The Influence of Iron Depletion and Chronic Energy Deficiency on the Risk of Hypothyroidism in Pregnant Women Living in Iodine Deficiency Disorders Endemic Areas in Badegan Ponorogo District East Java, Indonesia.

Several minerals are needed for thyroid hormone to work properly, such as iodine and iron. Iron is one of important essential trace elements that serves as co-factor for thyroid peroxidase (TPO). Those with iron deficiency have lower ferritin serum level than those who are normal. In particular, pregnant women with chronic energy deficiency (CED) have higher anemia risk than the otherwise. The study aimed to measure ferritin level, CED and hypothyroidism among pregnant women living in iodine deficiency disorders (IDD) endemic areas. A total of 37 pregnant women aged 18-45 y-oldwith pregnancy of 2 to 8 mo living in ID Dendemic of Dayakan and Watu Bonang Villages of Ponorogo District were include dinthestudy. Two different measurements were taken namely, anthropometric measurement of mid-upper arm circumference (MUAC) or upper circumference (UAC) which is more correct term to use, and blood markers of iodine and iron status were assessed using thyroid stimulating hormone (TSH), free thyroxine (fT4), and bloodferritin. Among pregnant women, 27% had hypothyroidism and 54.05% had iron depletion, with 30% had both conditions. The hypothyroidism was higher in pregnant women had CED than those non-CED, 50% vs. 18.5%. No significant correlation (p≥0.05) between hypothyroidism and both ferritin and CED, but adjusted odds ratio (AOR) was found at 7.7 (95% CI: 1.2-52.9), indicated more than four times higher risk of hypothyroidism in pregnant women with CED than the otherwise. Hypothyroidism in pregnant women living in Ponorogo was not caused by iron deficiency, but allegedly by lack of other nutritional intake. Conclusion: Integrated and sustainable efforts to improve nutritional status is needed since pre-conception and throughout pregnancy.