Application of povidone-iodine at delivery significantly increases maternal urinary iodine but not neonatal thyrotropin in an area with iodine sufficiency
-
Majid Valizadeh
,
Pantea Nazeri
Abstract
Background:
The aim of the present study was to investigate the effect of povidone-iodine (PVP-I) application at delivery on maternal urinary iodine concentration (UIC) and neonatal thyrotropin concentration.
Methods:
In this cross-sectional study, urine samples were collected from each pregnant woman after admission to the hospital and before routine application of the PVP-I for delivery preparation and after delivery at time of screening for congenital hypothyroidism. A heel-prick blood sample was taken from all newborns.
Results:
A total of 394 pregnant women at time of delivery participated in this study. Median (interquartile range [IQR]) maternal UIC values were 120 (105–157) and 253 (126–470) μg/L before and after delivery, respectively (p<0.001). No significant correlations were observed between maternal UIC before and after delivery and neonatal thyrotropin levels.
Conclusions:
Application of PVP-I significantly increased UIC in postpartum mothers; however, thyrotropin concentration in neonates, whose mothers had adequate UIC, was within the normal range.
Acknowledgments
This study was supported by financial grant from Zanjan University of Medical Sciences.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Ethical statements: The authors hereby affirm that the manuscript has not been submitted to more than one journal for simultaneous consideration and that the manuscript has not been published previously. This manuscript is not split up into several parts to increase the quantity of submissions and submitted to various journals or to one journal over time. No data have been fabricated or manipulated to support our conclusions.
References
1. Zimmermann MB. The role of iodine in human growth and development. Semin Cell Dev Biol 2011;22:645–52.10.1016/j.semcdb.2011.07.009Search in Google Scholar PubMed
2. Delange F. The role of iodine in brain development. Proc Nutr Soc 2000;59:75–9.10.1017/S0029665100000094Search in Google Scholar PubMed
3. Delange F. Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition. Public Health Nutr 2007;10:1571–80; discussion 81–3.10.1017/S1368980007360941Search in Google Scholar PubMed
4. Laurberg P, Andersen S, Bjarnadottir RI, Carle A, Hreidarsson A, et al. Evaluating iodine deficiency in pregnant women and young infants-complex physiology with a risk of misinterpretation. Public Health Nutr 2007;10:1547–52; discussion 53.10.1017/S1368980007360898Search in Google Scholar PubMed
5. Chen W, Sang Z, Tan L, Zhang S, Dong F, et al. Neonatal thyroid function born to mothers living with long-term excessive iodine intake from drinking water. Clin Endocrinol 2015;83:399–404.10.1111/cen.12625Search in Google Scholar PubMed
6. Fuse Y, Ohashi T, Yamaguchi S, Yamaguchi M, Shishiba Y, et al. Iodine status of pregnant and postpartum Japanese women: effect of iodine intake on maternal and neonatal thyroid function in an iodine-sufficient area. J Clin Endocrinol Metab 2011;96:3846–54.10.1210/jc.2011-2180Search in Google Scholar PubMed
7. Nishiyama S, Mikeda T, Okada T, Nakamura K, Kotani T, et al. Transient hypothyroidism or persistent hyperthyrotropinemia in neonates born to mothers with excessive iodine intake. Thyroid 2004;14:1077–83.10.1089/thy.2004.14.1077Search in Google Scholar PubMed
8. Li M, Eastman CJ. Neonatal TSH screening: is it a sensitive and reliable tool for monitoring iodine status in populations? Best Pract Res Clin Endocrinol Metab 2010;24:63–75.10.1016/j.beem.2009.08.007Search in Google Scholar PubMed
9. Ordookhani A, Pearce EN, Mirmiran P, Azizi F, Braverman LE. The effect of type of delivery and povidone-iodine application at delivery on cord dried-blood-specimen thyrotropin level and the rate of hyperthyrotropinemia in mature and normal-birth-weight neonates residing in an iodine-replete area: report of Tehran Province, 1998–2005. Thyroid 2007;17:1097–102.10.1089/thy.2007.0058Search in Google Scholar PubMed
10. Tahirovic H, Toromanovic A, Grbic S, Bogdanovic G, Fatusic Z, et al. Maternal and neonatal urinary iodine excretion and neonatal TSH in relation to use of antiseptic during caesarean section in an iodine sufficient area. J Pediatr Endocrinol Metab 2009;22:1145–9.10.1515/JPEM.2009.22.12.1145Search in Google Scholar PubMed
