File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Goitrogenesis during pregnancy and neonatal hypothyroxinaemia in a borderline iodine sufficient area

TitleGoitrogenesis during pregnancy and neonatal hypothyroxinaemia in a borderline iodine sufficient area
Authors
Issue Date2000
PublisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0300-0664
Citation
Clinical Endocrinology, 2000, v. 53 n. 6, p. 725-731 How to Cite?
AbstractOBJECTIVE: Severe iodine deficiency disorders (IDDs) may have been eradicated in many parts of the world, but milder forms still exist and may escape detection. We evaluated the impact of pregnancy on the maternal and fetal thyroid axis in Hong Kong, a coastal city in southern China with borderline iodine intake. DESIGN: A prospective study performed in a maternity hospital. PATIENTS: Two hundred and thirty pregnant women were prospectively studied and their neonates assessed at birth. MEASUREMENTS: Urine iodine concentration, thyroid function tests and thyroid volume (TV) by ultrasound were determined in the mothers during pregnancy and up to 3 months postpartum and in the neonates. RESULTS: Increased urinary iodine concentration was seen from first trimester onwards and the proportion of women having urine iodine concentration of < 0.4 μmol/l decreased from 11.3% in the first trimester to 4.7% in the third trimester. There was progressive reduction in circulating fT4 and fT3 concentrations and free thyroxine index (FTI) with increasing gestation and the percentage of women having subnormal levels at term were 53.2%, 61.1% and 4.8%, respectively. The serum TSH concentration during pregnancy doubled towards term. In the first trimester, multiparous women had significantly larger TV than the nulliparous women (P < 0.001). By the third trimester, TV had increased by 30% (range 3-230%) so that the goitre incidence was 14.1%, 21.8%, 25.9% during the three trimesters of pregnancy, and 24.3% and 21.9% at 6 weeks and 3 months postpartum (ANOVA, P < 0.05). The change in thyroid volume during pregnancy correlated positively with the change in thyroglobulin (r = 0.225, P < 0.002) and negatively with urinary iodine concentration (r = -0.149, P < 0.02). Fourteen women with excessive thyroidal stimulation in the second trimester (defined as those with thyroglobulin (Tg) concentrations in the highest tertile and FTI in the lowest tertile) were found to have lower urine iodine concentrations and larger TV (both P < 0.005) throughout pregnancy, and their neonates had higher cord TSH (P < 0.05), Tg (P < 0.05) and slightly larger TV (P = 0.06) as compared to the findings in 216 pregnant women without evidence of thyroid stimulation. Seven neonates (50%) born to these women had subnormal fT4 levels at birth. CONCLUSION: In a borderline iodine sufficient area, pregnancy posed an important stress resulting in higher rates of maternal goitrogenesis as well as neonatal hypothyroxinaemia and hyperthyrotrophinaemia. An adequate iodization program is necessary to eliminate iodine deficiency disorders during pregnancy.
Persistent Identifierhttp://hdl.handle.net/10722/77512
ISSN
2015 Impact Factor: 3.487
2015 SCImago Journal Rankings: 1.314
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorLao, TTen_HK
dc.contributor.authorChau, MTen_HK
dc.contributor.authorTam, SCFen_HK
dc.contributor.authorLow, LCKen_HK
dc.date.accessioned2010-09-06T07:32:42Z-
dc.date.available2010-09-06T07:32:42Z-
dc.date.issued2000en_HK
dc.identifier.citationClinical Endocrinology, 2000, v. 53 n. 6, p. 725-731en_HK
dc.identifier.issn0300-0664en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77512-
dc.description.abstractOBJECTIVE: Severe iodine deficiency disorders (IDDs) may have been eradicated in many parts of the world, but milder forms still exist and may escape detection. We evaluated the impact of pregnancy on the maternal and fetal thyroid axis in Hong Kong, a coastal city in southern China with borderline iodine intake. DESIGN: A prospective study performed in a maternity hospital. PATIENTS: Two hundred and thirty pregnant women were prospectively studied and their neonates assessed at birth. MEASUREMENTS: Urine iodine concentration, thyroid function tests and thyroid volume (TV) by ultrasound were determined in the mothers during