Deficiency In Pregnancy Research Articles

145 To determine if Vitamin D prophylaxis decreases the incidence of maternal and neonatal infection

To determine if Vitamin D prophylaxis decreases the incidence of maternal and neonatal infection. A secondary analysis assessing maternal and neonatal infection was performed on a RCT in which pregnant women received Vitamin D3 3000 IU daily or no supplement. Women with a confirmed intrauterine pregnancy 12-16 weeks without a history of Vitamin D use or malabsorption disorder were included. Maternal 25-hydroxyvitamin D (25(OH)D) levels were assessed at the time of enrollment and admission for delivery. Neonatal 25(OH)D level was assessed via cord blood. Outcomes collected included clinical chorioamnionitis (temperature > 38.0°C + maternal leukocytosis, purulent cervical discharge, or fetal tachycardia), endometritis (temperature > 38.0°C + uterine tenderness on exam), neonatal infection (as documented by NICU staff), neonatal sepsis (+ blood culture) and histologic chorioamnionitis (polymorphonucleocytes in the placental amnion and chorion). Parametric and nonparametric statistics were used to compare groups. A P value of <0.05 was statistically significant. Of the 412 women enrolled, 392 (95.1%) had completed pregnancies for analysis. Demographic characteristics, including baseline 25(OH)D levels, were similar between groups. Table 1. Compared to women who did not receive Vitamin D prophylaxis, those who did had a significantly higher 25(OH)D delivery (29.18 +/- 11.87 ng/mL vs. 23.79 +/- 9.29 ng/mL; P<0.001) and cord blood levels (33.73 +/- 13.68 ng/mL vs. 26.06 +/- 9.72 ng/mL; P<0.001). Vitamin D prophylaxis did not decrease the incidence of clinical chorioamnionitis, endometritis, neonatal infection, and neonatal sepsis. Table 2. Stratification by Vitamin D deficiency status revealed a higher incidence of clinical chorioamnionitis in those who did not receive intervention and remained Vitamin D deficient at delivery (9.7% vs. 1.6%; RR 5.9 95% CI 1.3-21.7; P=0.010). Vitamin D prophylaxis does not decrease the incidence of maternal or neonatal infection. Persistent Vitamin D deficiency in pregnancy may be associated with a risk for clinical chorioamnionitis.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Functional Study of the Human Riboflavin Transporter 2 Using Proteoliposomes System.

Riboflavin is essential for cell viability. The biologically active forms of riboflavin, FMN and FAD, participate in many biochemical redox reactions including the metabolism of carbohydrates, amino acids, and lipids. Differently from bacteria, fungi, and plants which synthesize riboflavin, higher organisms have lost the ability to synthesize the vitamin and must absorb it from food and intestinal microflora production. The riboflavin flux through cell membranes occurs via specific transporters belonging to the SLC52 family. Three members of this family have been identified so far which show poor homology with the riboflavin transporters of Saccharomyces cerevisiae or bacteria. Alterations of RFVTs are causative of severe diseases. Indeed, under pathological stress, humans are susceptible of developing riboflavin deficiency. Such a deficiency in pregnancy induces fetus abnormalities, and has been indicated as a risk factor for anemia, cancer, cardiovascular diseases, and neurodegeneration. Moreover, inherited diseases are also of interest; the most well-described is the Brown-Vialetto-van Laere syndrome, a rare neurological disorder characterized by infancy onset sensorineural deafness and pontobulbar palsy. Numerous polymorphisms of Slc52a2 and Slc52a3 genes associated with this syndrome have been discovered. In spite of their important metabolic role and their relevance to human health, the riboflavin transporters are still poorly characterized. Bacterial overexpression, purification, and protein reconstitution in liposomes represent an up-to-date methodology for obtaining functional data information. The methodology for reconstituting the RFVT2 into proteoliposomes and performing transport assay is described. These methods will be suitable for investigating the functional defects of the variants of RFVTs associated with human pathologies.