11. Brown RS, Bloomfield S, Bednarek FJ, Mitchell ML, Braverman LE. Routine skin cleansing with povidone-iodine is not a common cause of transient neonatal hypothyroidism in North America: a prospective controlled study. Thyroid 1997;7:395–400.10.1089/thy.1997.7.395Search in Google Scholar PubMed
12. Kislal F, Cetinkaya S, Dilmen U, Yasar H, Tezic T. Cord blood thyroid-stimulating hormone and free T4 levels in Turkish neonates: is iodine deficiency still a continuing problem? Pediatr Int 2010;52:762–8.10.1111/j.1442-200X.2010.03169.xSearch in Google Scholar PubMed
13. Hedayati M, Khazan M, Yaghmaee P, Yeghaneh MZ, Behdadfar L, et al. Rapid microwave digestion and microplate reading format method for urinary iodine determination. Clin Chem Lab Med 2011;49:281–4.10.1515/CCLM.2011.053Search in Google Scholar PubMed
14. World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. 2007. Available at: whqlibdoc.who.int/publications/2007/9789241595827_eng.pdf.Search in Google Scholar
15. Nohr SB, Laurberg P. Opposite variations in maternal and neonatal thyroid function induced by iodine supplementation during pregnancy. J Clin Endocrinol Metab 2000;85:623–7.10.1210/jc.85.2.623Search in Google Scholar
16. Sukkhojaiwaratkul D, Mahachoklertwattana P, Poomthavorn P, Panburana P, Chailurkit LO, et al. Effects of maternal iodine supplementation during pregnancy and lactation on iodine status and neonatal thyroid-stimulating hormone. J Perinatol 2014;34:594–8.10.1038/jp.2014.62Search in Google Scholar PubMed
17. Oltarzewski M, Szymborski J. Neonatal hypothyroid screening in monitoring of iodine deficiency and iodine supplementation in Poland. J Endocrinol Invest 2003;26:27–31.Search in Google Scholar
18. Domenech Martinez E, Barroso Guerrero F. Utility of congenital hypothyroidism screening in neonates for monitoring iodine deficit disorders in the Canary Islands (Spain). An Pediatr (Barc) 2003;58:357–63.Search in Google Scholar
19. Yaman AK, Demirel F, Ermis B, Piskin IE. Maternal and neonatal urinary iodine status and its effect on neonatal TSH levels in a mildly iodine-deficient area. J Clin Res Pediatr Endocrinol 2013;5:90–4.10.4274/Jcrpe.997Search in Google Scholar PubMed PubMed Central
20. Evans C, Barry Nix A, Hillier S, Moat SJ. Neonatal blood TSH concentration in Wales (UK): an indicator of iodine sufficiency. Clin Endocrinol (Oxf) 2014;81:606–9.10.1111/cen.12474Search in Google Scholar PubMed
21. Luton D, Alberti C, Vuillard E, Ducarme G, Oury JF, et al. Iodine deficiency in northern Paris area: impact on fetal thyroid mensuration. PLoS One 2011;6:e14707.10.1371/journal.pone.0014707Search in Google Scholar PubMed PubMed Central
22. Travers CA, Guttikonda K, Norton CA, Lewis PR, Mollart LJ, et al. Iodine status in pregnant women and their newborns: are our babies at risk of iodine deficiency? Med J Aust 2006;184:617–20.10.5694/j.1326-5377.2006.tb00417.xSearch in Google Scholar PubMed
23. Vandevijvere S, Coucke W, Vanderpas J, Trumpff C, Fauvart M, et al. Neonatal thyroid-stimulating hormone concentrations in Belgium: a useful indicator for detecting mild iodine deficiency? PLoS One 2012;7:e47770.10.1371/journal.pone.0047770Search in Google Scholar PubMed PubMed Central
24. Delshad H, Amouzegar A, Mirmiran P, Mehran L, Azizi F. Eighteen years of continuously sustained elimination of iodine deficiency in the Islamic Republic of Iran: the vitality of periodic monitoring. Thyroid 2012;22:415–21.10.1089/thy.2011.0156Search in Google Scholar PubMed
25. Chan LY, Chiu PY, Lau TK. Cord blood thyroid-stimulating hormone level in twin pregnancy. Acta Obstet Gynecol Scand 2003;82:28–31.10.1034/j.1600-0412.2003.820105.xSearch in Google Scholar PubMed
26. Konrade I, Dambrova M, Makrecka M, Neimane L, Strele I, et al. Seasonal iodine deficiency in Latvian school children. Thyroid 2012;22:1088–9.10.1089/thy.2011.0506Search in Google Scholar PubMed
27. Rezaeian S, Moghimbeigi A, Esmailnasab N. Gender differences in risk factors of congenital hypothyroidism: an interaction hypothesis examination. Int J Endocrinol Metab 2014;12:e13946.10.5812/ijem.13946Search in Google Scholar PubMed PubMed Central
28. Snitzer JL. Maternal and fetal thyroid function. N Engl J Med 1995;332:613–4.10.1056/NEJM199503023320919Search in Google Scholar PubMed
29. Clapin H, Lewis BD, Greed L, Dawkins H, O’Leary P. Factors influencing neonatal thyroid-stimulating hormone concentrations as a measure of population iodine status. J Pediatr Endocrinol Metab 2014;27:101–6.10.1515/jpem-2013-0189Search in Google Scholar PubMed
