Reproductive health of women with iodine deficiency disorders and antithyroid autoantibodies living in the iodine-deficient region

Aim. To assess the prevalence of gynecological diseases and thyroid status in women with iodine deficiency disorders and antithyroid autoantibodies living in the iodine-deficient region. Materials and Methods. A prospective, controlled, multicenter study involved 99 women of reproductive age residing in the territories of moderate to severe iodine deficiency. The study population was divided into three groups: 1) women with iodine deficiency disorders and antithyroid autoantibodies but without thyroid dysfunction (n = 22); 2) women with iodine deficiency disorders but without antithyroid autoantibodies (n = 35); 3) women without iodine deficiency disorders and antithyroid autoantibodies (n = 34). We then collected clinicopathological data, evaluated gynecological status was evaluated, and measured serum levels of thyroid-stimulating hormone, triiodothyronine (T3), thyroxine (T4), thyroglobulin, antibodies to thyroid peroxidase, and antibodies to thyroglobulin. Results. In total, 62.6 % women were diagnosed with iodine deficiency disorders, and 38.6 % had concomitant thyroid autoantibodies. Women with antithyroid autoantibodies frequently reported fatigue, memory impairment, and had a higher tendency toward overweight and obesity. The majority of women with iodine deficiency disorders and antithyroid autoantibodies (13; 59.1 %) had body mass index > 25.0 kg/m² compared with 12 (34.3 %) women with iodine deficiency disorders but without such autoantibodies (OR = 2.77; 95 % CI [0.92–8.32], p = 0.067). The prevalence of iron-deficiency anemia or latent iron deficiency among women with iodine deficiency disorders and antithyroid autoantibodies was associated with a 3.6-fold higher risk of complications as compared to women with iodine deficiency disorders but without such autoantibodies (OR = 3.63; 95 % CI [1.17–11.22], p = 0.023). Secondary infertility was more common in women with iodine deficiency disorders but without antithyroid autoantibodies (16; 45.7 %, OR = 6.33; 95 % CI [1.59–25.22], p = 0.010). Women with iodine deficiency disorders and antithyroid autoantibodies had a higher frequency of cesarean section due to complicated pregnancy and labor (8; 44.4 %, p = 0.001). Conclusion. Women of reproductive age living in iodinedeficient regions require a multidisciplinary approach, including assessment of thyroid function, detection of latent iron deficiency, preconception counseling, and pregnancy management within a high-risk group for obstetric and perinatal complications.

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