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Iodine Metabolism and Thyroid Function During the Perinatal Period: Maternal-Neonatal Correlation and Effects of Topical Povidone-Iodine Skin Disinfectants

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Abstract

An adequate maternal iodine intake during pregnancy and lactation is essential for growth and mental development in fetuses and newborns. There are limited data on perinatal iodine metabolism in mothers and infants, as well as the effect of povidone-iodine (PVP-I) antiseptics used in cesarean delivery. The urinary iodine concentration (UIC), serum iodine, thyrotropin (TSH), free thyroxine (FT4), and breast milk iodine concentration (BMIC) were measured consecutively in a total of 327 mothers and 249 term-infants in two prospective studies. The maternal median UIC was 164 μg/L in the third trimester, increased to 256 μg/L at 44 h after birth, and then decreased to 116 μg/L 1 month later. The BMIC on the 4th and 32th postpartum days was 17.6 and 13.5 μg/100 g, respectively. In neonatal infants born to the mothers unexposed to PVP-I, the median UIC was 131 μg/L in the first voiding urine and increased to 272 μg/L on day 4 and then slightly decreased to 265 μg/L on day 28 suggesting sufficient iodine reserve at birth. PVP-I antiseptics containing 1 g of iodine for skin preparation at cesarean delivery transiently increased maternal serum iodine concentration (1.9-fold), UIC (7.8-fold) at 41 h after surgery and BMIC, while it had little effect on maternal TSH, FT4, and neonatal UIC, TSH, or FT4. The iodine status of pregnant women and their infants was adequate in this population; however, the UIC in lactating mothers at one postpartum month was low enough to suggest iodine deficiency or near iodine deficiency. Further studies are necessary.

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Acknowledgements

The authors gratefully acknowledge the contribution of Professor Masakazu Mimaki, the Department of Pediatrics, Teikyo University; Ms. Kumiko Kurosaki, the Central Laboratory of Teikyo University; Mr. Toshinori Ohashi, Hitachi Chemical Co., Ltd. for biochemical analysis of iodine; and Mr. Yuji Yamagami, Kanagawa Health Service Association for neonatal blood TSH and FT4 measurement. We also thank all the staff in Ogawa Clinic and Nakamachidai Ladies Clinic. We wish to express special thanks to Ms. Sheryn Mason for assistance in the preparation of the manuscript.

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Authors and Affiliations

  1. Foundation for Growth Science, Research Committee On Iodine Related Health Problems, 5-1-16 Hongo, Bunkyou-ku, Tokyo, 1130033, Japan

    Yozen Fuse, Yoshimasa Shishiba & Minoru Irie

  2. Ogawa Clinic, 29 Maioka-cho, Totsuka-ku, Yokohama, 2440813, Japan

    Hiroyasu Ogawa

  3. Nakamachidai Ladies Clinic, 3-7-1 Nakamachidai, Tsuzuki-ku, Yokohama, 2240041, Japan

    Yoshiaki Tsukahara & Yoji Fuse

  4. The Japanese Red Cross Hokkaido College of Nursing, 664–1, Akebonochou, Kitami, Hokkaido, 0900011, Japan

    Yoshiya Ito

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Contributions

All the authors contributed to the study conception and design. The authors’ responsibilities were as follows: Y.F., YI., Y.S., and M.I. designed the research. Y.F., H.O., M.T., and Y.F. conducted the research. Y.F. analyzed and interpreted the data and wrote the first draft of the manuscript. All the authors read and approved the final manuscript. Y.F. was the principal investigator and had primary responsibility for the final content.

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Correspondence to Yozen Fuse.

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This study was conducted in accordance with the ethical guidelines contained in the Declaration of Helsinki and Medical Research Involving Human Subjects including epidemiological research, and written informed consent was obtained from each participant included in the study at the initial study visit. The study protocol was reviewed and approved by the joint Ethics Committee of Ogawa Clinic and Nakamachidai Ladies Clinic, Yokohama, Japan, on May 2010.

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The authors declare no competing interests.

This study was not registered to any clinical trials registry (CTR).

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Fuse, Y., Ogawa, H., Tsukahara, Y. et al. Iodine Metabolism and Thyroid Function During the Perinatal Period: Maternal-Neonatal Correlation and Effects of Topical Povidone-Iodine Skin Disinfectants. Biol Trace Elem Res 201, 2685–2700 (2023). https://doi.org/10.1007/s12011-022-03363-8

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