Objectives
To evaluate the effectiveness of iodine prophylaxis group (KI 200 and 300 µg/day ) in the background of anemia during pregnancy.
Methods
414 women from the 3 regions were included in the study (Nizhny Novgorod, Smolensk, Moscow) on the first trimester of pregnancy at the age of 18 to 42 years.Pregnant women were divided into 2 groups: Group 1 – with iodine intake 200 µg /day (KI), Group 2 – 300 µg /day during pregnancyBlood tests of hemoglobin (Hb), hematocrit (Ht), red blood cell (RBC), mean corpuscular hemoglobin (MCH), serum iron and serum ferritin (SF) and urine excretion of iodine (UI) were measured in each pregnant woman before and during iodine intake. Anemia diagnosis was based on the results of clinical studies of blood according to criteria WHO, 2001.
Results
Urinary iodine (UI) excretion in pregnant women in all 3 regions at the stage of screening was 140,8 µg/l. After 3 months of iodine prophylaxis the level of UI in pregnant women had statistically significant differences (p = 0.00): the median of UI was – 96.9 and 259.6 µg/l in the Group 1 and Group 2, respectively. There was a significant increase of urinary iodine levels in pregnant women in group 2 (p = 0,00), whereas in the Group 1 urine excretion of iodine was lower than in the screening stage (p = 0,00).Also in 3 months we detected the low level of serum ferritin (below15 µg/L) at each four pregnant (22.3%) in all regions in spite of the prevention of iron deficiency and normal levels of Hb, that could indicate of high incidence of latent iron deficiency in pregnant women.In addition, the positive correlation with the median UI and serum iron (p <0,03) and positive correlation with UI of hemoglobin (p <0,05), serum iron (p <0,05 ) and serum ferritin (p <0,05) was found. In comparing the baseline median UI among all pregnant women in the group with anemia (Hb levels less than 110 g / l) and without anemia we revealed a statistically significant difference (p <0.05), the median was - 105.1 and 145.5 µg/l respectively.
Conclusions
1. Pregnant women in iodine deficiency areas should be given a daily oral dose of iodine as potassium iodide 250 – 300 µg/ day 2. Iron-deficiency anemia and latent iron deficiency decrease the effectiveness of iodine prophylaxis in 1.5 times