title: Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey.
abstract: BACKGROUND
  A recent study showed first sign of reduction in goiter prevalence and elimination of iodine deficiency state among school-age children in Turkey after a decade of mandatory iodination of table salt. However, iodine status among pregnant women is a still debated issue in our country.
  
  
  OBJECTIVE
  To investigate iodine status, iodized salt consumption rate, and goiter prevalence in 1st trimester pregnant women 8 yr after the mandatory iodination. MATERIAL/ SUBJECTS AND METHODS: One hundred and forty-one 1sttrimester pregnant women who had been followed-up between January and October 2006 in the obstetric outpatient clinics in Turkey were included. Besides a physical examination, subjects underwent laboratory investigations for free T(3), free T(4), and urinary iodine concentration (UIC). All subjects completed a questionnaire regarding sociodemographic parameters, use of iodized salt, and pregnancy history. Goiter status was revealed by a palpation method according to World Health Organization (WHO) guidelines.
  
  
  RESULTS
  In this study, we found that the median UIC of pregnant women was 149.7 microg/l (range 20.9-275.1 microg/l). Almost half of the subjects were below the WHO, United Nations Children's Fund, and International Council for the Control of Iodine Deficiency Disorders lower median reference limits of 150 microg/l. Total goiter prevalence was 24.8%, of which 9.2% were visible goiters. Among the study patients, 2.1% had subclinical hypothyroidism, and 0.7% had overt hypothyroidism. The rate for iodized salt use among the pregnant women was 95%.
  
  
  CONCLUSIONS
  Our study revealed that iodine deficiency still remains a serious problem for pregnant women. Based on our results, antenatal follow-up protocols in the primary care setting in Turkey must include iodine supplementation.
authors.affiliation: Department of Family Medicine, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Kut
authors.forename: A
authors.initials: A
authors.lastname: Gursoy
authors.forename: S
authors.initials: S
authors.lastname: Senbayram
authors.forename: N
authors.initials: N
authors.lastname: Bayraktar
authors.forename: I Irem
authors.initials: II
authors.lastname: Budakoğlu
authors.forename: H S
authors.initials: HS
authors.lastname: Akgün
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006042:Goiter / Q000453:epidemiology; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology*; D007455:Iodine / Q000008:administration & dosage / Q000172:deficiency* / Q000652:urine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage*; D013974:Thyroxine / Q000378:metabolism; D014284:Triiodothyronine / Q000378:metabolism; D014421:Turkey / Q000453:epidemiology
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D014284:Triiodothyronine; D007455:Iodine; D013974:Thyroxine