Gestational changes of thyroid function and urinary iodine in thyroid antibody-negative Japanese women

Iodine is an essential nutrient for thyroid hormone synthesis, and iodine deficiency especially in pregnant and lactating women results in serious damage to their infants. To characterize iodine nutrition throughout gestation by using a food frequency questionnaire (FFQ) and urinary iodine concentration (UIC) measurement, and to establish appropriate gestational age-specific reference ranges for serum TSH and FT4 in thyroid autoantibody (ThAb) negative euthyroid Japanese women, a total number of 563 pregnant women including 422 subjects with negative ThAbs, 105 postpartum women and their 297 newborn infants were included in the study. Dietary iodine intake (DII) was evaluated by FFQ. Serum TSH, FT4 and UIC were sequentially determined in the three trimesters of pregnancy and at the 31st postpartum day. The overall median UICs throughout pregnancy and in the postpartum period were 224.0 and 135.0 mu g/L, respectively, suggesting sufficient iodine nutrition. The median DII was 842.4 mu g/day in pregnant women. In the longitudinal study, the median UIC in the first trimester (215.9 mu g/L) significantly decreased in the second trimester (136.0 mu g/L). The prevalence of pregnant women with a UIC below 150 mu g/L was 31.6% and that in lactating women with a UIC below 100 mu g/L was 33.3%. The pattern of gestational change in serum TSH and FT4 was comparable to that in iodine-sufficient areas. A substantial percentage of women might be at risk for iodine deficiency if there is a restriction of iodine-rich foods. However, iodine supplementation for pregnant women must be carefully balanced against the risk of iodine excess particularly in Japan. Further research in larger samples is needed.