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Risk of Iodine Deficiency in Extremely Low Gestational Age Newborns on Parenteral Nutrition

Neelakanta Kanike1, Sharon Groh-Wargo1, Megan Thomas2

  • 1Department of Pediatrics, Division of Neonatology, Case Western Reserve University, Metro Health Medical Center, Rm C.G75, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.

Nutrients
|June 5, 2020
PubMed

Insights

Iodine deficiency is common in pregnant women and extremely low gestational age newborns (ELGAN). ELGAN on parenteral nutrition (PN) are at risk for hypothyroidism, highlighting the need for iodine supplementation.

Area of Science:

  • Endocrinology
  • Neonatology
  • Nutritional Science

Background:

  • Iodine is essential for thyroid hormone synthesis, crucial for neurodevelopment.
  • Routine iodine status assessment is lacking in pregnant women and newborns.
  • Extremely Low Gestational Age Newborns (ELGAN) on parenteral nutrition (PN) do not receive iodine supplementation.

Purpose of the Study:

  • To assess iodine status and thyroid function in mother-infant dyads.
  • To evaluate iodine levels in breast milk and PN.
  • To correlate iodine status with thyroid function in ELGAN.

Main Methods:

  • Measured urine iodine and thyroid function tests (free T4, TSH, thyroglobulin) in 50 mother-infant dyads.
  • Sampled at birth, 1 week, 1, 2, 3 months, and near discharge.
  • Analyzed iodine content in milk and PN; correlated maternal/neonatal iodine with thyroid function.

Main Results:

  • 64% of mothers were iodine deficient at delivery; ELGAN showed transiently high iodine levels post-exposure.
  • ELGAN on PN developed iodine deficiency and elevated thyroglobulin by 1 month.
  • Iodine levels improved with enteral feeding by 2 months; PN-exposed ELGAN had significantly higher iodine than full-term infants.

Conclusions:

  • Iodine deficiency is prevalent in pregnant women and ELGAN.
  • ELGAN on PN are at high risk for iodine deficiency and subsequent hypothyroidism.
  • Consideration of iodine supplementation during pregnancy and postnatally is recommended.

Keywords:
extremely low gestation age neonatesmaternal iodine deficiencyneonatal iodine deficiencysubclinical hypothyroidismtotal parenteral nutrition

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