Thyroid status during pregnancy and post partum in regions of iodine deficiency and endemic goiter.
During pregnancy the thyroid is subjected to increased demands which is associated with a tendency to endogenous iodine deficiency. Under the conditions of insufficient iodine supply in the GDR the pathophysiological changes result in: 1. prevalence of goiter in about 60% of pregnant women; 2. enlargement of the extent of neck in more than 50% of all pregnant women examined only returning to the prepregnant status in 25%-40%; 3. prevalence of goiter in newborn with 5%; 12.8% of 1948 stilborn had macroscopically an enlarged thyroid gland, the highest weight being 45 g. More than 53% of the stilborn examined by autopsy had a thyroid weight of over 3 g; 4. in contrast to the regions with sufficient iodine supply renal iodine excretion was steadily decreasing during pregnancy and post partum, changing the iodine deficiency from grade II to grade III; 5. low iodine excretion in newborn: 1.3 +/- 0.2 microgram I/day in goitrous (1.2 +/- 0.2 nmol I/mmol creatinine) 2.2 +/- 0.4 micrograms I/day in non-goitrous (2.0 +/- 0.4 nmol I/mmol creatinine); 6. according to ETR more than 50% of the pregnant examined showed a hypothyroid tendency. The pathophysiological changes during pregnancy caused by insufficient iodine supply can be met efficiently by careful thyroid hormone treatment or by the administration of 150 micrograms I daily. A mandatory iodine salt prophylaxis is demanded.
D000293:Adolescent; D000328:Adult; D003404:Creatinine / Q000652:urine; D005260:Female; D005859:Germany, East; D006043:Goiter, Endemic / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D007455:Iodine / Q000008:administration & dosage / Q000172:deficiency* / Q000652:urine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D011644:Puerperal Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D012965:Sodium Chloride / Q000008:administration & dosage; D017673:Sodium Chloride, Dietary; D013961:Thyroid Gland / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000627:therapeutic use
D017673:Sodium Chloride, Dietary; D013963:Thyroid Hormones; C034024:iodized salt; D012965:Sodium Chloride; D007455:Iodine; D003404:Creatinine