Status of iodine in rural pregnant women of different trimesters in Lucknow-A cross-sectional study

Background and objectives: Iodine plays a critical role in fetal brain development and hence has immense importance during pregnancy. Even mild to moderate iodine deficiency in pregnancy has adverse effects on obstetric and neonatal outcome. So, the aim of this study was to assess the trimester-wise urinary iodine status of pregnant women in rural areas and determine their iodine intake. Methods: A cross-sectional study was conducted in Sarojini nagar, which is a rural block of Lucknow, Uttar Pradesh from August 2016 to July 2017. All married pregnant women (15-45 years) of different trimesters attending the primary health centre (PHC) for antenatal check-up were enrolled in the study after written consent. Total 300 pregnant women were interviewed for Knowledge, Attitude and Practice (KAP) survey. Urine and salt sample was taken from 200 of them for biochemical analysis of iodine. Estimation of iodine in urine was done by wet digestion method and in salt by iodometric titration. Results: The median urinary iodine concentration of the rural pregnant women was 246.5 mu g/L with IQR of 194.9-383.4 mu g/L. On comparing the urine iodine levels in the three trimesters, maximum deficiency was observed in first trimester (39.5%) followed by third trimester (31.6%) and a dip was seen in the second trimester (28.9%). The median urinary iodine levels did not show a significant difference across the three trimesters. Conclusion: Iodine insufficiency was observed among pregnant women. Maximum deficiency was observed in first trimester which is the most vulnerable period of gestation responsible for organogenesis and fetal brain development.