Thyroglobulin levels among iodine deficient pregnant women living in Northern Ireland

Background Iodine deficiency has re-emerged among pregnant cohorts in the UK. Thyroglobulin (Tg) is a protein produced uniquely by the thyroid gland which appears to mount a U-shaped response to extremes of iodine status. Tg has been suggested as an alternative marker for chronic iodine deficiency but the value of Tg in pregnancy has not been fully elucidated. A recent non-European study suggested a median Tg <= 10 mu g/L with 44 mu g/L was indicative of sufficiency in the second trimester of pregnancy. Methods We measured serum Tg levels in each trimester in 241 pregnant women living in Northern Ireland, a population with mild iodine deficiency at all stages of pregnancy as defined by urinary iodine concentration (UIC) and iodine: creatinine ratio (ICR). Women with Tg antibodies (6% in 1st trimester) were excluded. Results The median UIC in this cohort was in the deficient range at 73, 94 and 117 mu g/L in sequential trimesters (adequacy >= 150 mu g/L). Corresponding median Tg levels were 19, 16 and 16 mu g/L respectively. Median Tg for all samples was 17 mu g/L (IQR 11-31) suggestive of iodine deficiency. Tg was >44 mu g/L in 14.3%, 9.4% and 12.4% of women in sequential trimesters respectively. Women with either UIC/ICR below the cut-offs 150 mu g/L and 150 mu g/g creatinine had higher Tg concentrations in 1st and 2nd trimester (p < 0.01; p < 0.001) but not in 3rd trimester. Conclusion This study adds to the evolving evidence that Tg measurement is of value in reflecting iodine status in pregnancy.

Automated summary

This study adds to the growing evidence that Tg measurement is valuable in reflecting iodine status in pregnancy.