Iodine deficiency in pregnancy. Still a health issue for the women of Cassino city, Italy

Objective: WHO/UNICEF/ICCIDD recommend a median urinary iodine concentration (UIC) in pregnant women between 150 µg/L and 249 µg/L. In the present study, we evaluated whether in the urban area of Cassino (central Italy), following a national salt iodination program (30 mg/Kg) introduced in 2005, the increased demand of iodine during pregnancy was satisfied. Research Methods & Procedures: Between January 2016 and April 2017, 99 pregnant women were enrolled to evaluate UIC in morning spot urine samples, serum level of thyrotropin, free-thyroxine, anti-thyroglobulin, anti-thyroperoxidase autoantibodies, and thyroid volume by ultrasonography. Eighty clinically healthy non-pregnant women have been evaluated as control. Results: The median UIC was of 97.7 µg/L and 110.3 µg/L, respectively, in control and pregnant women. A significant increase (p<0.001) of median thyroid volume was observed in pregnant women, with respect to control women being, respectively, 10.4 ml (range 3.68-19.49 ml) and 7.16 ml (range 2.57-14.00 ml). A positive correlation was found between thyroid volume and anthropometric parameters, while an inverse correlation was observed between free-thyroxine serum levels and anthropometric parameters. Conclusions: This observational study demonstrated that the majority of pregnant women and their fetuses appear to be not protected by the detrimental consequences of iodine deficiency. Therefore, the identification of new strategies capable to increase the knowledge of and awareness in the general population of the beneficial effects of iodine supplementation during pregnancy is highly required.