COVID-19 Infections and Vitamin D Deficiency in Pregnancy

COVID-19 Infections and Vitamin D Deficiency in Pregnancy

Selenium Role in Reproduction, Pregnant/Postpartum Women and Neonates: A Current Study

Background: Selenium is a micronutrient, although required in low amounts, its importance in male and female reproduction is well known. Objectives: The core purpose of this study is to evaluate the role of selenium in human reproduction, during pregnancy/ lactation in women and newborns. The review explains side by side the sources of selenium, required amounts of selenium in humans and during pregnancy or lactation. Methods: Selenium deficiency is a major cause of male infertility. Similarly, selenium deficiency, both in pregnant and postpartum women, would greatly affect the health of the newborn baby in all respects. The effect of maternal selenium upon the fetus and the neonates even one year after birth has been explained with some recent examples. Results: The study elaborates the fact that the selenium deficiency in pregnancy and lactation is common due to fetal/infant development, so selenium supplements must be provided in order to overcome these deficiency symptoms. Conclusions: The better reproductive health in humans is possible due to the sufficient amounts of selenium present both in males and females as well.

A systematic review of association between vitamin D levels and pre-eclampsia in pregnant womens - An old problem revisited

The beneficial effects of sunlight in preventing bone-related disorders have been well-known for centuries. Vitamin D is a modified steroid, synthesised under the influence of sunlight in the skin. Low Vitamin D status has associated with a higher risk of pre-eclampsia in pregnant womens. The aim of this study was to undertake a systematic review of different studies investigating the association between Vitamin D levels and pre-eclampsia in pregnant womens. A systematic review was undertaken. MEDLINE, PUBMED, EMBASE, Google Scholar were searched. The review protocol was designed to answer the question. Search terms (Preeclampsia and Vitamin D or 1,25 dihydroxy vitamin D). The search was confined to peer-reviewed articles that were published in English and contained an abstract. Reference list of journal articles were also screened for additional citations fitting our search criteria. Twenty-Seven studies were included in the systematic review that investigates the association between Vitamin D and pre-eclampsia. The present systematic review concludes that maternal vitamin D deficiency in pregnancy is significantly associated with an elevated risk of preeclampsia. Pregnant womens should take vitamin D supplementation, expose themselves into the sunlight, and they should be physically active. Further taking Vitamin D supplementation in early pregnancy may be a simple way to reduce the risk of these adverse pregnancy outcomes.

Comparative evaluation of efficacy of ferrous ascorbate and ferrous calcium citrate prepared in multidrug delivery system on haemoglobin status in anaemic pregnant women

Iron deficiency anaemia (IDA), the most prevalent nutritional deficiency leading to mortality globally. Oral ferrous salts are effectively used to treat iron deficiency in pregnancy. For the present study, no direct comparison demonstrating the efficacy of ferrous ascorbate and ferrous calcium citrate was considered. An open-label, observational study was designed and conducted for two months. Subjects were randomly allocated to two groups (Group A and Group B). The medication followed in Group A was, ferrous calcium citrate with elemental iron 50 mg; In Group B ferrous ascorbate containing elemental iron 100 mg orally for two months at bedtime. Haemoglobin levels, other hematological parameters, weight changes, side effects, conjunctival colour and general wellbeing were assessed in every visit (i.e. 0, 30th and 60th day) for clinical efficacy assessment. There was an increase in the mean serum haemoglobin and ferritin levels (p&lt;0.05). In Group A and Group B, the mean values of all the assessment parameters increased significantly (p&lt;0.05) in follow-up visits (i.e. 1st month and 2nd month) when compared to baseline values. Out of 69 adverse drug events, 29 (42%) were reported from Group A and 40 (58%) from Group B. Ferrous calcium citrate showed considerable efficacy and safety profiles. Keywords: Iron deficiency; anaemia; haemoglobin; ferrous calcium citrate; ferrous ascorbate

Morphological and immunohistochemical parameters of chronic placental insufficiency in preeclampsia

