Keywords
preeclampsia
pregnancy
Abstract
Preeclampsia (PE) is one of the leading causes of perinatal and maternal morbidity. Although subclinical hypothyroidism in pregnancy is one of the established risk factors for PE, the link between iodine deficiency and PE is not fully understood. The aim of our study was to assess urinary iodine concentration (UIC), serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) levels in Polish women with PE (PE group, n=78) compared with healthy non-pregnant women (CNP group, n=30), and healthy pregnant women (CP group, n=46). The UIC was determined by inductively coupled plasma mass spectrometry (ICP-MS). Both the mean UIC of 144.6±36.4 μg/L in the CP group and the mean of 125.8±33.6 μg/L in the PE group, respectively, were lower compared to non-pregnant women (149.8±28.8 μg/L), and the difference between the PE and CNP groups was statistically significant. TSH values were the highest in the PE group, while the lowest average level was for the CNP group. The fT3 and fT4 values in the PE group were significantly lower compared to the CNP and CP groups. Despite iodine supplementation during pregnancy, the UIC was lower compared to non-pregnant women, while in women with PE it was at a significantly lower level. To reduce the incidence of possible health complications, proper iodine supplementation and monitoring of the UIC is recommended for pregnant women suffering from PE or at risk of developing PE.References
1. Amaral LM, Wallace K, Owens M, Lamarca B. Pathophysiology and current clinical management of preeclampsia. Curr Hypertens Rep. 2017;19(61):19-21.
2. The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin number 202: Gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133(1):el-e325.
3. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia : pathophysiology and clinical implications. BMJ. 2019;366:12381.
4. Aouache R, Biquard L, Vaiman D, Miralles F. Oxidative stress in preeclampsia and placental diseases. Int J Mol Sci. 2018;19:1496.
5. Bustan-Nahumson M, Bornstein S, Feldstein O, Levy M, Schreiber L, Bar J, et al. Preeclampsia in different maternal age groups – is there an association with pregnancy outcomes and placental pathology ? Reprod Sci. 2020;27:1879-87.
6. Armaly Z, Jadaon JE, Jabbour A, Abassi ZA. Preeclampsia : Novel mechanisms and potential therapeutic approaches. Front Physiol. 2018;9:1-15.
7. English FA, Kenny LC, Mccarthy FP. Risk factors and effective management of preeclampsia. Integr Blood Press Control. 2015;8:7-12.
8. Lisonkova S, Joseph KS. Incidence of preeclampsia: Risk factors and outcomes associated with early – versus late-onset disease. Am J Obstet Gynecol. 2013;209(6):544.e1-544.e12.
9. Businge CB, Madini N, Longo-mbenza B, Kenge A P. Insufficient iodine nutrition status and the risk of pre-eclampsia : A protocol for systematic review and meta-analysis. BMJ Open. 2019;9 (e025573).
10. Businge CB, Longo-Mbenza B, Adeniyi OV, Babeki VN, Kaboka AK, Muaka MM, et al. Iodine deficiency in pregnancy as a predictor of sub-clinical hypothyroidism, preeclampsia and future cardiovascular disease. Asian J Clin Nutr. 2017;9(3):118-23.
11. Cuellar-Rufino S, Navarro-Meza M, Garcia-Solis P, Xochihua-Rosas I, Arroyo-Helguera O. Iodine levels are associated with oxidative stress and antioxidant status in pregnant women with hypertensive disease. Nutr Hosp. 2017;34(3):661-6.
12. Aceves C, Anguiano B, Delgado G. The extrathyronine actions of Iodine as antioxidant, apoptotic and differentiation factor in various tissues. Thyroid. 2013;23(8):938-46.
13. Lazarus JH. Iodine Status in Europe in 2014. Eur Thyroid J. 2014;3: 3-6.
14. Harding K, Peña-rosas J, Webster A, Yap C, Payne B, Ota E, et al. Iodine supplementation for women during the preconception, pregnancy and postpartum period (Review). Cochrane Database Syst Rev. 2017;(3):CD011761.
15. Błażewicz A, Makarewicz A, Korona-Glowniak I, Dolliver W, Kocjan R. Iodine in autism spectrum disorders. J Trace Elem Med Biol. 2016;34:32-7.
16. Melse-Boonstra A, Gowachirapant S, Jaiswal N, Winichagoon P, Srinivasan K, Zimmermann MB. Iodine supplementation in pregnancy and its effect on child cognition. J Trace Elem Med Biol. 2012;26:134-6.
17. Iodine in pregnancy and lactation. WHO: Geneva, Switzerland; 2017.
18. Urinary iodine concentrations for determining iodine status deficiency in populations. Vitamin and Mineral Nutrition Information System. WHO: Geneva, Switzerland; 2013.
19. Gulaboglu M, Borekci B, Delibas I. Urine iodine levels in preeclamptic and normal pregnant women. Biol Trace Elem Res. 2010;136(3):249-57.
