Status of iodine deficiency among pregnant mothers in Himachal Pradesh, India

Objective: Iodine is an essential micronutrient needed for the production of thyroid hormones. Pregnant mothers who are deficient in iodine provide less iodine to the fetal thyroid. This results in low production of thyroid hormones by the fetal thyroid, thereby leading to compromised mental and physical development of the fetus. The current study aimed to assess the current status of iodine nutrition among pregnant mothers in Himachal Pradesh, India, a known endemic region for iodine deficiency. Design: Three districts, namely Kangra, Kullu and Solan, were selected. Setting: In each district, thirty clusters (villages) were identified by utilizing the population-proportional-to-size cluster sampling methodology. In each cluster, seventeen pregnant mothers attending the antenatal clinics were included. Subjects: A total of 1711 pregnant mothers (647 from Kangra, 551 from Kullu and 513 from Solan) were studied. Clinical examination of the thyroid of each pregnant mother was conducted. Spot urine samples were collected from ten pregnant mothers in each cluster. Similarly, salt samples were collected from eleven pregnant mothers in each cluster. Results: Total goitre rate was 42.2% (Kangra), 42.0% (Kullu) and 19.9% (Solan). The median urinary iodine concentration was 200mg/l (Kangra), 149 mg/l (Kullu) and 130mg/l (Solan). The percentage of pregnant mothers consuming adequately iodized salt (iodine content of 15 ppm and more) was found to be 68.3% (Kangra), 60.3% (Kullu) and 48.5% (Solan). Conclusion: Pregnant mothers in Kullu and Solan districts had iodine deficiency as indicated by a median urinary iodine concentration less than 150mg/l.