Pregnancy

Severe iodine deficiency is uncommon in Western countries, such as Australia and New Zealand, but several local surveys have identified that mild to moderate deficiency is more prevalent than once thought. A research group at Monash Medical Centre in Melbourne screened 802 pregnant women and found that 48.4% of Caucasian women had urinary iodine excretion (UIE) concentrations below 50 fjg/L compared to 38.4% of Vietnamese women and 40.8% of Indian/Sri Lankan women (Hamrosi et al 2005). These figures are disturbing when the WHO defines healthy UIE levels as greater than 100^g/L, mild deficiency is diagnosed at 51-100^g/L and moderate to severe deficiency at <50 fjg/L (Gunton et al 1999). A study conducted at a Sydney hospital involving 81 women attending a 'high' risk clinic found moderate to severe iodine deficiency in 18.8% of subjects and mild iodine deficiency in another 29.6% (Gunton et al 1999), the former clearly too close to the WHO maximum acceptable level of 20%. This study also revealed that almost 5% of the sample had UIE <25 /jg/L.

Based on such results it may well be expected that endemic cretinism could emerge, and that it has not yet occurred in Australia may be due to a low to moderate intake of goitrogens and adequate selenium levels.

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