Iodine nutrition status of pregnant women in an iodine-sufficient area

Background. Iodine is necessary for the synthesis of thyroid hormones, which play a decisive role in the development of the brain during fetal and early postnatal life. Objective. To evaluate whether prophylaxis with 20 to 30 mg of iodine per kilogram of salt is enough to ensure optimal iodine nutrition during pregnancy in an iodine sufficient area. Methods. A cross-sectional study of pregnant women was conducted in 2007. The urinary iodine concentration (UIC) was measured in 300 randomly selected women in Tuzla, Bosnia, and Herzegovina, in all three trimesters of pregnancy. Results. The median UIC of the pregnant women was 142 mu g/L, ranging from 27 to 1,080 mu g/L. The median UIC of the pregnant women in each trimester of pregnancy who were not restricting their salt intake was consistent with adequate iodine nutrition, as defined by the World Health Organization Technical Consultation, whereas the median UIC of women who were restricting their salt intake was insufficient. Conclusions. Pregnant women in the urban area of Tuzla had adequate iodine status except for those with restricted salt intake, which presents an increased risk to the mother as well to as the unborn child. Women in the rural area of Tuzla were found to be iodine-deficient, regardless of whether they had restricted their salt intake or not. However for those pregnant women who have been advised to restrict their salt intake and who thus face the risk of iodine deficiency, the use of salt with higher concentrations of iodine could be advised.