Concentração de iodo urinário em urina de 24 horas de gestantes e sua associação com bócio tireoidiano materno, aborto e peso neonatal: estudo piloto / Urinary iodine concentration in 24-hour urine of pregnant women and its association with goiter in the mother, abortion and neonatal weight: pilot study

Introdução: A comida tem um papel proeminente na obtenção do iodo e uma das melhores estratégias é a iodização do sal. No Brasil, a Anvisa reduziu as doses de iodo no sal de cozinha desde 2014. Portanto, é importante avaliar a concentração urinária de iodo (CIU) em nossa população. Com base no exposto, propõe-se avaliar a CIU das gestantes, associando-a à frequência de bócio materno, aborto e peso neonatal. Métodos: Trata-se de um estudo observacional com um corte transversal composto por 37 pacientes atendidos no Serviço de Obstetrícia da Faculdade de Medicina de Barbacena e uma clínica particular em Juiz de Fora. A CIU foi verificada em 24 horas de urina. Resultados: A média de CIU foi de 213,6 µg/l de urina, com dose mínima de 29 µg/l e máxima de 437 µg/l. A glândula tireoide foi avaliada durante o exame clínico prénatal (palpação da glândula) e em 24 pacientes (38,1%) foi considerada normal. A palpação da glândula tireoide foi associada à CIU. Houve maior iodúria em gestantes com glândula não palpável (p = 0,004; T = 14,13). Não houve associação entre a CIU e história de aborto ou peso fetal ao nascimento (p > 0,05). Conclusões: Apesar de ser uma amostra pequena da população, identificamos pacientes expostas ao déficit. No entanto, a CIU não parece estar associada ao peso do recém-nascido ou a abortos, mas à dosagem de TSH e ao tamanho da glândula tireoide. Assim, a palpação da glândula tireoide poderia ser usada como uma medida indireta do CIU. (AU)

Introduction: Food has a prominent role in providing iodine and one of the best strategies is salt iodization. The Brazilian Health Regulatory Agency has reduced iodine content in table salt since 2014. Therefore, there is a need for evaluating urinary iodine concentration in our population, especially after the modified recommendations. Based on the above, we sought to assess urinary iodine concentration in pregnant women, associating it with frequency of maternal goiter, abortion and neonatal weight. Methods: This observational, cross-sectional study included 37 patients seen at the Obstetrics Service of Barbacena Medical School and a private clinic in Juiz de Fora, both in the state of Minas Gerais, Brazil. Iodine concentration was determined in 24- hour urine through chromatography. Results: The mean 24-hour urine iodine was 213.6 µg/l, with minimum and maximum measures of 29 µg/l and 437 µg/l, respectively. The thyroid gland was assessed by prenatal clinical examination (palpation of the gland). In 24 patients (38.1%) it was considered normal. Palpation of the thyroid gland was associated with 24-hour urine iodine concentration, although a higher iodine concentration was identified in pregnant women with non-palpable gland (p = 0.004; T = 14.13). There was no association between 24-hour urine iodine concentration and history of abortion or birth weight (p > 0.05). Conclusions: This study, although based on a small sample of the population, was important to identify that even in areas where iodine is considered sufficient there may be patients exposed to iodine deficit. However, urinary iodine concentration does not appear to be associated with birth weight or abortion frequency but is associated with thyroid-stimulating hormone (TSH) level and thyroid gland size, suggesting that clinical evaluation of the thyroid gland is an important element for predicting urinary iodine concentration. Thus, palpation of the thyroid gland could be used as an indirect measure of urinary iodine concentration. (AU)

Bacteriuria asintomática recurrente en el embarazo y bajo peso al nacimiento / Asymptomatic recurrent bacteriuria during pregnancy and low birth weight

Las infecciones del tracto urinario representan las complicaciones más frecuentes en el embarazo; de tal forma se señala una prevalecencia promedio de 4 a 7 por ciento de bacteriuria asintomática durante esta etapa. El propósito de esta investigación es estudiar la asociación entre la bacteriuria asintomática recurrente (BAR) durante el embarazo y el bajo peso del recién nacido. Se efectuo un estudio de cohortes en derechohabientes adscritas a la unidad de Medicina Familiar No.10 en Jalapa, Veracruz, en el periodo de enero a diciembre de 1996. Para determinar esta asociación en una población de 846 embarazadas se estudio una muestra de 118 casos, formándose dos grupos: 59 con BAR (grupo experimental) y 59 sin BAR (grupo control). Las gestantes fueron estudiadas cuando acudieron a control prenatal realizándoles un urocultivo cuantitativo, el cual de resultar positivo requirió corroboración con otro. La prevalencia de BAR observada fue de 6.97 por ciento. Las diferencias encontradas al estudiar la asociación entre bacteriuria asintomática recurrente durante el embarazo y bajo peso del recién nacido no fueron estadísticamente significativas

Urinary Estriol Determinations in Normal and Pathological Pregnancies

Estriol excreation was studied in 216 normal and 61 pathologic pregnancies. The 95% fiducial limits of the normal excretion of estriol, within which 95% out of 100 future determinations in normal pregnancies are expected to fall, were established. The estriol curve in normal pregnancy in this study agrees well in its general shape with those presented by previous investigators who used different chemical methods of determination. The estriol values in pathologic pregnancies with preeclampsia. intrauterine fetal death and antepartum hemorrage have been analyzed. The clinical significance of estriol determinations during pregnancy was discussed.