Aim. To determine the morphological parameters of chronic placental insufficiency in pregnancy complicated by preeclampsia, also in women with chronic arterial hypertension (CAH).&#x0D; Materials and Methods. The analysis of history data, peculiarities of pregnancy and childbirth in women with hypertensive disorders was carried out. A review histology of 40 placentas in moderate preeclampsia, 40 placentas in severe preeclampsia, and 35 placentas of women with CAH and associated preeclampsia was performed. The control group consisted of 20 placentas of women with uncomplicated pregnancy without hypertensive disorders. Immunohistochemical examinations were performed on paraffin sections according to standard methods using primary goat antibodies to annexin V (R-20, sc-1929) and rabbit antibodies to erythropoietin (H-162, sc-7556) in a working dilution 1:200 with Super Sensitive IHC polymer detection system.&#x0D; Results. Based on the results of pathomorphological examination of placentas of women with hypertensive disorders, two forms of chronic placental insufficiency were identified. The defining form of placental insufficiency in women with CAH and associated preeclampsia was fetoplacental insufficiency, and in preeclampsia of moderate severity and in severe one utero-placental form of chronic placental insufficiency. Based on the study of the dynamics of expression of annexin V and erythropoietin, morphological parameters of the placental compensatory potential and placental hemostasis disorders in hypertensive disorders in pregnant women were determined.&#x0D; Conclusion. Diagnostic morphological criteria for fetoplacental insufficiency in women with hypertensive disorders are a combination of maternal and fetal malperfusion with obliterative angiopathy of stem villi vessels; in the utero-placental form obliterative angiopathy of spiral arteries, placental hypoperfusion with the development of local hypoxia and hemostatic disorders in the form of thrombosis of the intervillous space and villi infarcts.

Efficacy of intravenous versus oral iron in the treatment of anaemia in pregnancy-A comparative study

Introduction: One of the most common medical problems in pregnancy is iron deficiency anemia throughout the developing world1-5 with the burden of disease impacting in both mother and newborn. Anaemia affects nearly half of all the pregnant women in the world. Data shows that it affects approximately 52% patients in the developing and 23% patients in the developed world. Materials and Methods: A prospective study conducted on pregnant women in 26 to 34 weeks of gestation which comes under inclusion criteria. Duration of the study was 18 months.100 patients were taken 50 in each group, Blood indices such as Hb, MCV, serum ferritin, reticulocyte count and adverse drug reactions were compared. Results and Conclusion: Both intravenous and oral iron supplements were associated with increment of blood indices although rise was significantly higher intravenous group. Also intravenous iron is better tolerated compared to oral group. Thus, it can be concluded that IV iron therapy is much more effective in improving iron deficiency in pregnancy than oral. Keywords: Pregnancy, Hemoglobin, Iron sucrose, Iron deficiency anemia, Oral ferrous sulphate.

Evaluation of effect of vitamin D supplementation on vitamin D levels and pregnancy outcome

Introduction: Vitamin D is a fat-soluble vitamin which comes primarily from exposure to sunlight, and only few foods acts as a source of it. Vitamin D deficiency is a preventable health problem. Research shows that during pregnancy, adequate vitamin D intake is necessary for maternal, fetal and child health. This study was conducted to determine prevalence of vitamin D deficiency in pregnant women and neonates and will also help us to determine if 400IU daily recommended dose is sufficient to treat hypovitaminosis D. Materials and Methods: The study was carried out for 1 ½ years on 100 pregnant, divided in two groups in which one group was given supplementation and 2nd group was of unregistered patients. Results: The prevalence of Vitamin D deficiency was observed as 82% in present study. On supplementing the subjects with 400IU vitamin D with calcium 1000 mg daily, the prevalence reduced to 14% while normal levels were achieved in 58% as compared to 8% during the first trim which was significant with p value of Conclusion: We recommend evaluation of the status of vitamin D in all pregnant women along with D3 supplementation. Routine supplementation of pregnant mothers with 400IU vitamin D with calcium 1000 mg daily resulted in significant improvement of vitamin D levels in study group, but sufficient levels were reached in just over half of the females. We thus propose further research on the daily dosage recommendations along with other factors affecting vitamin D levels in pregnant females like eating pattern, compliance to prescribed drugs and sun light exposure. Keywords: Vitamin D levels, Vitamin D deficiency in pregnancy.

Moderate Iodine Deficiency Is Common in Pregnancy but Does Not Alter Maternal and Neonatal Thyroid Function Tests.

