Iron Deficiency Anemia and Iodine Prophylaxis in Pregnant Women

The aim of this study was estimate the influence of Iron Deficiency Anemia (IDA) on efficiency of the iodine prophylaxis for pregnant women, and also to offer the optimal levels of daily iodine intake during pregnancy and lactation. Materials and methods: serum thyroid stimulating hormone (TSH), free thyroxin (fT4), AT-TPO concentrations, urine excretion of iodine, levels of hemoglobin (Hb), hematocrit (Ht), red blood cell (RBC), mean corpuscular hemoglobin (MCH), serum iron levels and serum ferritin were measured. The volume of thyroid gland was defined by ultrasonography. The pregnant women were divided into two groups: Group 1 (n = 111) – KI (200 micro# grams/day) and Group 2 (n = 109) – KI (300 micrograms/day). Results: Median urinary iodine was 140,8 μg/l. During pregnancy there was an authentic rising of a median urinary iodine to 259,6 μg/l in group 2 (p = 0,0000) and in group 1 the iodine excretion in urine was more low than at a stage of screening and has compounded 96,9 μg/l (p = 0,002). During lactation there was an insufficient concentration of iodide in urine in group 1 and in group 2 there were normal indexes of a median urinary iodine – 88,6 and 123,2μg/l in groups 1st and 2nd accordingly (p = 0,004). In the third trimester 21,5% of women had a latent deficiency of iron. Authentic correlation between indexes of an iron deficiency anemia and iodine deficiency has not been detected. Conclusion: The median level of urinary iodine indicate optimal iodine nutrition during pregnancy and lactation and the requirement of iodine is at least 300 μg/day. In our research the negative influence of iron deficiency anemia on the efficiency of iodine prophylaxis during pregnancy has not been detected.

iodine deficiency, thyroid, iron, anemia, pregnant women

1. Герасимов Г.А., Петунина Н.А. Йод и аутоиммунные заболевания щитовидной железы // Пробл. эндокринол. 1993. N 3. С. 52–54.

2. Фадеев В.В., Мельниченко Г.А., Герасимов Г.А. Аутоиммунный тиреоидит. Первый шаг к консенсусу // Пробл. эндокринол. 2001. Т. 47. N 4. С. 7–13.

3. Andersson M., de Benoist B., Delange F., Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women and in children less that 2-years-old: conclusion and recommendations of the Technical Consultations // Public. Health. Nutrition. 2007. V. 10. N 12A. P. 1606–1611.

4. Björkstén F. Kinetic study of the horse#radish peroxidase-catalyzed oxidation of iodide // Biochem. Biophys Acta. 1970. V. 212. P. 396–406.

5. Bussen S., Steck T. Thyroid autoantibodies in euthyroid non-pregnant women with recurrent spontaneous abortions // Human. Reprod. 1995. V. 10. N 11. P. 2938–2940.

6. Delange F. Optimal iodine nutrition during pregnancy, lactation and the neonatal period // Int. J. Endocrinol. Metab. 2004. V. 2. P. 1–12.

7. Editorial: reaching optimal iodine nutrition in pregnant and lactating women and young children: programmatic recommendations / Eds. J. Untoro, N. Managasaryan, B. de Benoist, I. Danton_Hill // Public. Health. Nutrition. 2007. V. 10. N 12A. P. 1527–1529.

8. Glinoer D. The systematic screening and management of hypothyroidism and hyperthyroidism during pregnancy // Trends. Endocrinol. Metab. 1998. V. 9. N 10. P. 403–411.

9. Lobig H., Bohn W., Mau J., Schats H. Prevalence of postpartum thyroiditis in two iodine-deficient regions of Germany. / In: W. Scherbaum, U. Bogner, B. Weinheimer, G. Bottazzo (eds). Autoimmune thyroiditis. Springner-Verlag, Berlin, 1991. P. 185–193.

10. Ohtaki S., Nakagawa H., Kimura S., Yamazaki I. Analyses of catalytic intermediates of hog thyroid peroxidase during its iodinating reaction // J. Biol. Chem. 1981. V. 256. P. 805–810.

11. Roberts J.E., Hoffman B.R., Rutter R., Hager L.P. Electron-nuclear double resonance of horseradish peroxidase compound I. Detection of the porphyrin pication radical // J. Biol. Chem. 1981. V. 256. P. 2118–2121.

12. Roman R., Dumbord H.B. pH dependence of the oxidation of iodide by compound I of horseradish peroxidase // Biochemistry. 1972. V. 11. P. 2076–2082.

13. Taurog A. Hormone synthesis: thyroid iodine metabolism / In: L. Braverman, R.D. Utiger. Еds. Werner and Ingbar’s The Thyroid. Philapelphia: Lippincott Co., 1996. P. 48–71.

14. WHO: Assessing the Iron status of populations// Report of a Joint WHO / Centers for Disease Control and Prevention Technical Consultation on the Assessment of Iron Status at the Population / Geneva, 2004.

15. WHO: Iron Deficiency Anemia. A guide for programme managers // WHO/NHD.01.3.2001.

16. WHO, UNICEF and ICCIDD. Assessment of Iodine Deficiency Disorders and Monitoring their elimination // Geneva: WHO, WHO/Euro/NUT/ 2001.

17. Zimmermann M.B., Burgi Н., Hurrell R.F. Iron Deficiency Predicts Poor Maternal Thyroid Status during Pregnancy // J. Clin. Endocrinol. Metab. 2007. V. 92(9). P. 3436–3440.

18. Zimmermann M., Delange F. Iodine supplementation of pregnant women in Europe: a review and recommendations // Eur. J. Clin. Nutr. 2005. V. 58. P. 979–984.