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To explore main cause and health impact of iodine excess during pregnancy, we performed iodine evaluation for 390 consecutive pregnant women from January 1st, 2016 to December 31st, 2016. Among them, 18 women (4.62%) with apparently elevated urinary iodine concentration (UIC) were enrolled onto this study for subsequent follow-up. History of high iodine exposure was collected from all participants. Parameters about iodine status were monitors until termination of pregnancy, and dietary iodine intake condition and thyroid function were also evaluated.
A prospective follow-up was arranged for the 18 pregnant women with excessive iodine status. History of iodine exposure (including hysterosalpingography (HSG) using an oil-soluble iodinated contrast medium, examination by computed tomography scan with contrast, administration of amiodarone, history of receiving radioiodine therapy, etc.) was collected from all participants. Evaluation of dietary iodine intake was performed through a 72-hour dietary recall.The serum iodine concentration (SIC) and urinary iodine concentration (UIC) were monitored continuously in the whole course of pregnancy. All subjects with excessive iodine load were recommended by nutritionists to have their dietary iodine intake restricted, and resume iodine-containing supplements and foods until the UIC<250 μg/L and SIC≤90 μg/L. After delivery, maternal colostrum iodine concentration and neonatal iodine status (including neonatal UIC, condition of congenital hypothyroidism screening tests, and thyroid physical examination) were also assessed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HH group | Group (participants) with pre-gestational history of undergoing hysterosalpingography (HSG) using an oil-soluble iodinated contrast medium |
| |
| Non-HH group | Group (participants) without pre-gestational history of undergoing hysterosalpingography (HSG) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dietary iodine intake restriction | Other | All subjects with excessive iodine load were recommended by nutritionists to restrict dietary iodine intake, and resume iodine-containing supplements and foods until their iodine status return to normal. However, in this observational study, the intervention was a regular management in prenatal care, and not assigned by investigator of the study. |
| Measure | Description | Time Frame |
|---|---|---|
| prevalence of adverse pregnancy outcome | prevalence of stillbirth, abortion and other adverse pregnancy outcome | 6-9 months post identification of maternal iodine excess |
| composite neonatal outcome | Apgar scores, birth weight of the neonates,and prevalence of thyroid dysfunction in neonates | 6-9 months post identification of maternal iodine excess |
| Measure | Description | Time Frame |
|---|---|---|
| prevalence of maternal thyroid dysfunction in pregnancy | Laboratory reference ranges of TSH during pregnancy were 0.1~2.5 mIU/L for the first trimester, 0.2~3.0 mIU/L for the second trimester and 0.3~3.0 mIU/L for the third trimester.Prevalence of TSH elevation during pregnancy will be summarized. | through study completion, about 6-9 months post identification of maternal iodine excess |
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Inclusion Criteria:
Exclusion Criteria:
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All enrolled pregnant women will be from urban area of Beijing, whose dietary iodine intake and pre-gestational history of iodine exposure will be reviewd in detail.
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| Name | Affiliation | Role |
|---|---|---|
| Xuan Zhang, MD | Department of academic research,Peking Union Medical College Hospital | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28379180 | Result | Sun D, Codling K, Chang S, Zhang S, Shen H, Su X, Chen Z, Scherpbier RW, Yan J. Eliminating Iodine Deficiency in China: Achievements, Challenges and Global Implications. Nutrients. 2017 Apr 5;9(4):361. doi: 10.3390/nu9040361. | |
| 28056690 | Result | Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457. |
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| ID | Term |
|---|---|
| D007232 | Infant, Newborn, Diseases |
| ID | Term |
|---|---|
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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Urine for urinary iodine concentration analysis;serum for serum iodine concentration analysis; maternal breast milk for colostrum iodine concentration analysis
|
| prevalence of neonatal iodine excess | urinary iodine concentration will be examined for all neonates born to women with iodine excess in pregnancy, and prevalence of neonatal urinary iodine concentration ≥ 200μg/L will be summarized. | within 1 week after birth |
| 28770411 | Result | Xiao Y, Sun H, Li C, Li Y, Peng S, Fan C, Teng W, Shan Z. Effect of Iodine Nutrition on Pregnancy Outcomes in an Iodine-Sufficient Area in China. Biol Trace Elem Res. 2018 Apr;182(2):231-237. doi: 10.1007/s12011-017-1101-4. Epub 2017 Aug 2. |
| 28412871 | Result | So S, Yamaguchi W, Tajima H, Nakayama T, Tamura N, Kanayama N, Tawara F. The effect of oil and water-soluble contrast medium in hysterosalpingography on thyroid function. Gynecol Endocrinol. 2017 Sep;33(9):682-685. doi: 10.1080/09513590.2017.1307960. Epub 2017 Apr 17. |
| 25546154 | Result | Kaneshige T, Arata N, Harada S, Ohashi T, Sato S, Umehara N, Saito T, Saito H, Murashima A, Sago H. Changes in serum iodine concentration, urinary iodine excretion and thyroid function after hysterosalpingography using an oil-soluble iodinated contrast medium (lipiodol). J Clin Endocrinol Metab. 2015 Mar;100(3):E469-72. doi: 10.1210/jc.2014-2731. Epub 2014 Dec 29. |
| 26402613 | Result | Satoh M, Aso K, Katagiri Y. Thyroid Dysfunction in Neonates Born to Mothers Who Have Undergone Hysterosalpingography Involving an Oil-Soluble Iodinated Contrast Medium. Horm Res Paediatr. 2015;84(6):370-5. doi: 10.1159/000439381. Epub 2015 Sep 25. |
| 18958768 | Result | Mekaru K, Kamiyama S, Masamoto H, Sakumoto K, Aoki Y. Thyroid function after hysterosalpingography using an oil-soluble iodinated contrast medium. Gynecol Endocrinol. 2008 Sep;24(9):498-501. doi: 10.1080/09513590802246364. |
| 23979952 | Result | Omoto A, Kurimoto C, Minagawa M, Shozu M. A case of fetal goiter that resolved spontaneously after birth. J Clin Endocrinol Metab. 2013 Oct;98(10):3910-1. doi: 10.1210/jc.2013-1066. Epub 2013 Aug 26. No abstract available. |