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (<150 µg/L). Widespread desalinated water usage and no national fortification plan are possible causes. Studies assessing relationships between iodine status and maternal and neonatal thyroid function provided varying results. Our aims were to determine whether iodine deficiency was associated with altered maternal or neonatal thyroid function and the factors leading to iodine deficiency.MethodsA cross-sectional study including 100 healthy women without prior thyroid disease, in their first trimester of a singleton pregnancy were recruited from an HMO clinic in central Israel. The women were followed from their first trimester. All women completed a 24-h dietary recall and life habits questionnaires. We tested for UIC, maternal and neonatal thyroid function, maternal autoantibodies, and neonatal outcomes.ResultsMedian UIC in our cohort was 49 µg/L [25%–75% interquartile range (IQR) 16-91.5 µg/L], with 84% below adequacy range. No correlation was found between iodine deficiency and maternal or neonatal thyroid function which remained within normal ranges. Antibody status did not differ, but thyroglobulin levels were significantly higher in iodine insufficient subjects. UIC was higher in women consuming an iodine containing supplement. There was no association between UIC and dietary iodine content or water source.ConclusionsModerate iodine deficiency is common in our healthy pregnant women population. Our data imply that moderate iodine deficiency in pregnancy seem sufficient to maintain normal maternal and neonatal thyroid function.

Vitamin D in gestational diabetes mellitus and its association with hyperglycaemia, insulin sensitivity and other factors

We investigated if vitamin D is independently associated with hyperglycaemia in gestational diabetes mellitus (GDM). Serum 25 hydroxy vitamin D (25OHD), fasting blood glucose (FBG), HbA1c, fructosamine, insulin sensitivity (QUICKI equation), body mass index, clothing style and outdoor activity were measured in 58 pregnant women with GDM during the third trimester. 25OHD was also measured in 20 women with normal pregnancies. There was no significant difference in mean 25OHD concentrations between GDM (14.43 ± 5.27 ng/ml) and normal (15.45 ± 5.29 ng/ml) pregnancies, p = .354. However, a higher percentage of GDM subjects had 25OHD concentration <19.8 ng/ml (86 versus 65%, p = .003). 25OHD did not correlate with FBG, HbA1c, fructosamine, insulin sensitivity or insulin dosage (p > .05). On multivariate analysis, only ethnicity (p = .006) and outdoor activity (p = .004) were associated with 25OHD. We conclude that the lower 25OHD levels in our GDM patients were related to ethnicity and outdoor activity (Study FF-2017-111, National University of Malaysia, 16 March 2017). IMPACT STATEMENT What is already known on this subject? Vitamin D deficiency in pregnancy is widespread and particularly in certain ethnic groups. Low vitamin D levels may be an aetiological factor for gestational diabetes mellitus (GDM) but previous studies provide conflicting results perhaps due to confounding factors. What do the results of this study add? In this study of pregnant women with GDM from different ethnic backgrounds, we analysed serum 25-hydroxy vitamin D (25OHD) levels together with other confounding factors, that is, body mass index, ethnicity and sunlight exposure. Furthermore, instead of using consensus values, we determined cut-offs for different vitamin D status from normal pregnancies matched for gestational age and ethnicity. We found that a higher percentage of GDM subjects had lower vitamin D status but there was no correlation with hyperglycaemia or insulin sensitivity. The study showed that lower vitamin D levels in GDM was associated with ethnicity and less outdoor activity. What the implications are of these findings for clinical practice and/or further research? In GDM patients, low vitamin D levels may be modifiable by supplementation or lifestyle change. Longitudinal studies are needed to determine whether this would impact on the occurrence of GDM.

New Classification and Management of Abetalipoproteinemia and Related Disorders

New Classification and Management of Abetalipoproteinemia and Related Disorders

Iodine status of pregnant women with obesity from inner city populations in the United Kingdom.

Iodine is essential for foetal neurodevelopment and growth. Requirements increase in pregnancy to support increased thyroid hormone synthesis for maternal and foetal requirements, and for foetal transfer. Iodine deficiency in pregnancy is widely reported, and obesity has been associated with sub-optimal thyroid function. We evaluated iodine status and its relation with birthweight in a secondary analysis of pregnant women with obesity from multi-ethnic inner-city settings who participated in the UK Pregnancies Better Eating and Activity trial (UPBEAT). Iodine and creatinine concentrations were evaluated in spot urine samples in the second (15+0-18+6 weeks, n = 954) trimester of pregnancy. We assessed iodine status as urinary iodine concentration (UIC) and urinary iodine-to-creatinine ratio (UI/Cr) and applied WHO/UNICEF/IGN population threshold of median UIC > 150 µg/L for iodine sufficiency. Relationships between iodine status and birthweight were determined using linear and logistic regression with appropriate adjustment, including for maternal BMI and gestational age. Median (IQR) UIC and UI/Cr in the second trimester of pregnancy were 147 µg/L (99-257) and 97 µg/g (59-165), respectively. An UI/Cr <150 μg/g was observed in 70% of women. Compared to women with UI/Cr >150 µg/g, there was a trend for women with UI/Cr <150 µg/g to deliver infants with a lower birthweight (β = -60.0 g; 95% CI -120.9 to -1.01, P = 0.05). Iodine status of pregnant women with obesity from this cohort of UK women was suboptimal. Lower iodine status was associated with lower birthweight.

