Elevation of cord blood TSH concentration in newborn infants of mothers exposed to acute povidone iodine during delivery

Abstract

The thyroid function in full term newborn infants of 30 pregnant women given topical germicide providine-iodine (PVPI) during delivery was evaluated. For comparison 12 full term newborn infants of pregnant women using clorhexidine hydrochloride as germicide in selective cesarean section were designed as control. The two pregnant groups had similar median age (27.5 yr in PVPI group, range: 19-42 yr and 28.5 yr in control group, 19-40 yr) and gestational age (39 weeks, 38-42 weeks and 39.5 weeks, 38-42 weeks). Birth weight (3365 g, 2500-3860 g and 3265 g, 2850-4000 g) and the apgar score (9, 9-10 and 9, 8-10) of newborn were similar in both groups. Umbilical cord blood samples were taken after immediate clamping and serum total T3, total T4, free T4 and TSH concentrations were assayed by an immunofluorimetric method. T3, T4 and free T4 concentrations in the cord blood were not different in PVPI newborn infants (median values: 0.92 nmol/L, 135 nmol/L, and 15.9 pmol/L), in comparison to control newborns (0.97 mmol/L, 140.9 nmol/L and 17.3 pmol/L). In contrast, cord blood TSH concentration in newborn infants of PVPI pregnant women (median value: 6.47 mIU/L) was significantly higher (p < 0.01) than in control newborn infants (4.8 mIU/L). In PVPI exposed group 14 out of 30 newborn infants had TSH concentration above the upper value (6.7 mIU/L) observed in the control groups (X2 = 8.4, p < 0.01). These data suggest that fetal thyroid is susceptible even to acute iodine overload and support the recommendation that PVPI should be avoided during pregnancy.