Dataset Information

The impact of prolonged, maternal iodine exposure in early gestation on neonatal thyroid function.

ABSTRACT:

Context

Hysterosalpingography (HSG) using oil-soluble contrast medium (OSCM) improves pregnancy rates but results in severe and persistent iodine excess, potentially impacting the fetus and neonate.

Objective

To determine the incidence of thyroid dysfunction in newborns conceived within six months of OSCM HSG.

Design

Offspring study of a prospective cohort of women who underwent OSCM HSG.

Setting

Auckland region, New Zealand (2020-2022).

Participants

Offspring from the SELFI (Safety and Efficacy of Lipiodol in Fertility Investigations) study cohort (n=57).

Measurements

All newborns had a dried blood spot card for TSH measurement 48 hours after birth as part of New Zealand's Newborn Metabolic Screening Programme. Forty-one neonates also had a heel prick serum sample at one week to measure thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Maternal urine iodine concentration (UIC) and TSH in the six months after OSCM HSG were retrieved from the SELFI study for analyses.

Primary outcome

Incidence of hypothyroidism in the neonatal period.

Results

There was no evidence of primary hypothyroidism on newborn screening (TSH 2-10 mIU/L). All neonates tested at one week had normal serum TSH, FT4, and FT3 levels. However, increasing maternal peak UIC levels during pregnancy were associated with lower TSH levels (p= 0.006), although also associated with lower FT4 levels (p=0.032).

Conclusions

While pre-conceptional OSCM HSG in women did not result in neonatal hypothyroidism, gestational iodine excess was associated with a paradoxical lowering of neonatal TSH levels despite lower FT4 levels. These changes likely reflect alterations in deiodinase activity in the fetal hypothalamic-pituitary axis from iodine excess.

Trial registration

https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000738921, identifier 12620000738921.

SUBMITTER: Mathews DM

PROVIDER: S-EPMC9927197 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The impact of prolonged, maternal iodine exposure in early gestation on neonatal thyroid function.

Mathews Divya M DM Peart Jane M JM Sim Robert G RG O'Sullivan Susannah S Derraik José G B JGB Heather Natasha L NL Webster Dianne D Johnson Neil P NP Hofman Paul L PL

Frontiers in endocrinology 20230131

<h4>Context</h4>Hysterosalpingography (HSG) using oil-soluble contrast medium (OSCM) improves pregnancy rates but results in severe and persistent iodine excess, potentially impacting the fetus and neonate.<h4>Objective</h4>To determine the incidence of thyroid dysfunction in newborns conceived within six months of OSCM HSG.<h4>Design</h4>Offspring study of a prospective cohort of women who underwent OSCM HSG.<h4>Setting</h4>Auckland region, New Zealand (2020-2022).<h4>Participants</h4>Offspring ...[more]

PMID: 36798662

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Dataset Information

The impact of prolonged, maternal iodine exposure in early gestation on neonatal thyroid function.

Context

Objective

Design

Setting

Participants

Measurements

Primary outcome

Results

Conclusions

Trial registration

Publications

The impact of prolonged, maternal iodine exposure in early gestation on neonatal thyroid function.

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