Prevalence of iodine deficiency and goitre during pregnancy in east Hungary

Objective: To assess the iodine nutritional status and the prevalence of go itre during pregnancy in a region of Hungary that appeared to be iodine suf ficient in previous studies. Design: A cross-sectional voluntary screening study was organized in which 313 pregnant women participated. Methods: Urine iodine concentration and the volume of the thyroid gland wer e measured in every woman. In the presence of low urinary iodine concentrat ions, goitre, or both, thyroid function tests were performed. Results: Iodine deficiency was found in 57.1% of the pregnant women, and wa s severe in 15.6%. The volume of the thyroid gland was enlarged in 19.2% of individuals. Nodular goitre was found in 17 women (5.4%). The frequency of goitre and the mean thyroid volume were increased in the group of iodine-d eficient women. In the 89 cases of iodine deficiency or goitre, thyrotrophi n concentrations were in the normal range: however, the free triiodothyroni ne:free throxine ratio was increased in 97% of them, indicating that the th yroid gland was in a stimulated state in these individuals. Conclusions: Iodine deficiency with high prevalence of goitre was recognize d among pregnant women in an area that previously appeared to be iodine suf ficient. An unexpected mild iodine deficiency was also noted in the non-pre gnant control group. Reassessment and continuous monitoring of iodine nutri tional status is warranted even in populations that are apparently consider ed to be 'at no risk' of iodine deficiency, especially in pregnant women. R egular administration of iodine, starting at preconception or in early preg nancy and continuing during the period of nursing, is recommended in these regions.