Iodine status and associated factors among pregnant women attending antenatal care at four selected health facilities in Kasese District

Abstract

Background: Pregnancy increases the iodine dietary requirements to meet the needs of the mother and the baby. Both iodine deficiency and excessive iodine are known to cause fetal and maternal thyroid disease. Uganda lacks data on the current iodine nutrition of pregnant women. This study assessed the iodine nutrition of pregnant women attending antenatal care at selected health units in Kasese district. Methods: This was a cross-sectional study among 500 pregnant women attending antenatal care in Kasese district. Participants were randomly selected from four randomly selected health units. Socio-demographic, obstetric and Knowledge, Attitude and practice (KAP) data were collected using medical forms and semi structured questionnaires. Urine iodine concentration (UIC) was measured using the Sandell-Kolthoff method. The WHO cut offs for UIC categorization was used to classify the UIC. The modified Poisson model was run to determine the factors associated with the low. Results: Among 473 pregnant women attending antenatal care at the health units, the median UIC was 73.3mcg/dl (Interquartile range (IQR) 32.0,149.7 mcg/dl), indicating inadequate iodine intake. 73.6 % of the pregnant women had a low UIC of < 150mcg/dl (95% CI: 62.5,82.3%). The difference in median UIC among the four health units was not statistically significant (χ² (3) = 4.03, p = 0.26; χ² (3) with ties = 7.2, p = 0.07). Taking alcohol was associated with a high prevalence of low UIC (aPR= 1.2 95% CI: 1.1- 1.4, p value 0.01). Being employed was associated with higher prevalence compared to being unemployed (aPR= 1.1 95% CI:1.0-1.1, p value 0.06). Conclusions: The pregnant women in Kasese district had Inadequate iodine nutrition. Government should prioritize to monitor pregnant women’s iodine nutrition