The assessment of iodine sufficiency in women in the first trimester of pregnancy living in areas of the Voronezh region with varying levels of iodine consumption

RELEVANCE. In Russia, there is a widespread risk of developing iodine deficiency disorders (IDD) due to insufficient iodine in the diet [1, 2]. The primary at-risk group, where the consequences of insufficient iodine in the diet are most severe, includes pregnant and breastfeeding women, as well as children aged 0 to 3 years [1, 3, 4].

THE AIM OF THE STUDY. To assess the iodine sufficiency and consumption among the women in the first trimester of pregnancy living in areas of the Voronezh region with varying levels of iodine consumption.

MATERIALS AND METHODS. One hundred women in the first trimester of pregnancy living in areas of the Voronezh region were investigated. All the participants completed a questionnaire regarding the presence of diseases, medication intake, and nutrition. They were examined by an endocrinologist, had their thyroid gland palpated, underwent an ultrasound of the thyroid gland, and provided a single portion of daily urine (before 12:00), followed by the determination of iodine concentration in the urine and calculation of the median ioduria. An analysis of samples of table salt obtained from households was conducted to check for iodine (potassium iodate) using a rapid qualitative analysis method. Blood samples were taken to determine the levels of thyroid-stimulating hormone (TSH), antibodies to thyroid peroxidase (Anti-TPO antibodies), selenium, and zinc in the serum.

RESULTS. The median ioduria was 87.35 (≥150) µg/l. The proportion of households using iodised salt was 23% (n=23). Moderate increased iodine intake was observed in 12% of women; appropriate iodine intake — 15%; and insufficient iodine intake — 73%. Only 23% of women use iodised salt, and 6% regularly take iodine-containing medications, indicating inappropriate iodine consumption and a near-complete absence of iodine prevention in the at-risk group for iodine deficiency diseases. The median TSH level was 1.19 mIU/l, which falls within the reference range (0.4–4 mIU/l). The median selenium concentration was 0.098 µg/ml, which also corresponds to the reference range (0.07–0.12 µg/ml), with no significant differences in selenium concentration found between residents of Voronezh and surrounding areas. According to the results of the ultrasound of the thyroid gland, signs of thyroid pathology (nodular and autoimmune combined) were identified in 55% (n=55) of the examined pregnant women.

CONCLUSION. Extremely low levels of iodised salt consumption in households have been identified and Iodine deficiency intake was found in pregnant women.

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