20. Borekci B, Gulaboglu M, Gul M. Iodine and magnesium levels in maternal and umbilical cord blood of preeclamptic and normal pregnant women. Biol Trace Elem Res. 2009;129:1-8.
21. Gulaboglu M, Borekci B, Halici Z. Placental tissue iodine level and blood magnesium concentration in pre‐eclamptic and normal pregnancy. Int J Gynaecol Obstet. 2007;98:100-4.
22. Reische EC, Männistö T, Purdue-smithe A, Kannan K, Kim U, Suvanto E, et al. The joint role of Iodine status and thyroid function on risk for preeclampsia in finnish women : A population-based nested case-control study. Biol Trace Elem Res. 2021;199:2131-7 .
23. Iodine Global Network. Global Scorecard of Iodine Nutrition in 2017 in the general population and in pregnant women (PW). National Center for Enviromentental Health: Zurich, Switzerland; 2017.
24. American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’s Task Force of Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31.
25. Makhmudov AA, Caldwell KL. The Challenge of iodine deficiency disorder. A decade of CDC’s Ensuring the Quality of Urinary Iodine Procedures Program. National Center for Enviromentental Health: Zurich, Switzerland; 2011:52-9.
26. Zimmer M, Sieroszewski P, Oszukowski P, Huras H, Fuchs T, Pawłosek A. Rekomendacje Polskiego Towarzystwa Ginekologów i Położników dotyczące suplementacji u kobiet ciężarnych. GiPP. 2020;5(4):170-181.
27. Gietka-Czernel M. Profilaktyka niedoboru jodu – Iodine prophylaxis. Post Nauk Med. 2015;XXVIII(12):839-45.
28. Springer D, Jiskra J, Limanova Z, Zima T, Springer D, Jiskra J, et al. Thyroid in pregnancy: From physiology to screening. Crit Rev Clin Lab Sci. 2017;54(2):102-16.
29. Nwabuobi C, Arlier S, Schatz F, Guzeloglu-Kayisli O. hCG: Biological Functions and Clinical Applications. Int J Mol Sci. 2017;18:2037.
30. Pessah-Pollack R, Eschler DC, Pozharny Z, Davies T. Apparent insufficiency of iodine supplementation in pregnancy. J Women’s Health. 2014;23(1):51-6.
31. Bath SC, Furmidge-Owen VL, Redman CWG, Rayman MP. Gestational changes in iodine status in a cohort study of pregnant women from the United Kingdom: season as an effect modifier. Am J Clin Nutr. 2015;101:1180-7.
32. Sattar R, Ahmed E, Abbasi SQ. Thyroid hormones pattern in preeclampsia. Annals KEMU. 2018;24:863-6.
33. Muraleedharan N, Janardhanan JS. Thyroid hormone status in preeclampsia patients: A case – control study. J Res Med Sci. 2017;8: 68-73.
34. Khanam M, Ilias M. Study of thyroid hormonal status in preeclamptic patients. Med Today. 2013;25(02):63-6.
35. Gargari SS, Fateh R, Bakhshali-bakhtiari M, Saleh M, Mirzamoradi M, Bakhtiyari M. Maternal and neonatal outcomes and determinants of iodine deficiency in third trimester of pregnancy in an iodine sufficient area. BMC Pregnancy and Childbirth. 2020;20(174):1-9.
36. Yang J, Liu Y, Liu H, Zheng H, Li X, Zhu L, et al. Associations of maternal iodine status and thyroid function with adverse pregnancy outcomes in Henan Province of China. J Trace Elem Med Biol. 2018; 47:104-10.
37. Medici M, Korevaar TIM, Schalekamp-Timmermans S, Gaillard R, Rijke YB De, Visser WE, et al. Maternal early-pregnancy thyroid function is associated with subsequent hypertensive disorders of pregnancy: The generation R study. J Clin Endocrinol Metab. 2014; 99(12):e2591-8.
38. Lai H, Zhan Z, Liu H. Association between thyroid hormone parameters during early pregnancy and gestational hypertension: a prospective cohort study. J Intern Med. 2020;48(2):1-7.
39. Czerwińska E. Ocena spożycia jodu i sodu przez kobiety ciężarne. GiPP. 2018;3(1):10-5.
40. Szybiński Z. Sytuacja profilaktyki jodowej w Polsce w świetle ostatnich rekomendacji WHO dotyczących ograniczenia spożycia soli. Pediatr Endocrinol Diabetes Metab. 2009;15(2):103-7.
41. Zygmunt A, Adamczewski Z, Zygmunt A, Adamczewska K, Trofimiuk-Muldner M, Hubalewska-Dydejczyk A, et al. Ocena skuteczności profilaktyki jodowej w ciąży – analiza przeprowadzona w jednym z referencyjnych ośrodków. Endokrynol Pol. 2015; 66(5):404-11.
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