Multiple micronutrient deficiencies in pregnancy

Rationale: Many studies have focussed on maternal anaemia and iron deficiency and limited studies are available on multiple micronutrient deficiencies and the factors associated with them.

Changes in the management of iron in pregnancy

There is now a growing body of evidence which suggests that proactively preventing the progression from low iron to treating iron deficiency in pregnancy with scientifically modern supplements might offer the best course of action, rather than traditional oral iron supplements or treating with high-dose iron medicines later. Despite the huge importance of iron for human health, it is the most common nutritional deficiency in the world ( World Health Organization, 2008 ). For many years, this has been a neglected area of study or improvement ( Auerbach and Georgieff, 2020 ).

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

The prevalence of Vitamin D deficiency in pregnancy and neonatal outcomes

Introduction: Vitamin D is an essential fat-soluble vitamin and has multiple functions. It affects calcium metabolism, modulates the immune system, cell proliferation, and differentiation. Objective: To study the prevalence of vitamin D deficiency in pregnant women and neonatal outcome in a tertiary care hospital, to study the association between maternal vitamin D and medical disorders, and to correlate maternal vitamin D deficiency with neonatal vitamin D levels and neonatal outcomes. Materials and Methods: This cross-sectional and observational study was conducted over a period of one year on 355 antenatal women admitted for safe confinement. 4 ML of whole blood was collected from median ante-cubital fossa and vitamin D levels were assessed using ELFA [Enzyme Linked Fluorescent Assay] following delivery, and 2ml of cord blood was also collected and sent for Vitamin D levels. R esults: Out of the total study population, 12.96% (46) had adequate levels of vitamin D, the majority - 74.65% (265) had insufficient vitamin D levels, and 12.39% (44) had severe vitamin D deficiency. The overall deficiency among neonates was 95.22%. No significant association was found between vitamin D deficiency and maternal complications, except for the mode of delivery which was statistically significant with a P-value of 0.04. Conclusion: This study reaffirms that vitamin D deficiency is on the increase and therefore needs intervention by biochemical screening and corrective measures during pregnancy.

Antenatal Iron-Folic Acid Supplementation Is Associated with Improved Linear Growth and Reduced Risk of Stunting or Severe Stunting in South Asian Children Less than Two Years of Age: A Pooled Analysis from Seven Countries.

In South Asia, an estimated 38% of preschool-age children have stunted growth. We aimed to assess the effect of WHO-recommended antenatal iron, and folic acid (IFA) supplements on smaller than average birth size and stunting in South Asian children <2 years old. The sample was 96,512 mothers with their most recent birth within two years, from nationally representative surveys between 2005 and 2016 in seven South Asian countries. Primary outcomes were stunting [length-for-age Z-score (LAZ) < –2], severe stunting [length-for-age Z-score (LAZ) < –3], length-for-age Z score, and perceived smaller than average birth size. Exposure was the use of IFA supplements. We conducted analyses with Poisson, linear and logistic multivariate regression adjusted for the cluster survey design, and 14 potential confounders covering the country of the survey, socio-demographic factors, household economic status, maternal characteristics, and duration of respondent recall. The prevalence of stunting was 33%, severe stunting was 14%, and perceived smaller than average birth size was 22%. Use of antenatal IFA was associated with a reduced adjusted risk of being stunted by 8% (aRR 0.92, 95% CI 0.89, 0.95), of being severely stunted by 9% (aRR 0.91, 95% CI 0.86, 0.96) and of being smaller than average birth size by 14% (aRR 0.86, 95% CI 0.80, 0.91). The adjusted mean LAZ was significantly higher in children whose mothers used IFA supplements. Maternal use of IFA in the first four months gestation and consuming 120 or more supplements throughout pregnancy was associated with the largest reduction in risk of child stunting. Antenatal IFA supplementation was associated with a significantly reduced risk of stunting, severe stunting, and smaller than average perceived birth size and improved LAZ in young South Asian children. The early and sustained use of antenatal IFA has the potential to improve child growth outcomes in South Asia and other low-and-middle-income countries with high levels of iron deficiency in pregnancy.

