The Joint Role of Iodine Status and Thyroid Function on Risk for Preeclampsia in Finnish Women: a Population-Based Neste
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The Joint Role of Iodine Status and Thyroid Function on Risk for Preeclampsia in Finnish Women: a Population-Based Nested Case-Control Study Elijah C. Reische 1 & Tuija Männistö 2 & Alexandra Purdue-Smithe 1 & Kurunthachalam Kannan 3 & Un-Jung Kim 4 & Eila Suvanto 2 & Heljä-Marja Surcel 5,6 & Mika Gissler 7,8 & James L. Mills 1 Received: 21 May 2020 / Accepted: 9 August 2020 # This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2020
Abstract Preeclampsia, a pregnancy disorder that includes hypertension and proteinuria, is a major cause of maternal and fetal morbidity and mortality. Some studies, but not all, have found that women with preeclampsia have significantly lower iodine levels than healthy pregnant women. Resolving this issue is important because iodine deficiency in pregnancy is common in the USA and parts of Europe including Finland. We conducted a nested case-control study to determine whether the risk for preeclampsia is associated with iodine status. We measured serum iodine, thyroglobulin (Tg), and thyroid stimulating hormone (TSH) at 10–14 weeks gestational age in 204 women with preeclampsia and 246 unaffected controls selected from all births in Finland. We found no significant difference in iodine (case mean = 26.04 ng/mL, control mean = 27.88 ng/mL, p = 0.995), Tg (case mean = 31.11 ng/mL, control mean = 29.61 ng/mL, p = 0.996), and TSH (case mean = 1.30 mIU/L, control mean = 1.24 mIU/L, p = 0.896) levels between cases and controls. There was no significant relationship between preeclampsia risk and iodine, Tg, or TSH after adjustment for known risk factors. These results are reassuring given the high prevalence of iodine deficiency in pregnancy. Keywords Preeclampsia . Iodine . Thyroid hormones . Thyroid stimulating hormone . Thyroglobulin . Pregnancy
Introduction * James L. Mills [email protected] 1
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
2
Northern Finland Laboratory Center NordLab, Oulu University Hospital, 90120 Oulu, Finland
3
Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
4
Department of Earth and Environmental Sciences, University of Texas at Arlington, Arlington, TX 76019, USA
5
Biobank Borealis of Northern Finland, Oulu University Hospital, 90120 Oulu, Finland
6
Faculty of Medicine, University of Oulu, 90120 Oulu, Finland
7
Finnish Institute of Health and Welfare, 00290 Helsinki, Finland
8
Karolinska Institute, 17177 Stockholm, Sweden
Preeclampsia is a disorder of pregnancy characterized by placental and vascular abnormalities that can lead to multi-organ system dysfunction, pre-term delivery, and fetal or maternal death [1]. It is clinically defined by a combination of newonset hypertension and either proteinuria or organ dysfunction [1]. Preeclampsi
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