韶关市不同孕期孕妇尿碘水平调查

Investigation of urinary iodine levels in pregnant women during different pregnant gestation in Shaoguan

目的调查韶关市孕妇孕早期、孕中期和孕晚期尿碘水平,探讨孕妇尿碘筛查的时机和指导科学补碘。方法采用单纯随机抽样法抽取韶关市孕妇462例,其中孕早期166例,孕中期88例,孕晚期208例,收集尿样进行尿碘检测,并追踪妊娠结局。结果 462例孕妇尿碘中位数为182.69μg/L,处于WHO推荐的适宜水平。其中碘适量占23.38%,碘缺乏及碘过量分别占40.48%和18.61%。孕早期、孕中期碘缺乏率引起不良妊娠结局高于孕晚期差异无统学意义(P>0.05),孕早期及孕中期比较差异无统计学意义(P>0.05)。妊娠结局正常组孕晚期尿碘分级≥500μg/L孕妇比例明显高于妊娠结局异常组,差异有统计学意义(P<0.05)。结论通过监测孕妇尿碘,使其在适宜范围内,可使补碘的收益大于其危害,减少不良妊娠结局的发生。

Objective To investigate the relationship between the maternal urinary iodine levels and pregnancy outcomesat early pregnancy, second trimester and third trimester, and explore the best time for screening urine iodine and the guidanceof iodine intake. Methods A total of 462 pregnant women were sampled by the simple random sampling method, and inwhich there were 166 cases of early pregnancy, 88 cases of second trimester, 208 cases of third trimester. The urine samplesfrom all the pregnant women were collected and detected for the urine iodine levels regularly and the pregnancy outcomes werefinally tracked. Results The urinary iodine median concentration of the 462 pregnant women was 182.69 μg/L which was inthe appropriate range of WHO recommendation. Totally 23.38% of those women were iodine normal, but 40.48% and 18.61%were iodine deficiency and excess respectively. The normal rates of pregnancy outcomes at the early pregnancy and secondtrimester were lower than the rate at the third trimester, and therefore the abnormal rates of pregnancy outcomes at the earlypregnancy and second trimester were higher than the rate at the third trimester, but the difference was not statisticallysignificant（P〉0.05）. The proportion of urine iodine grading ≥500 μg/L of the pregnant women at the third pregnancytrimester in the normal pregnancy outcome group was significantly higher than that in the abnormal pregnancy outcome group,and the difference was statistically significant（P〈0.05）. Conclusion The slight and moderate iodine deficiency may have anegative effect on pregnant women and fetus, but adding iodine may not really have a positive effect on pregnant women andfetus. However, the urinary iodine monitoring for pregnant women in the appropriate range can make the benefits greater thanthe harm in order to correctly have iodine supplement to reduce the adverse pregnancy outcomes.