A Study On The Urinary Iodine And Thyroid Function During Pregnancy

Objective:1. To explore the urinary iodine level and thyroid function of pregnant women in Fujian province from 2015 to 2016.2. To establish a reference range for thyroid function in pregnant women during pregnancy.3. To explore the relationship between the rate of abnormal thyroid function and the urinary iodine level of pregnant women.4. To explore the influencing factors of abnormal thyroid function.Methods:We took a typical survey in Fujian province and sampled the inland areas in Mingxi and the coastal areas in Zhaoan as a survey point. Since May 2015 to March 2016 we investigate 303 pregnant women,each trimester 101 women in Mingxi,and 520 pregnant women,first trimester 171,second trimester 179 and third trimester 170 women in Zhaoan.We conducted a questionnaire on the participants, and collected random three urine samples and blood samples for text.We do as the arsenic cerium catalytic spectrophotometric method" (WS/T 107-2006) to detect urinary iodine content. Access2 immunoassay (CLIA) detect thyroid function in serum. Data was inputted by Epidata3.0 with double data in real time, then set up the database. We used the SPSS18.0 software to statistics data.Results:1. The study investigated a total of 824 pregnant women,303 in Mingxi inland areas and 521 in Zhaoan coastal areas.We investigated 271(32.9%) first trimester, the second 280(34%) and the third 272 (33%) women, the mean age of the volunteer was 28.09 ±4.43 years old, the average gestational age was 20.39 ± 10.44 week.2. The median urinary iodine concentration is 118.7 Ug/L, Mingxi inland areas women median urinary iodine concentration was 148.25 Ug/L, Zhaoan coastal areas women median urinary iodine concentration was 108.47 Ug/L, Mingxi pregnant women has a higher urinary iodine level than Zhaoan pregnant women.(P<0.05).3. (1)The first trimester raferance range for thyroid indicaters: TSH:0.8(0.11-3.44)uIU/mL, TG:7.98(1.06-53.10)ng/mL, FT3: 4.24(3.17-5.31)pmol/L,FT4:11.52(8.38-19.90)pmol/L,TT3:1.99(1.12-2.92)nmol /L, TT4:130.71(85.66-206.67)nmol/L?(2)The second trimester raferance range for thyroid indicaters: TSH:1.11(0.05-4.05)uIU/mL, TG:7.08(1.12-34.04)ng/mL, FT3: 33.74(2.69-4.83)pmol/L,FT4:9.36(7.01-12.90)pmol/L,TT3:1.98(0.89-3.05)nmol /L, TT4:116.25(64.21-178.34)nmol/L?(3)The third trimester raferance range for thyroid indicaters: TSH:1.14(0.04-3.86)uIU/mL, TG:8.65(1.42-36.94)ng/mL, FT3: 3.59(2.79-4.70)pmol/L,FT4:8.62(6.24-11.79)pmol/L,TT3:2.01(0.78-2.99)nmol/ L, TT4:116.78(53.03-195.30)nmol/L?4. In the frist trimester the TSH showed an upward trend, then sustaind a stable level.FT3 and FT4 trend downward throughout the whole pregnancy. TT4 showed an downward trend in the frist trimester then sustaind a stable leveL5. Among 719 volunteers,there were 179(24.9%) women detected thyroid dysfunction,11(1.5%)women detected hyperthyroidism,19(2.6%) subclinical hyperthyroidism,17(2.4%) subclinical hypothyroidism,15(2%) low T4,79(10.4%) TPOAb positive,56(7.4%) TgAb positive.Zaoan pregnant women got a higher hyperthyroidism and subclinical hyperthyroidism rate than Mingxi pregnant women.P<0.05.6. The MUI difference between normal pregnant women and thyroid dysfunction women is not statistically significant. Different urine iodine level (0?100?g/L, 100?150?g/L,150?250?g/L,250?500?g/L,500??g/L) got no effect on thyroid function detection. UIC got no diagnostic value for different types of thyroid dysfunction..The median e24-UIE in subclinical hyperthyroidism women was lower than normal women, Median e24-UIE in low T4 women is higher than normal women.E24-UIE got diagnostic value for hyroid dysfunction, clinical and subclinical hyperthyroidism,low T4, the cut-off point of diagnosis these disases was 122.25, 132.23,155.54?g/day?7. Gestation and e24-UIE can effect the thyroid function detection result.and gestation also can make effect on clinical and subclinical hyperthyroidism detection. Age can effect the TPOAb and low T4 detection result.Conlusion:1. The urinary iodine level among pregnant women in the inland areas is higher than pregnant women in coastal areas.2. The pregnant women in this study get proper state of iodine nutrition.3. The thyroid disfunction rate of pregnant women in this study is close to thyroid disfunction rate in proper iodine area.4. The study Established the different trimesters raferance range for thyroid indicaters successfully.5. In iodine sufficient area different urine iodine concentration pregnant women get no differ thyroid function, The criterion of WHO recommended that urine iodine cncentation 150?250?g/L for pregnant women is not proper for all women.6. Age, Gestation, e24-UIE can effect the thyroid function detection.