Skip to main content Accessibility help
×
Home

Iodine status during pregnancy in India and related neonatal and infant outcomes

  • Morven IFA Lean (a1), Mike EJ Lean (a1) (a2), Chittaranjan S Yajnik (a3), Dattatray S Bhat (a4), Suyog M Joshi (a4), Deepa A Raut (a4), Himangi G Lubree (a4) and Emilie Combet (a1)...

Abstract

Objective

To document iodine status in Indian pregnancies, associations with maternal diet and demographics, and offspring developmental measures.

Design

Longitudinal study following mothers through pregnancy and offspring up to 24 months.

Setting

Rural health-care centre (Vadu) and urban antenatal clinic (Pune) in the Maharashtra region of India.

Subjects

Pregnant mothers at 17 (n 132) and 34 weeks’ (n 151) gestation and their infants from birth to the age of 24 months.

Results

Median urinary iodine concentration (UIC) was 203 and 211 μg/l at 17 and 34 weeks of pregnancy, respectively (range 26–800 μg/l). Using the UIC distribution adjusted for within-person variation, extreme UIC quartiles were compared for predictors and outcomes. There was no correlation between UIC at 17 and 34 weeks, but 24 % of those with UIC in the lowest quartile at 17 weeks had UIC in the same lowest quartile at 34 weeks. Maternal educational, socio-economic status and milk products consumption (frequency) were different between the lowest and highest quartile of UIC at 34 weeks. Selected offspring developmental outcomes differed between the lowest and highest UIC quartiles (abdominal circumference at 24 months, subscapular and triceps skinfolds at 12 and 24 months). However, UIC was only a weak predictor of subscapular skinfold at 12 months and of triceps skinfold at 24 months.

Conclusions

Median UIC in this pregnant population suggested adequate dietary provision at both gestational stages studied. Occasional high results found in spot samples may indicate intermittent consumption of iodine-rich foods. Maternal UIC had limited influence on offspring developmental outcomes.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Iodine status during pregnancy in India and related neonatal and infant outcomes
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Iodine status during pregnancy in India and related neonatal and infant outcomes
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Iodine status during pregnancy in India and related neonatal and infant outcomes
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Email Mike.Lean@glasgow.ac.uk

