A cross-sectional study on iodine status among pregnant and non-pregnant women of Tripura: a North-Eastern state of India

Nilratan Majumder, Balaram Sutradhar, Saradindu Riang, Shib Sekhar Datta


Background: Due to excess metabolic demand of iodine in pregnancy, pregnant women and lactating mother and their neonates are most vulnerable of iodine deficiency disorder. Urinary iodine excretion is a good marker of recent dietary iodine intake. Thus, present study was conducted to assess the iodine status and median urinary iodine excretion (UIE μg/lit) among pregnant and non-pregnant women of Tripura.

Methods: Tribal and Bengali pregnant and non-pregnant women from Bokafa and Jolaibari Block of South Tripura district were included in the study. Urinary iodine excretion was done using simple micro plate method. Salt iodine was estimated using iodometric titration. All the tests were performed at CNRT Lab, ICMR, India.

Results: Total number of subjects included in this study was 1071. Total number of urine samples collected from pregnant and non-pregnant women was 538 and 533 respectively. Median value of UIE in pregnant and non-pregnant women of Tripura was 155.0µg/L and 130.0µg/L. In pregnant women percentage prevalence of severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-149µg/L) was found in 4.1%, 15.1% and 29.6% subjects. In case of non-pregnant women severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-99µg/L) was found in 0.6%, 9.6%, 27.8% subjects respectively. The overall prevalence of iodine deficiency was found in 48.8% pregnant women, compared to 38.0% non-pregnant subjects.

Conclusions: Efforts towards universal salt iodization need to be stepped-up in Sub-Himalayan region (NE part of India) and pregnant and lactating mothers may be targeted with alternate iodine supplements (Colloidal Iodine).


Iodine status, Pregnancy, Urinary iodine excretion

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Zimmermann MB, Andersson M. Update on iodine status worldwide. Curr Opin Endocrinol Diabetes Obes. 2012;19:382-87.

Zimmermann MB, Andersson M. Prevalence of iodine deficiency in Europe in 2010. Ann Endocrinol (Paris). 2011;72:164-66.

Velasco I, Bath SC, Rayman MP. Iodine as essential nutrient during the First 1000 Days of life. Nutrients. 2018;10(3):290.

Ramalingaswami V, Subramanian TA, Deo MG. The aetiology of Himalayan endemic goitre. Lancet. 1961;1:791-94.

Matovinovic J, Ramalingaswami V. Therapy and prophylaxis of endemic goitre. Bull World Health Organ. 1958;18:233-53.

Hintze G, Emrich D, Kobberling J. Treatment of endemic goitre due to iodine deficiency with iodine, levothyroxine or both: results of a multicentre trial. Eur J Clin Invest. 1989;19(6):527-34.

Zimmermann MB. The Effects of Iodine Deficiency in Pregnancy and Infancy. Paediatr Perinat Epidemiolo. 2012;26:108-17.

Yarrington C, Pearce EN. Iodine and pregnancy. J Thyroid Res. 2011;934104.

Abel MH, Korevaar TIM, Erlund I, Villanger GD, Caspersen HI, Arohonka P, et al. Iodine intake is associated with thyroid function in mild to moderately iodine deficient pregnant women. Thyroid. 2018;28(10):1359-71.

Dahl L, Markhus MW, Sanchez PVR, Moe V, Smith L, Meltzer HL, et al. Iodine deficiency in a study population of Norwegian pregnant women - Results from the Little in Norway Study (LiN). Nutrients. 2018;10(4):513.

Dunn JT, Crutchfield HE, Gutekunst R, Dunn AD. Two simple methods for measuring iodine in Urine. Thyroid. 1993;3:119-23.

Delange F. Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition. Public Health Nutr. 2007;10:1571-80.

Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Andersen S, Rasmussen LB, et al. Estimation of iodine intake from various urinary iodine measurements in population studies. Thyroid. 2009;19(11):1281-86.

World Health Organisation. United Nations Children’s Fund. International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination. A Guide for Programme Managers, 2007. Available at:;jsessionid=AB472E4912FF7E05A11230F142BB918D?sequence=1.

Simpong DL, Adu P, Bashiru R, Morna MT, Yeboah FA, Akakpo K, et al. Assessment of iodine status among pregnant women in a rural community in Ghana-a cross-sectional study. Arch Public Health. 2016;74:78.

Tayade SA, Chhabra S. Iodine status and it’s determinants in sub-population of pregnant women in rural Central India. Int J Reprod Contracept Obstet Gynecol. 2018;7(2):665-70.

WHO Secretariat. Andersson M, de Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: Conclusions and recommendations of the technical consultation. Public Health Nutr. 2007;10:1606-11.

Menon KC, Skeaff SA, Thomson CD, Gray AR, Ferguson EL, Zodpey S, et al. The effect of maternal iodine status on infant outcomes in an iodine deficient Indian population. Thyroid. 2011;21:1373-80.

Ategbo EA SR, Schultink W, van der Haar F, Pandav CS. An assessment of progress toward universal salt iodization in Rajasthan, India, using iodine nutrition indicators in school-aged children and pregnant women from the same households. Asia Pac J Clin Nutr. 2008;1:56-62.

Chakraborty I, Mazumdar P, Chakraborty PS, Chattopadhyay G, Bhowmick K. Iodine deficiency disorder among pregnant women in a tertiary care hospital of Kolkata, India. Southeast Asian J Trop Med Pub Heal. 2010;41:989-95.

Grewal E, Khadgawat R, Gupta N, Desai A, Tandon N. Assessment of iodine nutrition in pregnant north Indian subjects in three trimesters. Indian J Endocrinol Metab. 2013;17:289-93.

Yadav K, Srivastava R, Badhal S, Palanivel C, Pandav CS, Karmarkar MG. Iodine nutrition of pregnant women in India: evidence of significant iodine deficiency. Ind J Med Specialities. 2012 Jan 1;3(1).

Shamim AA, Christian P, Schulze KJ, Ali H, Kabir A, Rashid M, et al. Iodine status in pregnancy and household salt iodine content in rural Bangladesh. Matern Child Nutr. 2012;8(2):162-73.

Kapil U, Pathak P, Tandon M, Singh C, Pradhan R, Dwivedi SN. Micronutrient deficiency disorders amongst pregnant women in three urban slum communities of Delhi. Indian Pediatr. 1999;36:983-9.

Pathak P, Singh P, Kapil U, Raghuvanshi RS. Prevalence of iron, vitamin A, and iodine deficiencies amongst adolescent pregnant mothers. Indian J Pediatr. 2003;70:299-301.