Deficiency of iodine and overcoming of its consequences during pregnancy and a lactation of
the Hormones of a Thyroid Gland (HTG) at a stage of pre-natal development are the most important regulators of formation and maturing of a brain of future child. Only they provide the full-fledged anatomist - morphological laying of the main components of the central nervous system in the I trimester of pregnancy (at a stage of embryonic life).Maternal hormones are responsible
for formation of the most significant structures of a brain of a germ (bark, subcrustal kernels, mozolis - that body, a corpus striatum, subarakhnoidalny ways), snails of the acoustic analyzer, an eye, a facial skeleton, pulmonary fabric, etc.
the miyelinization nervous otrostkov maturing of mezhneyronalny communications depends On hormonal activity of ShchZh of the fruit which begins funk - to tsionirovat in the II trimester.
the Increased need for iodine at a gestation and a lactation
Physiological levels of consumption of iodine (mkg/days)
|of WHO *||of NAN (USA) *|
|of the Girl - teenagers and adult women||150||150|
|the Feeding women||200||290|
| of * WHO / MSKYDZ [WHO, 2001: 7. (WHO/NHD/01. 1.) ] |
** National Academy of Sciences, USA [IDD Newsletter. 2001; 17 (1): 15]
the Main factor of a successful current of all phases prenatal and early post-natal the periods, indispensable guarantee of adequate supply of the developing GShchZh organism (at first from mother, and after 12 - y weeks of a gestation - own) yavlya - etsyatsya full providing the pregnant woman fizio - logical amounts of iodine. Iodine serves as important external “raw materials“ for synthesis of GShchZh.
At the healthy woman who does not have endocrine a stalemate - logiya and living in conditions adequate snab - a zheniye iodine, the increased need for GShchZh against a gestation successfully is provided with a number of physiological mechanisms:
- of Hormonal function of a horion: a beta - subjed - Nice of a horionichesky gonadotrophin and horiona - chesky tireotropny hormone directly stimulate the pregnant woman`s ShchZh in the I trimester.
- Hormonal function of a placenta: placentary tireotropin - a releasing hormone influences ShchZh in later terms, stimulating in hypo - a fiza production of tireotropny hormone. Besides, high activity of a placenta in about - tsessa of peripheral activation of GShchZh is proved (their fer - mentativny deiodinating - due to production of special enzymes by it: yodtironinovy deyodinaz II and III types).
- Participation of a liver is that under a cart - action of the accruing production of placentary estrogen it strenuously develops a trance - the portny protein which is specifically connecting, transferring and depositing GShchZh - tiroksin - the connecting globulin. Participation of kidneys is reduced by
- to raised kl - to an iodine rens due to acceleration of its glomerular filtration and to the strengthened removal of iodine from the pregnant woman`s organism with urine. In turn, the increased expenses and losses of a microcell of a sta - mulirut its intratireoidny clearance that increase of absorption of iodine in ShchZh leads.
absolutely normal prisposo - bitelny character only when the pregnant woman daily receives adequately high amounts of iodine with food.
the Need for iodine after conception significantly increases and makes, agrees the last otsen - Kam of experts (2001) not less than 200 mkg a day.with
At sufficient consumption of iodine set of the listed factors, strenuously stimulating ShchZh, increases its function (physiological gipertireoz pregnant women) at the expense of what on all stages of a gestation of joint stock company - the increased inquiries in GShchZh are tivno satisfied.Absolutely other reactions are observed by
at Bor - mine, living in conditions iodic a nedosta - accuracy (Russia). Against poor stocks of an intr - tireoidny iodine ability of ShchZh to develop additional portions of hormones considerably is reduced therefore it is deprived of an opportunity to provide with them an organism of the pregnant woman and a fruit fully. From - for it at most of pregnant women the hidden or obvious pathological shifts are formed:
- the Relative or obvious gipotiroksinemiya (abnormal decrease in concentration of free fraction of a tiroksin in blood serum, and poses - - in 2 - y to a half of a gestation - reciprocal pova - a sheniye of level of a hypophysial tireotropin and/or a triyodtironin, but the last is not capable to get into fruit brain neyrotsita). Excess leak from follicles of ShchZh of a kolloa - submultiple protein of a tireoglobulin, a molecule kotoro - go the grown poor GShchZh stocks have
- the Suprafiziologichesky hypertrophy of ShchZh (on it is given - ny ultrasonography of ShchZh observes increase tireoid - a leg of volume higher than 15%) up to formation at the pregnant woman of a diffusion craw.
of the Consequence of a defitsitayod
the Lack of GShchZh quite often arises because of a defa - Zita of their raw materials - iodine. In the conditions of iodic deficiency the fruit is threatened various adverse posledst - the Viy. The group of the states which are reflection of a prenatal gipotiroksinemiya is especially dangerous:
- neurologic cretinism / subcretinism;
- the isolated relative deafness;
- the isolated squint;
- a congenital hypothyroidism (the tranzitorny form, is more often with a craw);
- congenital anomalies of internals.
less - ny, than in the centers of considerable deficiency of iodine, but nevertheless are rather actual as Russia treats regions of moderately expressed deficiency of iodine.by
In regions poor in iodine significantly increased the frequency of infertility, spontaneous abortions, prezh - devremenny childbirth, the pathological course of pregnancy and childbirth, still births, a gipog - laktiya and ablaktation.
At children decrease to intelligence - an alny index (on 15 points), and also vyso - a cue risk of congenital malformations (first of all, hearts), respiratory a distress - sind - rum, perinatal, infantile and child mortality is registered.
At mothers with an endemichesky craw more often than at the others, children are born in asphyxia, from a prizn - Kami of a pre-natal hypotrophy, with the lowered indicators on APGAR scale, and chest vskarm - a livaniye come into on weight fortune from later terms. From the first days of life are available for such children the manifestation weakened nespets - fichesky immunity.serves Gipofunktion`s
of ShchZh of the pregnant woman as the main prerequisite of development not only various deviations from TsNS at the child (nevrolo - gichesky cretinism and subcretinism), but also tireoidny disadaptation at it in the neonatality period (tranzitorny neonatal hypodash endemicheskiya - oz, a neonatal endemichesky craw).
Overcoming of deficiency of iodine
at the initiative of WHO (UN), by the end of the XX century the problem of deficiency of iodine at the population of Earth was recognized as global.Vnutriutrobno`s
the postponed deficiency of iodine are extremely common and most frequent cause of intellectual backwardness which is very easy for preventing by the prenatal grant of physiological doses of iodine.by
Due to the care, first of all about intelligence of the nation, in many countries at the state level are already introduced and actively target programs of the iodic prevention (IP) move ahead.to
as the Universal measure serves consumption of iodinated salt (8 - 10 g). But with guarantee to fill necessary reserves of iodine in an organism of pregnant women only this way steadily and it is fully impossible. Therefore in iodine deficiency regions purpose of the tableted preparations containing 200 mkg of iodine is required. Such preparation is ÉîäÁàëàíñ® 200.to
In obstetric practice its continuous daily application is necessary for women in three situations:
- when planning pregnancy (as minimumv a current of 3 months before conception);
- during pregnancy (since the first weeks of a gestation to the child`s birth);
- throughout the entire period of breastfeeding.
to WHO as reliably prevents formation of various complications in gestational and a lactation - this period, tireoidny insufficiency and an endemichesky craw (at the pregnant woman, a fruit and is new - the born child), and also prevents risk of the progressing decrease in intellectual development at the level of all nation.