Iodine Deficiency Disorders among Pregnant Women in Sarawak, Malaysia
Keywords:
Iodine deficiency disorders, pregnant women, mandatory USI, SarawakAbstract
ABSTRACT
Iodine deficiency disorders among pregnant women in Sarawak, Malaysia
 Lim Kuang Kuay1 , Chan Ying Ying1, Nur Azna Mahmud1, Tan Beng Chin2, Hasimah Ismail1,  Chua Boon Kee2, Foo Leng Huat3.
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1Institute for Public Health, Ministry of Health, Malaysia.
2 Sarawak State Health Department, Ministry of Health, Malaysia.
3Program of Nutrition, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
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Introduction: Â Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after seven years of mandatory USI.
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Methods: A total of 508 first trimester PW attending government Maternal and Child Health Care Clinics in all 11 divisions in Sarawak between 1st April to 15th June 2015 were recruited. Urine samples were obtained and analysed for urinary iodine concentration (UIC) using the modified Sandell-Kolthoff reaction method. For pregnant women, an adequate iodine intake was defined as a median UIC between 150-249 µg/L according to The WHO/UNICEF/ICCIDD’s criterion. For further analyses, the 11 divisions were then combined into 3 regions, namely Central (Kapit, Mukah, Sibu, Sarikei, Betong), Southern (Kota Samarahan, Kuching, Sri Aman) and Northern (Miri, Bintulu, Limbang).Â
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Results: The median UIC of the PW in Sarawak was 105.6 µg/L, indicating iodine deficiency. A total of 330 (65.0%) PW had UIC<150 µg/L. In terms of urinary iodine levels by region, the median UIC in Central, Southern and Northern region were 85.5 µg/L, 97.4 µg/L, 136.3 µg/L respectively. The differences in median UIC between regions were significant. In addition, the Northern region (p = 0.001) and parous parity (p = 0.014) were significantly associated with higher median UIC. No significant association was found for age, ethnicity nor gravida.
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Conclusions: This study indicates inadequate iodine status among PW in Sarawak despite seven years of mandatory USI. In fact, the majority of PW appear not to be protected against IDD and its consequences. Therefore, a comprehensive assessment of iodine status during pregnancy in Sarawak is urgently needed, in particular, the reasons for the ineffectiveness of the USI legislation.
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Keywords: Iodine deficiency disorders, pregnant women, mandatory USI, Sarawak
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