DOI: https://doi.org/10.22141/2224-0721.15.2.2019.166102

Analysis of the prevalence of thyroid pathology during gestation among women from Lviv region

B.R. Grytsyshyn

Abstract


Background. The unified theory of iodine deficiency does not provide a comprehensive coverage of the etiological and pathogenetic essence of goiter transformation. It was found that in areas with the same level of iodine deficiency, there is often a different incidence of goiter in pregnant women, and in one region, the incidence is recorded only among a part of women, with different degrees of thyroid gland enlargement. The purpose of the study is to establish the frequency of thyroid diseases in pregnant women who live in Lviv region, as well as factors affecting the nature of thyroid pathology development during gestation. Materials and me­thods. The prevalence of thyroid diseases in pregnant women in Lviv region was monitored for the period from 2010 to 2015. In addition, statistical data on the frequency and structure of thyroid pathology among pregnant women, the characteristics of the pregnancy course, childbirth, and the condition of newborns according to the data of maternity wards of Lviv Regional Clinical Hospital were studied. To clarify the structure of prevalence and quantitative nosological distribution of thyroid pathology among pregnant women, a statistical analysis of birth histories provided by maternity wards (department of extragenital pathology and department of pathological pregnancy) for the 2015 was conducted. Results. Monitoring the mountainous areas of Lviv region indicates an increase in the frequency of thyroid pathology in pregnant women, specifically in the mountainous areas with iodine deficiency (Sambir), and a significant increases in the industrial foothill ­areas (Stryi) and Lviv. When evaluating the frequency of thyroid diseases in pregnant women from Lviv region, a lack of an effective system for iodine prophylaxis was detected, which is characterized by an increase in thyropathy in absolute values from 1500–2000 cases in 2010 to 5000–6000 cases in 2015 (almost 2.5­fold increase). Conclusions. Climate­geographical, socio­economic, environmental, industrial features of Lviv region increase the severity of goiter endemia, affect the nature of the development and epidemiological parameters of thyroid pathology among pregnant women, lead to an increase in the frequency of pathological course of gestation, childbirth, deterioration of physical and intellectual development of children.


Keywords


thyroid gland; iodine deficiency; pregnancy; childbirth

References


Ma ZF, Skeaff SA. Assessment of population iodine status. In: Pearce EN, editor. Iodine Deficiency Disorders and Their Elimination. Cham, Switzerland: Springer International Publishing; 2017. 15-28 pp.

Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: A review. Am J Clin Nutr. 2009 Feb;89(2):668S-72S. doi: 10.3945/ajcn.2008.26811C.

Counts D, Varma SK. Hypothyroidism in children. Pediatr Rev. 2009 Jul;30(7):251-8. doi: 10.1542/pir.30-7-251.

World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination : a guide for programme managers, 3rd ed. Geneva, Switzerland: WHO Press; 2007.

Christensen-Adad FC, Mendes-dos-Santos CT, Goto MM, et al. Neonatal screening: 9% of children with filter paper thyroid-stimulating hormone levels between 5 and 10 μiu/ml have congenital hypothyroidism. J Pediatr (Rio J). 2017 Nov - Dec;93(6):649-654. doi: 10.1016/j.jped.2017.05.003.

Deladoëy J, Van Vliet G. The changing epidemiology of congenital hypothyroidism: Fact or artifact? Expert Rev Endocrinol Metab. 2014 Jul;9(4):387-395. doi: 10.1586/17446651.2014.911083.

Hashemipour M, Dehkordi EH, Hovsepian S, Amini M, Hosseiny L. Outcome of congenitally hypothyroid screening program in Isfahan: Iran from prevention to treatment. Int J Prev Med. 2010 Spring;1(2):92-7.

Mehrnejat N, Yazdanpanah H, Fadaei Nobari R, et al. Spatial analysis of neonatal congenital hypothyroidism and nitrate as an environmental pollutant in Isfahan province during 2010–2013. Int J Prev Med. 2015 Aug 14;6:76. doi: 10.4103/2008-7802.162952.

Delshad H, Amouzegar A, Mirmiran P, Mehran L, Azizi F. Eighteen years of continuously sustained elimination of iodine deficiency in the Islamic Republic of Iran: The vitality of periodic monitoring. Thyroid. 2012 Apr;22(4):415-21. doi: 10.1089/thy.2011.0156.

Nazeri P, Mirmiran P, Mehrabi Y, Hedayati M, Delshad H, Azizi F. Evaluation of iodine nutritional status in Tehran, Iran: Iodine deficiency within iodine sufficiency. Thyroid. 2010 Dec;20(12):1399-406. doi: 10.1089/thy.2010.0085.

Myroniuk NI, Turchyn VI, Luzanchuk IA. Prevalence and incidence of diffuse and nodular goiter in children and adults in western region of Ukraine. Lvivskyy medychnyy chasopys. 2004;10(1):70-75. (in Ukrainian).

Delshad H, Touhidi M, Abdollahi Z, Hedayati M, Salehi F, Azizi F. Inadequate iodine nutrition of pregnant women in an area of iodine sufficiency. J Endocrinol Invest. 2016 Jul;39(7):755-62. doi: 10.1007/s40618-016-0438-4.

De Benoist B, McLean E, Andersson M, Rogers L. Iodine deficiency in 2007: Global progress since 2003. Food Nutr Bull. 2008 Sep;29(3):195-202. doi: 10.1177/156482650802900305.

Vanderpump MP, Lazarus JH, Smyth PP, et al. Iodine status of UK schoolgirls: A cross-sectional survey. Lancet. 2011 Jun 11;377(9782):2007-12. doi: 10.1016/S0140-6736(11)60693-4.

Ma ZF, Venn BJ, Manning PJ, Cameron CM, Skeaff SA. Iodine supplementation of mildly iodine-deficient adults lowers thyroglobulin: A randomized controlled trial. J Clin Endocrinol Metab. 2016 Apr;101(4):1737-44. doi: 10.1210/jc.2015-3591.

Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American thyroid association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011 Oct;21(10):1081-125. doi: 10.1089/thy.2011.0087.




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© "Publishing House "Zaslavsky", 1997-2019

 

   Seo анализ сайта