title: High prevalence of thyroid dysfunction among pregnant women in Lubumbashi, Democratic Republic of Congo.
abstract: BACKGROUND
  Despite notable progress in the fight against iodine deficiency disorders in the Democratic Republic of Congo, a recent study has shown that pregnant women in Lubumbashi were still iodine deficient. Our objective was to assess thyroid function in this population.
  
  
  METHODS
  In a cross-sectional study conducted in maternity units from three different socioeconomic areas in Lubumbashi, serum thyrotropin, free thyroxine, thyroglobulin, and thyroperoxidase antibodies were measured in 225 pregnant women attending antenatal visits, in 75 women who recently delivered, and in 75 nonpregnant controls. The outcome was the prevalence of thyroid dysfunction.
  
  
  RESULTS
  Median values in pregnant women, women who recently delivered, and nonpregnant women were 1.80, 2.80, and 1.54 mIU/L for thyrotropin (p<0.001); 0.85, 1.11, and 1.16 ng/dL for free thyroxine (p<0.001); and 13.3, 9.5, and 10.4 ng/mL for thyroglobulin (p=0.01), respectively. The prevalence of thyroid dysfunction in pregnant women, in women who recently delivered, and in nonpregnant women was 31%, 8%, and 20% for isolated hypothyroxinemia (p<0.001); 12%, 24%, and 5% for subclinical hypothyroidism (p=0.002); 8%, 3%, and 3%, for overt hypothyroidism (p=0.09); and 5%, 13%, and 4%, for positive thyroperoxidase antibodies (p=0.03), respectively. In multiple logistic regression, women who were pregnant or who recently delivered, who lived in a poor socioeconomic area, and who had low urinary iodine concentration were more likely to have an increased serum thyrotropin: odds ratio (OR)=3.43 (95% confidence interval [CI] 1.23-9.53) for pregnancy, OR=4.49 [CI 1.66-15.01] for postpartum period, OR=3.68 [CI 1.85-7.35] for semiurban area, and OR=0.44 [CI 0.19-0.96] for urinary iodine concentration ≥ 250 μg/L.
  
  
  CONCLUSIONS
  Our results show that there is a high prevalence of thyroid dysfunction in pregnant women of Lubumbashi, and this high prevalence is associated with iodine deficiency. To prevent obstetrical adverse outcomes and neurological damage in children, iodine supplementation is needed before conception or in early pregnancy in Lubumbashi.
authors: 1 Division of Epidemiology and Biostatistics, Institute of Experimental and Clinical Research, Catholic University of Louvain , Brussels, Belgium .
authors: Laurence
authors: L
authors: Habimana
authors: Kabange E
authors: KE
authors: Twite
authors: Chantal
authors: C
authors: Daumerie
authors: Pierre
authors: P
authors: Wallemacq
authors: Philippe
authors: P
authors: Donnen
authors: Muenze K
authors: MK
authors: Kalenga
authors: Annie
authors: A
authors: Robert
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D013954:Thyroglobulin / Q000097:blood; D013959:Thyroid Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine
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