Correlation Analysis Of Iodine Intervention In Pregnant Womenwith Adverse Pregnancy Outcomes And The Incidence Ofabnormal Neonatal TSH Levels

Objective :To investigate the correlation between urinary iodine levels in pregnant women and adverse pregnancy outcomes and the incidence of abnormal neonatal TSH levels.Methods : A total of 302 pregnant women with abnormal urinary iodine levels in early pregnancy who underwent physical examination and delivered in Hefei First People’s Hospital and Medical Union Hospital in August 2020 and December 2021 were selected.The intervention group was randomly divided into a control group(n=159) and an intervention group(n=143).The intervention group was provided a dietary intervention,mainly by increasing or decreasing the intake of seafood(mainly kelp and laver)to maintain the appropriate level of iodine;and the control group did not receive an iodine nutritional intervention.The incidence of adverse pregnancy outcomes and neonatal TSH(thyroid stimulating hormone)levels were compared between the two groups after delivery.The influencing factors rela Ted to adverse pregnancy outcomes were analyzed.Results: There was no statistically significant difference in urinary iodine levels between the intervention group and the control group before the intervention(P<0.05),indicating that the two groups were comparable.Urinary iodine levels were significantly different after the intervention(P<0.05).The incidence of adverse pregnancy outcomes was 3.5% in the intervention group and 25.2% in the control group,macrosomia and premature infants accounted for 11.9% and 5.0%,respectively.There were statistically significant differences in the incidence of adverse pregnancy outcomes between the intervention group and the control group(P< 0.05).The incidence of abnormal TSH levels was 2.8% in the intervention group and 8.2% in the control group,with a significant difference between the two groups(P< 0.05).The reference range of neonatal TSH levels was provided by the new screening laboratory of Hefei Women and Children’s Health Center.Binary logistic regression analysis of the influencing factors of adverse pregnancy outcomes,showed that urinary iodine in pregnant women(OR=0.352,95% CI:0.215-0.577)and mode of delivery(OR=8.733,95% CI:: 4.139～18.426)and red blood cell count(OR=1.123,95% CI:1.007～1.252) were independent influencing factors.Conclusion: The maintenance of an appropriate iodine level during pregnancy is closely related to pregnancy outcome and neonatal TSH levels.Maternal iodine intervention can significantly reduce the incidence of abnormal pregnancy and neonatal TSH abnormalities,thereby reducing the incidence of thyroid diseases.At the same time,it is necessary to promote pregnant women’s awareness of self-health care,increase the frequency of prenatal examinations,support the maintenance of appropriate iodine nutrition status,and reduce the occurrence of childbirth complications and adverse pregnancy outcomes.