30. Ng SM, Wong SC, Paize F, Chakkarapani E, Newland P, et al. Multivariate analyses of factors that affect neonatal screening thyroid stimulating hormone. J Pediatr Endocrinol Metab 2011;24:727–32.10.1515/JPEM.2011.234Search in Google Scholar PubMed
31. Herbstman J, Apelberg BJ, Witter FR, Panny S, Goldman LR. Maternal, infant, and delivery factors associated with neonatal thyroid hormone status. Thyroid 2008;18:67–76.10.1089/thy.2007.0180Search in Google Scholar PubMed
32. Rashmi, Seth A, Sekhri T, Agarwal A. Effect of perinatal factors on cord blood thyroid stimulating hormone levels. J Pediatr Endocrinol Metab 2007;20:59–64.10.1515/JPEM.2007.20.1.59Search in Google Scholar
33. Andersson M, de Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition Iodine deficiency as a cause of brain damage The role of iodine in brain development. Public Health Nutr 2007;10:1606–11.10.1017/S1368980007361004Search in Google Scholar PubMed
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Original Articles
- Standard body mass index reference data of prepubescent diabetic Egyptian children
- Frequency and risk factors of depression in type 1 diabetes in a developing country
- Association of obesity and health related quality of life in Iranian children and adolescents: the Weight Disorders Survey of the CASPIAN-IV study
- Association between urinary phthalates and metabolic abnormalities in obese Thai children and adolescents
- A pilot study of the effect of human breast milk on urinary metabolome analysis in infants
- Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio?
- Cardiovascular and metabolic risk in pediatric patients with congenital adrenal hyperplasia due to 21 hydroxylase deficiency
- Application of povidone-iodine at delivery significantly increases maternal urinary iodine but not neonatal thyrotropin in an area with iodine sufficiency
- Influence of topical iodine-containing antiseptics used during delivery on recall rate of congenital hypothyroidism screening program
- Applying targeted next generation sequencing to dried blood spot specimens from suspicious cases identified by tandem mass spectrometry-based newborn screening
- Short Communication
- Initial patient choice of a growth hormone device improves child and adolescent adherence to and therapeutic effects of growth hormone replacement therapy
- Case Reports
- An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm
- Fetal goitrous hypothyroidism treated by intra-amniotic levothyroxine administration: case report and review of the literature
- Carotid intima media thickness in a girl with sitosterolemia carrying a homozygous mutation in the ABCG5 gene
- Sirolimus in the treatment of three infants with diffuse congenital hyperinsulinism
Articles in the same Issue
- Frontmatter
- Original Articles
- Standard body mass index reference data of prepubescent diabetic Egyptian children
- Frequency and risk factors of depression in type 1 diabetes in a developing country
- Association of obesity and health related quality of life in Iranian children and adolescents: the Weight Disorders Survey of the CASPIAN-IV study
- Association between urinary phthalates and metabolic abnormalities in obese Thai children and adolescents
- A pilot study of the effect of human breast milk on urinary metabolome analysis in infants
- Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio?
- Cardiovascular and metabolic risk in pediatric patients with congenital adrenal hyperplasia due to 21 hydroxylase deficiency
- Application of povidone-iodine at delivery significantly increases maternal urinary iodine but not neonatal thyrotropin in an area with iodine sufficiency
- Influence of topical iodine-containing antiseptics used during delivery on recall rate of congenital hypothyroidism screening program
- Applying targeted next generation sequencing to dried blood spot specimens from suspicious cases identified by tandem mass spectrometry-based newborn screening
- Short Communication
- Initial patient choice of a growth hormone device improves child and adolescent adherence to and therapeutic effects of growth hormone replacement therapy
- Case Reports
- An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm
- Fetal goitrous hypothyroidism treated by intra-amniotic levothyroxine administration: case report and review of the literature
- Carotid intima media thickness in a girl with sitosterolemia carrying a homozygous mutation in the ABCG5 gene
- Sirolimus in the treatment of three infants with diffuse congenital hyperinsulinism
