Charles Bitamazire Businge

Walter Sisulu University, South Africa

Title: Iodine deficiency in pregnancy, along a concentration gradient, is associated with increased severity of preeclampsia in rural Eastern Cape, South Africa

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Biography

Charles Bitamazire Businge (MMed Obstetrics and Gynaecology, Makerere University; PhD in Medicine, University of Cape Town) is a senior lecturer in Obstetrics and Gynaecology at Walter Sisulu University, South Africa. His research niche is the pathophysiology, prevention, screening, early detection, and mitigation of chronic non-communicable diseases among women and their progeny.

Abstract

Background: Preeclampsia is a leading cause of maternal mortality and morbidity in South Africa. Iodine deficiency in pregnancy, which is amenable to correction through iodine supplementation, has been reported to increase the risk of preeclampsia. However, the association of iodine nutrition status with preeclampsia in South Africa has not been studied.

Methods: Fifty-one randomly selected normotensive pregnant controls at term, together with 51 consecutively selected cases of preeclampsia and 51 cases with severe preeclampsia/eclampsia, all in the third trimester, were enrolled at the Mthatha Regional and Nelson Mandela Academic Hospitals in the Eastern Cape Province, South Africa. The urinary iodine concentration (UIC), serum thyroid-stimulating hormone (TSH), triiodothyronine (FT3), thyroxine (FT4), and thyroglobulin (Tg) levels were compared between cases and controls.

Results: The median values for normotensive, preeclampsia and severe preeclampsia/eclampsia participants were: age (yrs) 23, 24 and 19 p= 0.001; UIC (?g/L) 217.1,127.7, and 98.8 p=0.005; Tg (?g/L) 19.4, 21.4, and 32.9 p=0.001; FT4 (pmol/L) 14.2, 13.7, and 12.8 p=0.005; FT3 (pmol//L) 4.8, 4.4, and 4.0, p=0.001; TSH (mIU/L) 2.3, 2.3, and 2.5 p=0.661). UIC < 100 ?g/L, Tg > 20?g/L, and FT4 < 12 pmol/L were independent predictors of preeclampsia.

Conclusion: women with preeclampsia/eclampsia had significantly lower UIC and higher Tg, suggesting protracted inadequate iodine intake that was also associated with lower levels of thyroid hormones. Inadequate iodine intake during pregnancy, severe enough to significantly lead to elevated Tg and or diminished FT4, was associated with increased risk of severe preeclampsia.