pregnancy and up to 3 months postpartum and in the neonates. RESULTS: Increased urinary iodine concentration was seen from first trimester onwards and the proportion of women having urine iodine concentration of < 0.4 μmol/l decreased from 11.3% in the first trimester to 4.7% in the third trimester. There was progressive reduction in circulating fT4 and fT3 concentrations and free thyroxine index (FTI) with increasing gestation and the percentage of women having subnormal levels at term were 53.2%, 61.1% and 4.8%, respectively. The serum TSH concentration during pregnancy doubled towards term. In the first trimester, multiparous women had significantly larger TV than the nulliparous women (P < 0.001). By the third trimester, TV had increased by 30% (range 3-230%) so that the goitre incidence was 14.1%, 21.8%, 25.9% during the three trimesters of pregnancy, and 24.3% and 21.9% at 6 weeks and 3 months postpartum (ANOVA, P < 0.05). The change in thyroid volume during pregnancy correlated positively with the change in thyroglobulin (r = 0.225, P < 0.002) and negatively with urinary iodine concentration (r = -0.149, P < 0.02). Fourteen women with excessive thyroidal stimulation in the second trimester (defined as those with thyroglobulin (Tg) concentrations in the highest tertile and FTI in the lowest tertile) were found to have lower urine iodine concentrations and larger TV (both P < 0.005) throughout pregnancy, and their neonates had higher cord TSH (P < 0.05), Tg (P < 0.05) and slightly larger TV (P = 0.06) as compared to the findings in 216 pregnant women without evidence of thyroid stimulation. Seven neonates (50%) born to these women had subnormal fT4 levels at birth. CONCLUSION: In a borderline iodine sufficient area, pregnancy posed an important stress resulting in higher rates of maternal goitrogenesis as well as neonatal hypothyroxinaemia and hyperthyrotrophinaemia. An adequate iodization program is necessary to eliminate iodine deficiency disorders during pregnancy.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0300-0664en_HK
dc.relation.ispartofClinical Endocrinologyen_HK
dc.rightsClinical Endocrinology. Copyright © Blackwell Publishing Ltd.en_HK
dc.subject.meshAnalysis of Varianceen_HK
dc.subject.meshCase-Control Studiesen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFetal Blood - chemistryen_HK
dc.subject.meshGoiter - epidemiology - ultrasonography - urineen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshInfant, Newbornen_HK
dc.subject.meshIodine - deficiency - urineen_HK
dc.subject.meshParityen_HK
dc.subject.meshPostpartum Perioden_HK
dc.subject.meshPregnancyen_HK
dc.subject.meshPregnancy Complications - epidemiology - ultrasonography - urineen_HK
dc.subject.meshPregnancy Trimestersen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshThyroglobulin - blooden_HK
dc.subject.meshThyroid Function Testsen_HK
dc.subject.meshThyroid Gland - ultrasonographyen_HK
dc.subject.meshThyrotropin - blooden_HK
dc.subject.meshThyroxine - blood - deficiencyen_HK
dc.subject.meshTriiodothyronine - blooden_HK
dc.titleGoitrogenesis during pregnancy and neonatal hypothyroxinaemia in a borderline iodine sufficient areaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0300-0664&volume=53&spage=725&epage=731&date=2000&atitle=Goitrogenesis+during+pregnancy+and+neonatal+hypothyroxinaemia+in+a+borderline+iodine+sufficient+areaen_HK
dc.identifier.emailKung, AWC: awckung@hku.hken_HK
dc.identifier.emailLow, LCK: lcklow@hkucc.hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.identifier.authorityLow, LCK=rp00337en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1365-2265.2000.01156.xen_HK
dc.identifier.pmid11155095-
dc.identifier.scopuseid_2-s2.0-0034490935en_HK
dc.identifier.hkuros56567en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034490935&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume53en_HK
dc.identifier.issue6en_HK
dc.identifier.spage725en_HK
dc.identifier.epage731en_HK
dc.identifier.isiWOS:000166797400011-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridLao, TT=7005722132en_HK
dc.identifier.scopusauthoridChau, MT=7006073758en_HK
dc.identifier.scopusauthoridTam, SCF=7202037323en_HK
dc.identifier.scopusauthoridLow, LCK=7007049461en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats