title: Maternal Iodine Exposure: A Case of Fetal Goiter and Neonatal Hearing Loss.
abstract: A 27-year-old gravid 1 at 27 weeks 6 days with a history of hypothyroidism had an ultrasound that demonstrated a 3.9 × 3.2 × 3.3-cm well-circumscribed anterior neck mass, an extended fetal head, and polyhydramnios. Further characterization by magnetic resonance imaging (MRI) showed a fetal goiter. During her evaluation for the underlying cause of the fetal goiter, the patient revealed she was taking nutritional iodine supplements for treatment of her hypothyroidism. She was ingesting 62.5 times the recommended amount of daily iodine in pregnancy. The excessive iodine consumption caused suppression of the fetal thyroid hormone production, resulting in hypothyroidism and goiter formation. After the iodine supplement was discontinued, the fetal goiter decreased in size. At delivery, the airway was not compromised. The infant was found to have reversible hypothyroidism and bilateral hearing loss postnatally. This case illustrates the importance of examining for iatrogenic causes for fetal anomalies, especially in unregulated nutritional supplements.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Reproductive Medicine, and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia rachael.overcash@gmail.com.
authors.forename: Rachael T
authors.initials: RT
authors.lastname: Overcash
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of California San Diego, San Diego, California; and.
authors.forename: Krishelle L
authors.initials: KL
authors.lastname: Marc-Aurele
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Reproductive Medicine, and.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hull
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Reproductive Medicine, and.
authors.forename: Gladys A
authors.initials: GA
authors.lastname: Ramos
mesh_terms: D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006042:Goiter / Q000139:chemically induced*; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy*; D007231:Infant, Newborn; D007455:Iodine / Q000009:adverse effects* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D018811:Maternal Exposure; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011296:Prenatal Diagnosis; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000196:embryology; D013972:Thyrotropin / Q000097:blood; D014463:Ultrasonography
chemical_list: D013972:Thyrotropin; D007455:Iodine