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Open AccessArticle

Risk of Iodine Deficiency in Extremely Low Gestational Age Newborns on Parenteral Nutrition

1
Department of Pediatrics, Division of Neonatology, Case Western Reserve University, Metro Health Medical Center, Rm C.G75, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
2
Department of Obstetrics & Gynecology, Case Western Reserve University, Metro Health Medical Center, Cleveland, OH 44109, USA
3
Department of Quantitative Health Sciences, Section of Biostatistics, Cleveland Clinic, Cleveland, OH 44195, USA
4
Department of Laboratory Medicine & Pathology, Mayo Clinic Foundation, Rochester, MN 55905, USA
*
Author to whom correspondence should be addressed.
Current address: Department of Pediatrics, Division of Neonatology, Indiana University School of Medicine, The Women’s Hospital-Deaconess, Newburgh, IN 47630, USA.
Nutrients 2020, 12(6), 1636; https://doi.org/10.3390/nu12061636
Received: 4 May 2020 / Revised: 21 May 2020 / Accepted: 26 May 2020 / Published: 1 June 2020
(This article belongs to the Section Nutrition and Metabolism)
Iodine is an essential component of thyroid hormones, which play a critical role in neurodevelopment. The iodine status of pregnant women and their newborns is not checked routinely. Extremely Low Gestational Age Newborns do not receive Iodine supplementation while on parenteral nutrition (PN). We measured urine iodine levels and thyroid function tests in 50 mother–infant dyads at birth, at 1 week, 1, 2, 3 months and near discharge. We correlated maternal and neonatal urine iodine levels with thyroid functions and measured iodine levels in milk and PN. In our study, 64% of mothers were iodine deficient at the time of delivery, their free T4 levels were 0.48 (0.41–0.54) ng/dL with normal thyroid-stimulating hormone (TSH). Iodine levels were thirty-fold higher in extremely low gestational age newborns (ELGAN) exposed to iodine comparing to full terms (p < 0.001), but this effect lasted <1 week. At 1 month of age, ELGAN on PN developed iodine deficiency (p = 0.017) and had high thyroglobulin levels of 187 (156–271) ng/mL. Iodine levels improved with enteral feeds by 2 months of age (p = 0.01). Iodine deficiency is prevalent among pregnant women and ELGAN; in particular, those on PN are at risk of hypothyroidism. Iodine supplementation during pregnancy and postnatally should be considered to avoid iodine deficiency. View Full-Text
Keywords: neonatal iodine deficiency; subclinical hypothyroidism; extremely low gestation age neonates; total parenteral nutrition; maternal iodine deficiency neonatal iodine deficiency; subclinical hypothyroidism; extremely low gestation age neonates; total parenteral nutrition; maternal iodine deficiency
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Kanike, N.; Groh-Wargo, S.; Thomas, M.; Chien, E.K.; Mhanna, M.; Kumar, D.; Worley, S.; Singh, R.J.; Shekhawat, P.S. Risk of Iodine Deficiency in Extremely Low Gestational Age Newborns on Parenteral Nutrition. Nutrients 2020, 12, 1636.

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