Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo

• Published in: Public health nutrition Vol. 16; no. 8; pp. 1362 - 1370
• Main Authors: Habimana, Laurence, Twite, Kabange E, Wallemacq, Pierre, De Nayer, Philippe, Daumerie, Chantal, Donnen, Philippe, Kalenga, Muenze K, Robert, Annie
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-08-2013
• Subjects: Adult; Anemia - blood; Anemias. Hemoglobinopathies; Biological and medical sciences; Cross-Sectional Studies; Democratic Republic of the Congo; Dietary Supplements; Digestion; Diseases of red blood cells; Female; Ferritins - blood; Fetuses; Hematologic and hematopoietic diseases; Hormones; HOT TOPIC – Nutrition in pregnancy; Humans; Hypothyroidism; Iodine; Iodine - administration & dosage; Iodine - deficiency; Iodine - urine; Iron, Dietary - administration & dosage; Iron, Dietary - blood; Medical sciences; Menstruation; Metabolic diseases; Metals (hemochromatosis...); Miscarriage; Nutrient deficiency; Nutritional Status; Other metabolic disorders; Postpartum Period - blood; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - urine; Pregnancy Trimester, Third - blood; Risk Factors; Rural areas; Rural Population; Salt; Sample size; Socioeconomic Factors; Thyroid gland; Ultrasonic imaging; Urban areas; Urban Population; Women's Health; Womens health; Congo (Democratic republic); Congo; Africa; Democratic Republic of the Congo; Congo-Democratic Republic of Congo; Congo, Dem. Rep., Katanga, Lubumbashi; Pregnancy; Iodine deficiency; Iron deficiency; Democratic Republic of Congo; Lubumbashi; Human; Iron deficiency anemia; Deficiency; Metabolic diseases; Hemopathy; Iron; Inorganic element; Female; Woman; Sideropenia; Iodine
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980012005484

Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects, but such data are not available in the Democratic Republic of Congo. We aimed to assess iodine and Fe status in pregnant women from Lubumbashi.
Cross-sectional study. We measured urinary iodine concentration (UIC) in random urine samples using a modified Sandell–Kolthoff digestion method; the WHO reference medians were used to classify iodine intake as deficient, adequate, more than adequate or excessive. Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when ,12 ng/ml.
Maternity units from rural, semi-urban and urban areas of Lubumbashi, Democratic Republic of Congo.
Two hundred and twenty-five randomly selected pregnant women attending prenatal consultation, seventy-five postpartum women and seventy-five non-pregnant women as controls.
Overall median UIC in pregnant women was 138 (interquartile range: 105–172) mg/l, indicating iodine deficiency, whereas postpartum and nonpregnant women had adequate iodine intake: median UIC5144mg/l and 204mg/l,respectively. Median UIC values were lower in late pregnancy than in early pregnancy: in the first, second and third trimester respectively 255mg/l, 70mg/l and 88mg/l in the rural area; 306mg/l, 166mg/l and 68mg/l in the semi-urban area; and 203mg/l, 174mg/l and 99mg/l in the urban area. Fe was insufficient in 39% of pregnant women compared with 21% of non-pregnant and postpartum women. In the third trimester, deficiencies in both iodine and Fe were high: 40%, 12% and 18% in the rural, semi-urban and urban areas, respectively.
Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi. Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced.