Abstract: SAT 758

Iodine Supplementation in Women during Preconception, Pregnancy, and Lactation: Current Clinical Practice By American Obstetricians and Midwives

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Abstract


Iodine deficiency is a major worldwide public health problem, especially for pregnant women. Iodine deficiency is responsible for irreversible fetal brain damage and abnormal infant development. In the United States, iodine status in pregnant women is considered mildly deficient. Therefore, the Endocrine Society, the American Thyroid Association, the Teratology Society, and the American Academy of Pediatrics recommend that women receive prenatal vitamins containing 150 μg of iodine daily during preconception, pregnancy, and lactation. view more

Iodine deficiency is a major worldwide public health problem, especially for pregnant women. Iodine deficiency is responsible for irreversible fetal brain damage and abnormal infant development. In the United States, iodine status in pregnant women is considered mildly deficient. Therefore, the Endocrine Society, the American Thyroid Association, the Teratology Society, and the American Academy of Pediatrics recommend that women receive prenatal vitamins containing 150 μg of iodine daily during preconception, pregnancy, and lactation.
The aim of this study was to evaluate awareness of iodine nutrition among obstetricians and midwives in the United States, and to document current clinical practice regarding recommendations for iodine supplementation for women during preconception, pregnancy, and lactation.
All midwife members of the American College of Nurse-Midwives (ACNM) and all obstetrician members of the American Medical Association (AMA) were invited to participate in a web-based survey.
275 obstetricians and 199 midwives responded. 38% of obstetricians and 49% of midwives considered iodine status in U.S. pregnant women to be deficient and 60% of both obstetricians and midwives considered iodine supplementation useful for U.S. women of childbearing age and pregnant women. However, one third of obstetricians and midwives were not aware that iodine deficiency in pregnant women is harmful to the fetus. Most obstetricians and midwives would rarely or never recommend iodine-containing prenatal multivitamins for women planning pregnancy (68% and 70%, respectively), for pregnant women (66% and 67%), or for lactating women (68% and 72%). Of the 32% of respondents who did report prescribing iodine containing supplements, 85% recommended supplementation during the first trimester and 78% during the second and third trimesters. However, of those who did recommend iodine supplementation, only 44% would prescribe the recommended 150 μg iodine daily during pregnancy.
In contrast to the strong recommendation of many medical societies, the majority of US obstetricians and midwives who responded to our survey do not recommend iodine-containing vitamins in women planning pregnancy, during pregnancy, and during lactation. Our findings demonstrate that U.S. obstetricians and midwives have a lack of awareness of the need for iodine supplementation and suggest that education of both groups is necessary to protect at-risk women.

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