References

Hide All
1. Haldimann, M, Alt, A, Blanc, A et al. (2005) Iodine content of food groups. J Food Compost Anal 18, 461471.
2. Fisher, J, Tran, T, Biggs, B et al. (2011) Iodine status in late pregnancy and psychosocial determinants of iodized salt use in rural northern Viet Nam. Bull World Health Organ 89, 813820.
3. Kochupillai, N, Pandav, CS, Godbole, MM et al. (1986) Iodine deficiency and neonatal hypothyroidism. Bull World Health Organ 64, 547551.
4. Blazer, S, Moreh-Waterman, Y, Miller-Lotan, R et al. (2003) Maternal hypothyroidism may affect fetal growth and neonatal thyroid function. Obstet Gynecol 102, 232241.
5. Pop, VJ, Brouwers, EP, Vader, HL et al. (2003) Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol (Oxf) 59, 282288.
6. Haddow, JE, Palomaki, GE, Allan, WC et al. (1999) Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 341, 549555.
7. Delange, F (1994) The disorders induced by iodine deficiency. Thyroid 4, 107128.
8. Patel, J, Landers, K, Li, H et al. (2011) Thyroid hormones and fetal neurological development. J Endocrinol 209, 18.
9. Melse-Boonstra, A, Gowachirapant, S, Jaiswal, N et al. (2012) Iodine supplementation in pregnancy and its effect on child cognition. J Trace Elem Med Biol 26, 134136.
10. Chakrabarty, A (2011) 71 million hit by iodine deficiency in India. http://www.dnaindia.com/india/1593586/report-71-million-hit-by-iodine-deficiency-in-india (accessed June 2012).
11. Kochupillai, N & Mehta, M (2008) Iodine deficiency disorders and their prevention in India. Rev Endocr Metab Disord 9, 237244.
12. Lightowler, HJ & Davies, GJ (1998) Iodine intake and iodine deficiency in vegans as assessed by the duplicate-portion technique and urinary iodine excretion. Br J Nutr 80, 529535.
13. Kapil, U (2007) Health consequences of iodine deficiency. Sultan Qaboos Univ Med J 7, 267272.
14. Kumar, S (1995) Indicators to monitor progress of National Iodine Deficiency Disorders Control Programme (NIDDCP) and some observations on iodised salt in west Bengal. Indian J Public Health 39, 141147.
15. Menon, KC, Skeaff, SA, Thomson, CD et al. (2011) The effect of maternal iodine status on infant outcomes in an iodine-deficient Indian population. Thyroid 21, 13731380.
16. Kapil, U, Saxena, N, Ramachandran, S et al. (1997) Iodine status of pregnant mothers residing in a district of endemic iodine deficiency in the state of Himachal Pradesh, India. Asia Pac J Clin Nutr 6, 224225.
17. Chakraborty, I, Chatterjee, S, Bhadra, D et al. (2006) Iodine deficiency disorders among the pregnant women in a rural hospital of West Bengal. Indian J Med Res 123, 825829.
18. Chakraborty, I, Mazumdar, P, Chakraborty, PS et al. (2010) Iodine deficiency disorder among pregnant women in a tertiary care hospital of Kolkata, India. Southeast Asian J Trop Med Public Health 41, 989995.
19. Mazumdar, A, Jaiswal, A, Chatterjee, SG et al. (2010) Iodine deficiency in pregnancy in a iodine replete area of eastern India. Endocr J 57, Suppl. 2, S453.
20. Rendina, D, De Filippo, G, Mossetti, G et al. (2012) Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. J Endocrinol Invest 35, 407412.
21. Ayturk, S, Gursoy, A, Kut, A et al. (2009) Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area. Eur J Endocrinol 161, 599605.
22. Kapil, U (2011) Presence of severe iodine deficiency in areas with adequate salt iodization. Indian J Pediatr 78, 1299.
23. Kapil, U (2008) Current status of salt iodization and level of iodine nutrient in India. Afr J Pharm Pharmacol 2, 6676.
24. Kapil, U (2000) Status of urinary iodine excretion in post salt iodization phase in selected districts of India. Indian Pediatr 37, 12821284.
25. International Institute for Population Studies & Macro International (2007) National Family Health Survey (NFHS-3), 2005–06, India: Key Findings. Mumbai: International Institute for Population Studies.
26. Bulliyya, G, Dwibedi, B, Mallick, G et al. (2008) Determination of iodine nutrition and community knowledge regarding iodine deficiency disorders in selected tribal blocks of Orissa, India. J Pediatr Endocrinol Metab 21, 7987.
27. Moleti, M, Di Bella, B, Giorgianni, G et al. (2011) Maternal thyroid function in different conditions of iodine nutrition in pregnant women exposed to mild-moderate iodine deficiency: an observational study. Clin Endocrinol (Oxf) 74, 762768.
28. Sooch, SS, Deo, MG, Karmarka, Mg et al. (1973) Prevention of endemic goiter with iodized salt. Bull World Health Organ 49, 307312.
29. Kochupil, N, Karmarka, MG, Weightma, D et al. (1973) Pituitary–thyroid axis in Himalayan endemic goiter. Lancet 1, 10211024.
30. Zimmermann, MB (2009) Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. Am J Clin Nutr 89, issue 2, 668S672S.
31. Pettigrew-Porter, A, Skeaff, S, Gray, A et al. (2011) Are pregnant women in New Zealand iodine deficient? A cross-sectional survey. Aust N Z J Obstet Gynaecol 51, 464467.
32. World Health Organization/UNICEF/International Council for the Control of Iodine Deficiency Disorders (2007) Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: A Guide for Programme Managers. Geneva: WHO.
33. Mian, C, Vitaliano, P, Pozza, D et al. (2009) Iodine status in pregnancy: role of dietary habits and geographical origin. Clin Endocrinol (Oxf) 70, 776780.
34. Delange, F (2007) Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition. Public Health Nutr 10, 15711580.