Intravenous iron isomaltoside versus oral iron supplementation for treatment of iron deficiency in pregnancy: protocol for a randomised, comparative, open-label trial

BackgroundIron deficiency is common in pregnancy. If left untreated, iron deficiency can lead to iron deficiency anaemia, which is a condition related to maternal and neonatal morbidity. The prevalence of iron deficiency increases through the trimesters, which means that women with iron deficiency in the beginning of pregnancy also have a great risk of developing iron deficiency anaemia during pregnancy. Standard treatment is oral iron in individualised intensified doses based on screening values in 1st trimester.Maternal symptoms of iron deficiency and iron deficiency anaemia include fatigue, reduced physical performance, and restless legs syndrome (RLS). Severe anaemia may cause dizziness, dyspnea, palpitation, orthostatism, and syncope, and it decreases the woman’s ability to cope with blood loss during delivery. The anaemia may also compromise contractility in the uterine musculature increasing the risk for prolonged labour, caesarean section, and postpartum haemorrhage. Foetal iron deficiency may cause low birthweight and adversely affect foetal and early childhood brain development with long-term deficits.MethodsIn this randomised comparative, open-label, single-centre, phase IV trial, 200 pregnant women between 14 and 21 weeks of gestation who have iron deficiency after 4 weeks of standard treatment will be randomised 1:1 to either a single 1000 mg dose of intravenously administered ferric derisomaltose/iron isomaltoside 1000 or a fixed dose of 100 mg oral ferrous fumarate containing 60 mg ascorbic acid.The primary endpoint is to prevent iron deficiency anaemia defined by a low level of haemoglobin throughout the trial. Other endpoints include other haematological indices of iron deficiency and anaemia, clinical outcomes by questionnaires, and collection of adverse events. Explorative endpoints by medical record follow-up include complications up to 7 days after delivery.DiscussionThis trial will provide evidence on how to prevent iron deficiency anaemia. The trial population represents a clinical reality where pregnant women often have sustained iron deficiency despite an increased oral iron dose. Thus, this evidence can be used to consider the optimal 2nd line of treatment in iron-deficient pregnant women.Trial registrationEuropean Union Drug Regulating Authorities Clinical Trials Database 2017-000776-29. Registered on 3 May 2017.ClinicalTrials.gov NCT03188445. Registered on 15 June 2017.

The Joint Role of Iodine Status and Thyroid Function on Risk for Preeclampsia in Finnish Women: a Population-Based Nested Case-Control Study.

Preeclampsia, a pregnancy disorder that includes hypertension and proteinuria, is a major cause of maternal and fetal morbidity and mortality. Some studies, but not all, have found that women with preeclampsia have significantly lower iodine levels than healthy pregnant women. Resolving this issue is important because iodine deficiency in pregnancy is common in the USA and parts of Europe including Finland. We conducted a nested case-control study to determine whether the risk for preeclampsia is associated with iodine status. We measured serum iodine, thyroglobulin (Tg), and thyroid stimulating hormone (TSH) at 10-14 weeks gestational age in 204 women with preeclampsia and 246 unaffected controls selected from all births in Finland. We found no significant difference in iodine (case mean = 26.04 ng/mL, control mean = 27.88 ng/mL, p = 0.995), Tg (case mean = 31.11 ng/mL, control mean = 29.61 ng/mL, p = 0.996), and TSH (case mean = 1.30 mIU/L, control mean = 1.24 mIU/L, p = 0.896) levels between cases and controls. There was no significant relationship between preeclampsia risk and iodine, Tg, or TSH after adjustment for known risk factors. These results are reassuring given the high prevalence of iodine deficiency in pregnancy.