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Iodine supplementation in women of reproductive age: a survey of clinical practice among Italian gynecologists and midwives

  • M. L. TandaEmail author
  • C. Cusini
  • A. Colombo
  • P. Premoli
  • S. Rosetti
  • A. Cromi
  • E. Piantanida
  • L. Bartalena
Comment

Synthesis of maternal thyroid hormones, necessary for healthy development of central nervous system of the fetus, increases in pregnancy by approximately 50% because of several mechanism that, since the earliest phase modify thyroid homeostasis (e.g,. increased levels of serum thyroxine-binding globulin due to the increase in estrogen levels, stimulation of TSH receptors by human chorionic gonadotropin, increased urinary loss of iodine). In addition, because of the increased renal iodine excretion and fetal iodine need (after the 18th week of gestation), dietary iodine requirements are higher in pregnancy than they are for non-pregnant adult.

Thus, for both maternal and fetal/neonatal regular thyroid function, it is necessary to replete intrathyroidal iodine stores by an adequate iodine supply, throughout pregnancy and breastfeeding. The best strategy to prevent (in iodine-replete areas) or to correct (in iodine-insufficient areas) iodine deficiency in pregnancy, and its negative...

Keywords

Iodine Thyroid Pregnancy Reproduction Clinical practice 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

This paper did not require approval by the Ethics Committee.

Informed consent

This paper did not involve patients.

References

  1. 1.
    Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S (2017) 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 27:315–389CrossRefGoogle Scholar
  2. 2.
    Rotondi M, Chiovato L, Pacini F, Bartalena L, Vitti P (2018) Management of subclinical hypothyroidism in pregnancy: a comment from the Italian Society of Endocrinology and the Italian Thyroid Association to the 2017 American Thyroid Association guidelines—“The Italian Way”. Thyroid 28(5):551–555CrossRefGoogle Scholar
  3. 3.
    De Leo S, Pearce EN, Braverman L (2017) Iodine supplementation in women during preconception, pregnancy, and lactation: current clinical practice by US obstetricians and midwives. Thyroid 27:434–439CrossRefGoogle Scholar
  4. 4.
    Olivieri A, Vitti P (2014) Attività di monitoraggio del programma nazionale per la prevenzione dei disordini da carenza iodica. Rapporti ISTISAN 14:6Google Scholar
  5. 5.
    Moleti M, Di Bella B, Giorgianni G, Mancuso A, De Vivo A, Alibrandi A, Trimarchi F, Vermiglio F (2011) Maternal thyroid function in different conditions of iodine nutrition in pregnant women exposed to mild-moderate iodine deficiency: a pilot study. Clin Endocrinol (Oxf) 74:762–768CrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2019

Authors and Affiliations

  • M. L. Tanda
    • 1
    Email author
  • C. Cusini
    • 1
  • A. Colombo
    • 1
  • P. Premoli
    • 1
  • S. Rosetti
    • 1
  • A. Cromi
    • 2
  • E. Piantanida
    • 1
  • L. Bartalena
    • 1
  1. 1.Endocrine Unit, Department of Medicine and Surgery, Ospedale di CircoloASST dei Sette Laghi, University of InsubriaVareseItaly
  2. 2.Department of Obstetrics and Gynecology, “Filippo Del Ponte” HospitalUniversity of InsubriaVareseItaly

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