35. Barker, DJP, Eriksson, JG, Forsen, T et al. (2002) Fetal origins of adult disease: strength of effects and biological basis. Int J Epidemiol 31, 12351239.
36. Fall, CHD, Stein, CE, Kumaran, K et al. (1998) Size at birth, maternal weight, and type 2 diabetes in South India. Diabet Med 15, 220227.
37. Margetts, BM, Yusof, SM, Al Dallal, Z et al. (2002) Persistence of lower birth weight in second generation South Asian babies born in the United Kingdom. J Epidemiol Community Health 56, 684687.
38. Misra, A, Chowbey, P, Makkar, BM et al. (2009) Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 57, 163170.
39. Shantha, GPS, Kumar, AA, Jeyachandran, V et al. (2009) Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India. Thyroid Res 2, 2.
40. Katre, P, Bhat, D, Lubree, H et al. (2010) Vitamin B-12 and folic acid supplementation and plasma total homocysteine concentrations in pregnant Indian women with low B-12 and high folate status. Asia Pac J Clin Nutr 19, 335343.
41. Rao, S, Yajnik, CS, Kanade, A et al. (2001) Intake of micronutrient-rich foods in rural Indian mothers is associated with the size of their babies at birth: Pune maternal nutrition study. J Nutr 131, 12171224.
42. National Institute of Nutrition (1989) Nutritive Value of Indian Foods. Hyberabad: Indian Council of Medical Research.
43. Bhat, DS, Thuse, NV, Lubree, HG et al. (2009) Increases in plasma holotranscobalamin can be used to assess vitamin B-12 absorption in individuals with low plasma vitamin B-12. J Nutr 139, 21192123.
44. Chanoine, JP, Bourdoux, P, Thi, NBV et al. (1987) Iodine contamination of urine samples by test strips. Clin Chem 33, 1935.
45. Bhate, VK, Joshi, SM, Ladkat, RS et al. (2012) Vitamin B12 and folate during pregnancy and offspring motor, mental and social development at 2 years of age. J Dev Orig Health Dis 3, 123130.
46. Zimmermann, MB & Andersson, M (2012) Assessment of iodine nutrition in populations: past, present, and future. Nutr Rev 70, 553570.
47. Subcommittee on Interpretation and Uses of Dietary Reference Intakes, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (2003) Appendix E – Adjustment of observed intake data to estimate the distribution of usual intakes in a group. In Dietary Reference Intakes: Applications in Dietary Planning, pp. 196208. Washington, DC: National Academies Press.
48. Mackerras, DEM, Singh, GR & Eastman, CJ (2011) Iodine status of Aboriginal teenagers in the Darwin region before mandatory iodine fortification of bread. Med J Aust 194, 126130.
49. Bleichrodt, N & Born, MP (1994) A metaanalysis of research on iodine and its relationship to cognitive development. In Damaged Brain of Iodine Deficiency: Cognitive, Behavioral, Neuromotor, Educative Aspects, pp. 195200. [JB Stanbury, editor]. New York: Cognizant Communication Corp.
50. Delange, F, Wolff, P, Gnat, D et al. (2001) Iodine deficiency during infancy and early childhood in Belgium: does it pose a risk to brain development? Eur J Pediatr 160, 251254.
51. McCance, RA & Widdowson, EM (1951) Composition and function of colostrum and regression milk. Nature 167, 722.
52. Longvah, T, Toteja, GS & Upadhyay, A (2013) Iodine content in bread, milk and the retention of inherent iodine in commonly used Indian recipes. Food Chem 136, 384388.
53. Andersen, S, Karmisholt, J, Pedersen, KM et al. (2008) Reliability of studies of iodine intake and recommendations for number of samples in groups and in individuals. Br J Nutr 99, 813818.
54. Andersson, M, de Benoist, B, Delange, F et al. (2007) Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Public Health Nutr 10, 16061611.
55. Hamrosi, MA, Wallace, EM & Riley, MD (2005) Iodine status in pregnant women living in Melbourne differs by ethnic group. Asia Pac J Clin Nutr 14, 2731.
56. Saikia, TC, Thakur, C & Dutta, N (1996) Thyroid status of pregnant women in sub-Himalayan iodine deficient Dibrugarh district (North East India). Indian J Physiol Allied Sci 50, 173181.
57. Menon, KC, Skeaff, SA, Thomson, CD et al. (2011) Concurrent micronutrient deficiencies are prevalent in nonpregnant rural and tribal women from central India. Nutrition 27, 496502.
58. Knudsen, N, Bulow, I, Laurberg, P et al. (2002) Parity is associated with increased thyroid volume solely among smokers in an area with moderate to mild iodine deficiency. Eur J Endocrinol 146, 3943.
59. Laurberg, P, Andersen, S, Knudsen, N et al. (2002) Thiocyanate in food and iodine in milk: from domestic animal feeding to improved understanding of cretinism. Thyroid 12, 897902.
60. Koenig, F, Andersson, M, Hotz, K et al. (2011) Ten repeat collections for urinary iodine from spot samples or 24-hour samples are needed to reliably estimate individual iodine status in women. J Nutr 141, 20492054.
61. Laurberg, P, Andersen, S, Bjarnadottir, RI et al. (2007) Evaluating iodine deficiency in pregnant women and young infants – complex physiology with a risk of misinterpretation. Public Health Nutr 10, 15471553.

Keywords

Iodine status during pregnancy in India and related neonatal and infant outcomes

  • Morven IFA Lean (a1), Mike EJ Lean (a1) (a2), Chittaranjan S Yajnik (a3), Dattatray S Bhat (a4), Suyog M Joshi (a4), Deepa A Raut (a4), Himangi G Lubree (a4) and Emilie Combet (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed