function of pregnant women living in areas previously affected by severe iodine deficiency and in longstanding iodine sufficient areas in Java, Indonesia. This cross-sectional study was conducted in Magelang, Java, from July to November 2015, in four sub-districts; two previously affected by severe iodine deficiency (area 1) and two that were iodine-sufficient (area 2). Iodine intake was estimated using median urinary iodine concentration in spot samples and mean urinary iodine excretion in 3 x 24-hour samples, thyroid hormones (thyroid-stimulating hormone and free thyroxine) were measured in venous blood samples, and iodine content of household salt samples was estimated by titration. We recruited a total of 244 pregnant women, 123 in area 1 and 121 in area 2. Urinary iodine results suggested adequate habitual iodine intakes in both areas (median urinary iodine concentration in area 1: 222 μg/l (interquartile range 189, 276 μg/l), area 2: 264 μg/l (interquartile range 172, 284 μg/l), however, the risk of inadequate intakes increased with advancing trimester (Odds Ratio = 2.59 (95% CI 1.19-5.67) and 3.85 (95% CI 1.64-9.02) at second and third trimesters, respectively). Estimated prevalence of thyroid function disorders was generally low. Salt was iodized to approximately 40 ppm and foods rich in native iodine did not contribute significantly to dietary intakes. Adequately iodized salt continues to prevent iodine insufficiency in pregnant women living in areas previously affected by severe iodine deficiency in Java, Indonesia. Monitoring and surveillance, particularly in vulnerable groups, should be emphasized to ensure iodine sufficiency prevails.
碘是认知发育和生长所必需的微量营养素。怀孕期间最佳摄入量至关重要。我们报告了印度尼西亚爪哇省以前受严重碘缺乏影响地区和长期碘充足地区孕妇的碘状况和甲状腺功能。这项横断面研究于 2015 年 7 月至 11 月在爪哇省马格朗的四个分区进行; 两个以前受严重碘缺乏影响（地区 1），两个碘充足（地区 2）。碘摄入量是通过对随机尿液样本中碘中位数浓度和 3x24 小时尿液样本中碘平均排泄量的估计来确定的，静脉血样本中测量了甲状腺激素（促甲状腺激素和游离甲状腺素），并通过滴定法估计了家用盐样本中的碘含量。我们共招募了 244 名孕妇，其中 123 名来自地区 1，121 名来自地区 2。两个地区的尿液碘结果均表明习惯性碘摄入量充足（地区 1 的中位数尿液碘浓度：222μg/l（189,276μg/l），地区 2：264μg/l（172,284μg/l）），然而，随着妊娠中期的进展，摄入不足的风险增加（第二和第三妊娠中期的比值比分别为 2.59（95%CI 1.19-5.67）和 3.85（95%CI 1.64-9.02））。甲状腺功能障碍的估计患病率通常较低。盐被碘化至约 40ppm，富含天然碘的食物对膳食摄入量没有显著贡献。在印度尼西亚爪哇省以前受严重碘缺乏影响的地区，充足的碘盐继续预防孕妇碘缺乏。应强调监测和监测，特别是在弱势群体中，以确保碘充足。
