Resumo:
During the pregnancy, due to several physiological questions, it occurs an
increase of 50-70% in the daily iodine nutritional demand. Low iodine ingestion during
pregnancy might cause goiter, cretinism, intellectual disorder, growth retardation, neonatal
hypothyroidism and increase of abortion risk. In Brazil, the level of salt iodization for human
consumption was reduced to 15-45mg/kg in 2013 and scarses analysis indicate a prevalence
between 20-57% of iodine deficiency (ID) in the pregnant women population. Disorders
related to the nutritional iodine status could highly contribute to the additional increment in
the risk of health problems related to high risk pregnancy. Objective: to analyse the iodine
nutritional status of in high risk pregnancy women (HRPW) assisted at Reference Maternity
Professor José Maria de Magalhães Netto, Salvador, Bahia. Methods: transversal study of
241 HRPW and 50 low risk pregnancy women (LRPW) as a group of control. Some aspects
were evaluated: urine iodine concentration (UIC), socioeconomic, demographic,
anthropometric and health data. Results: in the HRPW, the average age was 28,66±7,15 years
old, 68,5% were in the third quarter of pregnancy, furthermore 77,241(32,5%) had high blood
pressure and 41/241 (17 %) had diabetes; Indeed, 53% (n=128) were on a salt/iodine
restriction diet (IRD) and 41,9% (n=101) had overweight or obesity before pregnancy. The
median UIC was 119μg/L (percentile 25-75 th: 58,7-200,4μg/L),with mean of
140,6±104μg/L. indicating insufficient iodine ingestion. 61,8% (n=149) presented UIC
below 150μg/L. The prevalence of slight, moderate and severe ID were 18,3%, 24,5% e
19,15, respectively. None of HRPW showed excess of iodine ingestion. The mean UIC in
first trimester was 164,62±103,29μg/L (adequate), while pregnant women on second and third
trimester presented mean UIC of 140,5±98,84μg/L and 139,14±107,07μg/L, respectively.,
indicating ID. Hypertensive HRPW (n=77) showed mean UIC of 122,93 ±111,80μg/L vs.
149,90±100,39μg/L in non hypertensive women (p=0,011). Family income superior to two
minimum salary lead to protection against ID [OR 2,142 (0,990-4,634)], (p=0,009). There
was an eminent risk of ID in patients under IRD [OR=1,82 ;IC:(1,073-0,88)], (p=0,026); and
twice higher risk in hypertensive HRPW [OR=2,127(1,178-3,829); p=0,011)]. Conclusion:
We observed a high prevalence of ID (61,8%) in HRPW analysed at Maternity José Maria de
Magalhães Netto, with median UIC of 119μg/L, indicating ID. 19,1% of the HRPW presented
severe ID. High blood pressure and iodine restriction diet were important risk factors
associated to ID. These data alert to the urgent need for a national and detailed Brazilian
pregnant women's iodine nutritional status evaluation.
